With a mission of advancing the highest standards of the practice of anesthesiology, the American Board of Anesthesiology (ABA) is committed to partnering with physicians to advance lifelong learning and exceptional patient care. They administer primary and subspecialty certification exams as well as the Maintenance of Certification in Anesthesiology Program (or MOCA 2.0), which has recently been redesigned and improved to include the microlearning initiative, MOCA Minute, a web based learning and assessment tool.
Dr. Deborah Culley is an attending physician and vice chair of research at the Brigham and Women’s Hospital in Boston and an associate professor of anesthesiology at Harvard Medical School. She’s also secretary on the board of directors for the ABA and she understands the tremendous impact the MOCA Minute is having on individual physicians and the profession as a whole.
In this episode of the Leading Learning podcast, Celisa talks with Deb about what the ABA is doing to better meet the needs of physicians through MOCA Minute and MOCA 2.0, why each of the programs was developed, and how everyone benefits.
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[01:28] – A preview of what will be covered in this podcast where Celisa interviews Dr. Deborah Culley, secretary on the board of directors for the American Board of Anesthesiology, about their microlearning initiative and its evolving approach to maintenance of certification.
Note that the idea for this interview came from Jack Coursen, a Leading Learning listener, who was interested in learning more about what the ABA is doing with microlearning. So know that you can always reach out to us with ideas and suggestions—in fact we welcome them!
[02:40] – Introduction to Deb and some background information about the ABA, her role and work.
[05:10] – The ABA first came across my radar screen because of its microlearning initiative, the MOCA Minute. Would you give us a brief history of the why and the what of the ABA’s microlearning? What are you doing with microlearning, and why did the ABA want to get into microlearning in the first place?
Deb explains that the MOCA Minute is a web-based learning and assessment tool that they began piloting in 2014 to help anesthesiologists prepare for the once every ten-year MOCA exam (a test they use to determine if physicians are keeping up to date with regards to their medical knowledge). The research showed that those who participated in the MOCA Minute performed better on subsequent exams than those who didn’t – even in content areas not covered by the MOCA Minute questions – suggesting that it actually enhanced learning in other areas as well.
Around the same time they were also redesigning their MOCA program to make it more relevant and meaningful and in 2016 they expanded the pilot to gauge whether they could successfully replace the current MOCA exam with it. Deb says the MOCA Minute consists of multiple-choice questions that anesthesiologists can answer at their convenience (on their cell phone, tablet, or computer). They immediately get feedback with rationale on correct and incorrect answers—it also links them to related learning resources. The physicians participating in MOCA Minute answer 30 questions per quarter (or 120 per calendar year) and must meet a performance standard to remain in good standing with the ABA.
Unlike the once every ten-year MOCA exam, the MOCA Minute provides opportunities for learning and self-assessment. As far as why they went through with this process, Deb says that MOCA Minute was initially conceptualized as a learning tool but they quickly determined it was also a valuable assessment tool. And unlike the traditional, once every ten-year exam, it offers convenience, it’s engaging, and it can help physicians identify areas where they could benefit from significantly more learning.
It’s a lifelong learning tool that offers continuous learning and assessment, personalization, and they can introduce new topics on demand when a need arises. Through the MOCA Minute, they are also able to track individual performance over time as well as trends in the knowledge of all their members so they can identify needs for more learning for each person as well as for the group. Based upon this data, they now collaborate with continuing medical education providers to drive the development of new learning opportunities.
[09:23] – I’m curious about the outcomes and results the ABA is looking for with its microlearning—what results are you after, and what are you measuring and evaluating to gauge your success?
Deb shares that from the conception of the MOCA Minute they set out to create a program that was more relevant, easily accessible, and that was meaningful to their physician practice. They wanted to promote lifelong learning rather than episodic cramming (which occurred for the once every ten-year exam). They also wanted to help identify topics where physicians could use additional learning and then direct them to targeted educational opportunities.
