President’s Message: Evolving Family Medicine Certification By Listening, Learning, and Supporting

One of the major goals of the American Board of Family Medicine (ABFM) is to increase the value of board certification for individual Diplomates. To do this requires understanding the needs and preferences of family physicians participating in certification—which is why we have worked so hard in recent years to create more opportunities for listening and sharing. We occasionally hear Diplomates express their belief that we are developing the process, writing the examination and assessment items, and creating the activities for certification all inside of a small office in Lexington, Kentucky.

Each of our major initiatives to improve the value of board certification—the Family Medicine Certification Longitudinal Assessment (FMCLA), enhancing item development, revising the Performance Improvement (PI) activity design, the upgrading of Knowledge Self-Assessments (KSAs), and more—has been shaped by Diplomate feedback and involvement.

It is worth describing the variety of ways in which we seek your input. At the most basic level, as you complete your certification activities, you are asked to complete a short survey that asks about your impressions of the activity. Did you learn from it? Did it change your practice? How might it be improved? These survey responses help us to track trends and specific requests that target our plans to improve these activities. With respect to our current work on the KSAs, it was your comments that led us to begin changing all items to a single best answer format, improve the user interface, update the critiques, and modify the pass rate to be 80% overall, not by categories. Similarly, comments from the initial cohort of FMCLA participants helped us make immediate changes to the delivery platform with respect to the size and placement of the clock, and to understand more deeply what they valued from the new examination alternative. Information gleaned from ABFM surveys are also used by our researchers to help us better understand the trends in the ecology of family medicine practice, so we can support advocacy efforts for the specialty.

Another strategy for engagement and learning happens when our staff attend state chapter and other society meetings. Before the pandemic, we visited approximately 30 state chapters over the course of the year where we met local physicians in their home environment. We also visited other academic organizations, residencies, and academic departments. These visits help us to learn what’s on your minds and to update you on the current opportunities and changes with certification. These conversations have shaped our short- and long-term plans. During the pandemic, we have sought to continue the dialogue through virtual meetings as much as possible and look forward to getting back to in-person interactions as soon as it is safe to do so. We also have developed collaborative pilots with individual state chapters, which help them meet the needs of their members and help us learn from them to create more effective engagement strategies for improving certification.

We are also excited about our new Engagement Network—a group of volunteers who serve as a virtual focus group to give us constructive feedback on specific issues and questions with respect to a broad range of certification programs. Soon, we will be moving this from a series of short surveys to a more bi-directional, interactive platform that allows you to drive the questions and influence changes that we may not have thought to ask about. Be on the lookout later this year for more information about how you can become involved in our Engagement Network.

Finally, our Communications staff, working with our certification personnel, are committed to achieving a better understanding of how you wish to receive communication from us. ABFM sends out over 2,000,000 emails per year; our Support Center handles thousands of phone calls and we’ve extended hours in peak time to help you. Much like the temperature of the porridge in the story of Goldilocks and the Three Bears, we hear from Diplomates that our communication is too much, just right, and not enough—which compels us to seek ways to better tailor the methods, frequency, and timing of our communication. Much work has gone into the redesign of the MyABFM Portfolio in the last year, knowing that “just-in-time” information is most important to you. You will read more about that in this issue—specifically about how this was designed by family physicians for family physicians. We look forward to learning your impressions about that later this spring when it is launched.

As you may have noticed, this issue of The Phoenix looks very different than previous issues. The new and improved format has been designed based on comments and feedback from you. We hope these improvements will help you find relevant information faster so you can stay up to date on board certification and share with your colleagues. We wish to use this issue of The Phoenix to share the real degree to which family physicians across the nation from diverse backgrounds are intimately involved in helping to ensure that your ABFM certification is relevant, up-to-date, and meaningful to you.

Our goal in all of this is to improve the value of board certification to you and those who receive care from you. We want to be partners in supporting improvement in health care. To do this we seek bi-directional communication to continually improve what we do for ABFM certification. Thank you, now and in the future.