Sarah K. Meadows, MS, CCMEP, had been manager, accreditation and programs, with Denver-based National Jewish Health’s Office of Professional Education for only a few months when she had the opportunity to explore integrating Maintenance of Certification Part II and Part IV with a performance-improvement CME project getting under way.

During her previous nine years in CME, she had heard a lot of talk about how MOC might be a good opportunity for CME providers, but exactly how to take advantage of it remained somewhat of a mystery. And not just to CME providers: Even some of the 24 member boards of the American Board of Medical Specialties that require their physicians to continuously measure their performance in six core competencies adopted by ABMS and the Accreditation Council of Graduate Medical Education are still exploring how to hook what they’re doing with what CME providers offer.

But after some team discussions on how to enhance the education they were currently providing with their performance improvement activities, Meadows decided to look into the incorporation of MOC Parts II and IV.
After all, PI CME activities already measure a performance baseline prior to the program, then measure the outcomes to determine what changed (or did not change) as a result. Though the specifics of how MOC is carried out can vary according to the specialty or subspecialty, all the boards use a four-part structure to ensure the process is continuous, and Parts II and IV happen to mesh pretty well with some CME initiatives. Part II—Lifelong Learning and Self-Assessment—requires docs to participate in educational and self-assessment programs set by their board; and Part IV—Practice Performance Assessment—asks them to evaluate how what they’re learning is being carried out in their clinical practices, again measured against specialty-specific standards. (Parts I and III require physicians to maintain their state licensure and demonstrate through formal exams that they satisfy specialty-specific knowledge and practice requirements.)

The biggest difference between providing MOC Part IV under the auspices of the American Board of Pediatrics and PI CME is the number of times you go in and really take a look at what you’re doing, says Meadows. “As we started thinking about that, we thought a possible improvement in our PI CME approach may be having more than two checkpoints, one at the baseline and one at the end. What made a lot more sense is to have a checkpoint in the middle to see if what you’re doing is working along the way. If it is, great. If it’s not, then what can we modify so that we have better outcomes?”