The Critical Care Medicine Board met virtually on October 29, 2021 to discuss recent and upcoming changes at ABIM, as well as many other important issues facing the discipline. Joining the meeting as guests were:
- Christopher Barnett, MD, co-Chair of the ABIM Critical Care Medicine Board Exam Committee, and a professor of cardiology and critical care at UCSF
- Margaret Pisani, MD, co-Chair of the ABIM Critical Care Medicine Board Exam Committee and a specialist in pulmonary critical care
- Denise Buonoccore, MSN, RN, ACNPC, CCNS, CCRN, CHFN, Immediate Past Chair, Board of Directors, American Association of Critical Care Nurses
- Mary Pat Aust, Equity Diversity and Inclusion Lead, American Association of Critical Care Nurses
- Richard Schuch, EdD., Chief Learning Officer and Senior Vice President, Education, The American College of Chest Physicians (CHEST)
- Eileen Larsson, Chief Program Officer for the American Thoracic Society (ATS)
- Joyce Reitzner, MBA, MIPH, Executive Director and Chief Operating Officer, Association of Pulmonary and Critical Care Medicine Program Directors (APCCMPD)
- David Martin, CAE, CEO & EVP, Society of Critical Care Medicine (SCCM)
- Greg Martin, MD, MSc, FCCM, President, SCCM, and Executive Associate Division Director, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University
- Below is a summary of the key takeaways from the meeting:
Richard J. Baron, MD, ABIM President and CEO, joined the Critical Care Medicine Board to provide members with recent updates, including:
- Reflecting on the spring 2021 Internal Medicine Summit, and how ABIM and specialty societies could collaborate to advance diversity, equity and inclusion (DEI) efforts across internal medicine.
- Sharing reactions to a joint statement issued by ABIM, the American Board of Family Medicine (ABFM), and the American Board of Pediatrics (ABP) cautioning physicians about disseminating misinformation on COVID-19. Members said they appreciated the statement and noted that it helped them as they spoke with their patients and family members about COVID and the vaccine. They are caring for a large number of patients, many of whom are unvaccinated and hospitalized, which could have been avoided had they understood the importance of getting the vaccine. Several members said they treat patients who believed misinformation about vaccine safety and efficacy.
- Previewing the Longitudinal Knowledge Assessment (LKA), slated to launch in 12 disciplines in 2022 – and in 2023 in Critical Care Medicine.
Procedural Requirements: Pulmonary Disease and Critical Care Medicine
Anamika Gavhane, ABIM Director of Medical Specialties & Policy Coordination, shared a request from (APCCMPD) to remove pulmonary artery catheterization from the list of procedural requirements that fellows must perform competently in order to be eligible for ABIM certification in both pulmonary and critical care medicine.
The APCCMPD request led to the decision to conduct a review of all the current procedural requirements in these disciplines. She noted that it is important to review these requirements periodically so ABIM is assessing what is seen most in practice.
Because most fellows train in combined pulmonary disease/critical care medicine fellowships, the Pulmonary and Critical Care Medicine Boards will work together to decide whether the current lists of procedural competencies may need to change.
ABIM will reach out to stakeholders (item writers, societies, patients/public organizations, physicians and program directors) to foster a discussion about what procedures all pulmonology/critical care fellows should be able to perform independently and competently by the end of their training. Members discussed what other organizations should be consulted in the outreach and how to get input from patient and public groups.
Laura Evans, MD, Chair of the ABIM Critical Care Medicine Board, noted that the critical care medicine specialty is pursued by physicians with different medical backgrounds, and it follows that the physicians in the disciplines have strengths and weaknesses in different competencies. There was some discussion amongst the Specialty Board about how procedural training might vary depending on the program fellows choose.
The next step is that ABIM will send a list of currently required and suggested procedures to diplomates in pulmonary and critical care and will ask them which procedures they perform in practice and how often they perform them. The data will be shared with stakeholder groups as described above to ask for their views on the procedural competencies. Once completed, all the information gathered will be presented to the Pulmonary and Critical Care Medicine Boards for a decision on whether to remove or add procedures to the requirements.
Diversity, Equity and Inclusion: Progress Report
Pamela Browner White, Senior Vice President of Communications and Chief Diversity, Equity and Inclusion Officer; Lorna Lynn, MD, Vice President for Medical Education Research and the Staff Administrator for the Board of Director’s Committee on Diversity, Equity and Inclusion; and Weifeng Weng, PhD, Director of Research Analysis, updated the Critical Care Medicine Board on ABIM’s progress in advancing DEI and becoming an actively anti-racist organization.
Ms. Browner White noted that she has been Chief Equity, Diversity and Inclusion Officer for a little more than a year at the time of the meeting, and encouraged Specialty Board members to visit the year in review post on the ABIM blog.
She also reminded the Specialty Board of ABIM and ABIM Foundation’s Racial Justice statement: “It’s not simply enough to say passively we will do no harm; we pledge actively to do our part in opposing and dismantling systems and policies that cause harm to our patients and disproportionately affect those in Black and Brown communities.”
