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On June 7 and 9, hundreds of internists and nephrologists—including four members of our Board of Directors—took the American Board of Internal Medicine’s (ABIM) Knowledge Check-In for the first time. We are grateful to all of the physicians willing to be early adopters of this new format and pave the way for their colleagues. A preliminary evaluation of the post-Knowledge Check-In survey indicates that:

Internal Medicine (81% response rate):

  • 92% said the test/registration process was handled in an efficient manner (4% neither agree/disagree)
  • 81% reported the external resource (UpToDate®) was valuable for answering the test questions (11% neither agree/disagree)
  • 65% were satisfied with their overall testing experience (21% neither agree/disagree)

Nephrology (87% response rate):

  • 97% said the test/registration process was handled in an efficient manner (2% neither agree/disagree)
  • 62% reported the external resource (UpToDate®) was valuable for answering the test questions (19% neither agree/disagree)
  • 58% were satisfied with their overall testing experience (27% neither agree/disagree)

I’ll let their words—shared below in unedited form—paint a more complete picture of what they told us went right and areas where we need to improve.

Our commitment to you.

This is the first time ABIM has offered this assessment, and we learned a lot over the last couple of days. And while the majority of physicians were able to take the Knowledge Check-In without any issues some —including one of our Directors—experienced technical problems. We will use what we learned, especially the feedback from test takers, to improve so that we can deliver the best experience possible. Of course, as with any time technology fails us, a small number of physicians who had planned carefully to fit this into very busy lives had a frustrating experience. We are working diligently to offer them back-up plans while simultaneously learning from their experience to do better in the future. 

If you took the Knowledge Check-In, I encourage to you share your suggestions for improvement directly with me at rbaronmd@abim.org.  

“I like the time, the acces to uptodate, very clinical practical questions. In general i like this test better that the 10 year assessment. Up date addition is tremendosuly value”

“I had one glitch in my computer trying to do a windows update which cost me a bit more than 4 minutes to get back to my test module. It created some panic on my part but I am glad I was able to finish it. Neat experience and was really easy to do. I think it is a good alternative to th 10 year MOC testing and encourages one to do more MOC modules. Recommend some times earlier in the day where the brain is more refershed and can function better. thank you”

“This was the first round for the knowledge check in. Here are my recommendations:1) a little more time is needed for each session. 2) a more focussed review may be applicable for each check in. There was ALOt of rheumatology which I never use in my practice as a hospitlast and medical director.”

The administration of the Knowledge Check-In also represented the first time physicians had the choice of taking an ABIM assessment in their home, office or test center; about 57% chose the online option, with the other 43% opting for the test center. For this first administration, technical issues were more likely to occur among those testing in their home or workplace than in the test center. Based upon what we’ve learned and the fixes we are putting in place, we expect physicians taking it at home or workplace during the next administration to have a much smoother experience.

“It was great to do this at home. Thanks for providing that option.”

“I had some issues with my computer that held things up that did not come up on the testing I did to prepare for this day. These were the fact that my camera is built in to my laptop and docked and cannot be moved around easily and the fact that I have 2 monitors that I did not know was a problem and my microphone worked on test but not in real world.”

“I appreciated the ability to schedule and do the testing when convient to my schedule.”

“the system precheck was time consuing and cumbersome as it took two separte calls to IT on two separte days because of problems accepting the unidentified app for pearson vue. this led to time wasted and worry regarding being able to log in. Also, during the check in process the proctor didnt know answers to my questions and just read off a template. In the future, it would be advisable to let the MD know how long is allotted for each sections, how many sections and how many questions in each section. This would allow us to properly prepare so we could practice time testing.”

“I was just nervous with the computer making sure I hit all the buttons appropriately. As I was further along felt more comfortable with the digital format.”

“up to date resource didn’t load several times; this was easily fixed when clicking on the uptodate logo in the top left. Loved having that resource. I was nervous about taking the test outside a testing center but this went well. PearsonVue was easy to work with and helpful.”

For many physicians, UpToDate performed as expected. We did receive some reports—from both those taking the Knowledge Check-In online and in a test center—that the software took longer to load than it should have. ABIM is working closely with Pearson VUE and UpToDate to investigate these issues and is already putting fixes in place to ensure improved performance for the fall.

“I loved using UpToDate. I felt this was a great resource to double check answers and mimics everyday practice.”

“Having access to external reference is more similar to my actual daily practice. Maybe a little more time should be allow for each question. Also Up-To-Date is good. There are other good references too to consider to include (such as the ACP online website).”

“I did not think the amount of time provided was sufficient to read the questions and confirm answers w/ UptoDate (UTD). I had to rush at the end and did not have a chance to review any of my marked questions. [The] test still not reflective of the breadth that a practicing clinician has. Use of up to date is a positive change because more reflective of how we confirm/refute our clinical suspicions in current practive”

“Having the UpToDate resource made the testing experience better and a more realistic evaluation of practice ability. The test required clinical knowledge and reasoning ability but the availability of UpToDate reduced the need to memorize easily retreivable facts. However, the UpToDate resource did not load easily on my computer and navigation was difficult – e.g. it was hard to go back to the lookup screen from a topic screen – the navigation seemed to “jump” irradically.”

“Seemed fine overall. Access to UpToDate was wonderful. There are specific questions I might have issues with but that’s probably to be expected.”

“Use of external resource was a mimic of actual practice and in this fashion a good proxy of critcial thinking.”

What’s Next?

The next administration of the Knowledge Check-In in Internal Medicine is scheduled September 12 and 15, and in Nephrology November 1 and 6. The complete Knowledge Check-In rollout schedule is available on ABIM’s website.

We are, together, a learning community, constantly improving and maintaining our skills in service of our patients. We at ABIM have been hearing that you wanted alternatives to a once-every-10-years daunting exam experience, and we have been working with many of you to deliver something different. Over the past several days, colleagues demonstrated leadership and willingness to innovate by stepping up to try something new and help all of us get better. We commit to continue to innovate with you with the shared goal of recognizing publicly the very special skills internists and internal medicine subspecialists bring to their patients every day. Thanks for all you do in a very challenging environment.