She says they also wanted to incorporate the latest advances in education technology and adult learning theory. They developed prospective matrices to evaluate whether the MOCA Minute was a success. In the short term, they’ve used physician feedback and over the long term, they’re doing research to measure the impact of the program on physician knowledge, retention, and engagement.
[11:04] – MOCA Minute is a pilot and aims to replace the decennial MOCA exam. What is the timeline and what are the criteria for deciding whether the pilot is successful?
Deb says they applied earlier this year to their parent organization to transition the MOCA Minute from a pilot to a permanent program and it was approved in April 2018. And they decided to make it permanent because it was widely embraced by anesthesiologists and has proven to be a robust evaluation tool to assess physician knowledge.
[12:38] – You give the physicians that use MOCA Minute three ways to access the questions: weekly e-mails in their online portal account, or via the MOCA Minute mobile app. Have you collected data on which way is most popular?
Deb shares they have and that the MOCA Minute is most often accessed through the portal—either via the email that’s sent to them or the website (57%). Roughly 43% access it through the app that’s available for both Apple and Android devices.
[13:19] – The microlearning that is MOCA Minute isn’t offered in isolation; it’s part of MOCA 2.0. As you did for MOCA Minute, would you share both the what and the why of MOCA 2.0?
Deb explains that MOCA 2.0 is their continuing certification program of which the MOCA Minute is a core component. Most physicians pursue board certification following residency because it documents and demonstrates that they’re meeting the highest standards in their specialty. Once they’re certified they need to maintain that certification. Deb talks about how the program is constructed and explains that MOCA Minute is essentially part of that.
[15:00] – What’s the business model you’re using to support MOCA 2.0 and MOCA Minute? I think it’s an annual fee for MOCA 2.0, which includes the MOCA Minute—is that correct?
Deb says that’s correct—physicians now pay an annual fee (instead of every ten years) as a way of staying engaged with their diplomates. She explains how they’ve added tremendous value to the program by investing in technology that allows them to be more agile and innovative but the cost of physicians hasn’t changed whereas the value proposition has. Ultimately, their goal is to improve public health and the MOCA Minute provides an opportunity for them to address public health concerns much faster than they could do with a once every ten-year exam.
Another part of that model is they wanted to engage their diplomates and with MOCA, they’ve evolved from being a transactional organization to a partnership-driven one with one of their primary partners being their diplomates themselves. As they redesigned the MOCA program Deb talks about how they relied heavily on diplomate feedback to guide their decisions.
[18:33] – How did the ABA go about making the business case to invest in MOCA 2.0 and MOCA Minute?
Deb shares that they all recognized as ABA directors that medical practice was changing rapidly with the current times and in order to stay relevant you have to be willing to innovate. She says they made a strategic decision to invest their reserves into something that would offer greater value to physicians, incorporate advancements in technology and adult learning theory, and to create a robust assessment and self-assessment tool. Their intent was to drive lifelong learning and improve patient outcomes and much of the work was done in-house.
[20:39] – What are some of the lessons you’ve taken away from the experience of rolling out MOCA 2.0 and the MOCA Minute? And any words of advice or caution that you might have for other organizations considering doing something similar to MOCA 2.0 or MOCA Minute?
Deb discusses how they’ve learned there are additional benefits by offering self-assessment opportunities to their diplomates. They’ve also found that communication, customer service, and engagement with their diplomates are critical. She says they now solicit information from them, receive their feedback, and use it to enhance the program.
One of the most interesting things about the program is since they launched the MOCA Minute pilot, 22 out of the 24 medical specialty boards under the umbrella of the American Board of Medical Specialties have now undertaken similar efforts—so they’re now providing an entire group of physicians an opportunity to have continuous lifelong learning.
[22:15] – What is one of the most powerful learning experiences you’ve been involved in, as an adult, since finishing your formal education?
Deb shares for her that would be simulation—it’s an engaging experience and probably where she learns the most.
[23:20] – How to learn more about ABA and/or MOCA:
[24:03] – Wrap Up
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[25:56] – Sign off