She said much of the work has been guided by this statement, and updated members in a number of areas ABIM is making progress.
Dr. Lynn and Dr. Weng then provided an overview of race and ethnicity data for the overall internal medicine diplomate population and for critical care medicine diplomates. Dr. Lynn noted that while the current reports rely on external data, in the future, ABIM will ask diplomates to self-identify with regards to their gender, race and ethnicity.
ABIM will collaborate with society partners and others to decide on what identifiers will be used. Making the reasons clear as to why we will begin to the collect this information is vitally important; it’s all about assuring that our programs are fair, and that we make sure a broad range of voices are included in our discussions.
Critical Care Medicine Board members shared their reactions to these data and their ideas for how ABIM can best move this work forward, as well as their personal experiences working within their own institutions. There was a discussion about how to recruit potential future physicians earlier (primary, middle and high school) to reach more of those who are underrepresented in medicine. Many feel it is a pipeline issue and that reaching out to students much earlier in their academic career will help foster an interest in STEM and careers in medicine.
As ABIM continues this work it will keep the community informed on its progress. More information can be found in a special section of our blog entitled ABIM’s Commitment to Health Equity.
Openings on the Critical Care Medicine Board & Item-Writing Task Force
The Critical Care Medicine Board has an opening for a physician with experience in critical care medicine. Physicians who are underrepresented in medicine are encouraged to apply. Sandra Davidson, ABIM Senior Program Manager, Medical Specialties, reviewed the process for recruiting and selecting new Critical Care Medicine Board members. Members will review candidates and recommend two that will be presented to the ABIM Council, who will make the final decision. ABIM is also currently seeking critical care physicians to serve on its Item-Writing Task Force to assist with creating exam content. Learn more about the opportunity and how to apply on ABIM’s website.
Longitudinal Knowledge Assessment (LKATM) Update
Alison Carey, Senior Director of Engagement and Digital Experience, and Jeffrey Miller, ABIM’s Chief Information Officer, gave the Specialty Board a preview of the Longitudinal Knowledge Assessment (LKA) platform and updated them about how ABIM has engaged physicians throughout the development process to ensure it will meet their needs and provide a good user experience.
The engagement work included establishing a Physician Advisory Panel of 10 board certified physicians, who met on a monthly basis to share feedback on a variety of areas, such as the LKA assessment platform, communications materials, and other program design elements.
The Panel’s insights were enhanced through regular user-testing sessions, additional physician interviews, surveys and feedback gleaned from diplomate phone calls and emails. In addition, in August 2021, 26 physicians volunteered to serve as beta testers for the LKA platform to help identify bugs and any user experience issues; their feedback resulted in important improvements to the assessment platform prior to launch.
All of this physician feedback also helped generate a comprehensive LKA Physician Journey, outlining physician opportunities and challenges. Some of the top challenges were discussed during the meeting to help prepare members in case colleagues approach them with questions.
For example, one challenge identified was that enrolling and participating at the beginning of a physician’s assessment due year is a departure from how many diplomates engage with MOC, and may not be intuitive. To address this challenge, ABIM will communicate clearly through multiple channels, including emails, social media, its website and more to ensure physicians are informed about this new process.
Critical Care Medicine Board Members also shared concerns about the number of questions someone would need to answer if they participated in the LKA for more than one certificate, and learned that staff are exploring ways to realize efficiencies for aligned disciplines in the future that could reduce the number of questions needed. It was also recognized that diplomates often have assessments due in different years, and for some they may decide to mix and match by choosing LKA in one discipline and the traditional, 10-year MOC exam in another.
ABIM plans to continue engaging with the community beyond the LKA launch and make improvements based upon physician feedback. All ABIM Board Certified physicians are encouraged to join the Community Insights Network where they may receive occasional requests to share their thoughts about various ABIM programs or topics.
Enrollment for the 2022 LKA opens December 1, 2021 for 12 disciplines, and the first batch of questions will be delivered January 4, 2022. As a reminder, the LKA will launch in 2023 for Critical Care Medicine. Learn more about LKA’s features, benefits, and other important details at abim.org/lka.
LKA Rollout Schedule
Exploring Opportunities to Enhance Trust Between ABIM and the Community
In an effort to continually improve its programs and relationships with the diplomate community, Specialty Board members engaged in an exercise aimed at identifying opportunities to enhance trust between ABIM and the physicians it serves. Insights previously gleaned through Governance member feedback have informed other important changes at ABIM, including advancing DEI initiatives, better accommodations for nursing mothers, and the LKA launching in 2022.
A number of ideas emerged during this session, such as highlighting how the ABIM Governance structure reflects the critical care medicine community, making the process of MOC, Governance and decision-making clear, and celebrating how feedback from diplomates is used to develop actionable items and enact change at ABIM.
Similar sessions are being held at each ABIM Specialty Board meeting throughout the fall. The top ideas will be presented to the ABIM Council for further consideration of future implementation.
The Critical Care Medicine Board values the feedback and commentary of the entire medical community, including diplomates and society partners.
Do you have any questions? Are you interested in how to get involved?
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