Focused Practice in Hospital Medicine: Reflections on Procrastination and the Teamwork Effectiveness Assessment Module

The great procrastinator. That’s what I call myself sometimes. I last re-certified for the ABIM board certificate in 2005. That was under the old system of every ten year renewals (but not the really old system of never having to renew). At the time one needed 100 total points and to pass the general internal medicine test. I waited until the last calendar year and then within a few months in early 2005, I did a patient survey module one week while on service, handing out patient surveys to every patient I saw, and then went to a Wake Forest MOC course where I completed four modules within 4 days. Boom, all my points done with only the test standing in my way. I put in a few months of brushing up on outpatient medicine with Med-Study study guides (which I highly recommend, no conflict of interest here, I paid for my own books) and then passed the secured exam. I was set for the next ten years.

Seeing how this worked for me the last time, I let the years slip by, busy with many other duties, without doing any MOC’s along the way. I figured I could replicate this whirlwind strategy again. Little did I know that the ABIM would change the rules and little did I know that I would be saddled with many new work and SHM responsibilities in 2015.

So, here I am, entering the final calendar year again and starting from scratch. With the new rules by the ABIM to go to a more continuous process, I know that I won’t be facing the same procrastination dilemma again as we will all be showing continuous progress every two years. Its more complicated this time around and there are still bugs and issues I think the ABIM needs to work out, but for better or worse, I know the more continuous process will help keep physicians more current.

The good news this time around is we now have a new certificate just for hospitalists, the Focused Practice in Hospital Medicine (FPHM), a pilot project since 2009. This time, the modules and the test will all be pertinent to what I do in my day job as a hospitalist. No longer will I need to brush up on outpatient medicine for my test. The number of inpatient based Medical Knowledge modules and PIM’s (Performance Improvement Modules) is growing all the time.

I thought I would devote some of my blogspace over the next year to going through the recertification process in the Focused Practice in Hospital Medicine. Maybe to help you guys learn what to do and also learn from my mistakes.

As I scanned for opportunities to gain points, especially in the PIM arena, which I think is a bit more difficult to attain than the Medical Knowledge Assessment modules, I came across a pilot module only available to the FPHM pathway. This first module I will review is the Teamwork Effectiveness Assessment Module. This module was created in October 2012 and early research (by ABIM researchers Chesluk, Reddy, et al.) points to success at inspiring physicians who completed the module into trying to incorporate the feedback given to them by their raters into improving their own teamwork six months after completing the module.

The basics of the module are as follows:

– Step 1 is for the MOC candidate to perform a self-assessment on their effectiveness at working as a team with the other members of the hospital multidisciplinary team. Fair enough, we know from leadership training that getting physicians to self assess their practice is an excellent way to bring issues into focus for self-raters that they might otherwise continue to let slide.

– Step 2 is then asking 15 members of your hospital multidisciplinary team, be it nurses, nurse managers, pharmacists, unit coordinators, case managers, etc… (no more than 5 docs, and no learners) to go online and take the same survey that you had completed in the self-assessment. The survey is estimated to take 15 minutes, but so far most surveyors I have talked to say it takes no more than 5-10 minutes max. The goal is to get 10 surveys turned in. Once the 10 threshold is reached, Step 3 kicks in where a trusted advisor will go over the results of the survey with you.

– In step 4, you will reflect upon the survey and how you plan to use the results in improving your teamwork. Lastly, in step 5, you claim credit worth 20 points toward the Self-evaluation Practice Assessment category of MOC

I have taken the first step and registered for the TEAM module and sent out my surveys, so if you have one in your in-box, please complete it! The big obstacle I see to this module is getting an appropriate survey response percentage. They do allow you to add names to your survey list if your returns are not coming in. Additionally, there is a time limit of 5 weeks in which the surveys must all be back. Hopefully, this won’t require too much bugging of friends and colleagues.

So, that’s where I am in obtaining my own certificate for Focused Practice in Hospital Medicine. It should be a busy year ahead of me at least through the secured hospital medicine exam on October 22nd, 2015. I will blog about the process as I go along and hopefully you can learn something. I welcome comments and suggestions, too, if you have already been through the new process.

Finally, where are you in your journey? It’s never too early to take those first steps and join the 3,300 fellow hospitalists already on the pathway toward obtaining their own certificate in FPHM!