Incorporating Physician Input Into a Maintenance of Certification Examination: A Content Validity Tool.

Abstract

PURPOSE\nAs part of the American Board of Internal Medicine s (ABIM s) continuing effort to update its Maintenance of Certification (MOC) program, a content validity tool was used to conduct structured reviews of the MOC exam blueprints (i.e., tables of test specifications) by the physician community. Results from the Cardiovascular Disease MOC blueprint review are presented as an example of the process ABIM conducted for several internal medicine disciplines.\n\n\nMETHOD\nRatings of topic frequency and importance were collected from cardiologists in 2016 using a three-point scale (low, medium, high). The web-based survey instrument presented 188 blueprint topic descriptions each combined with five patient-related tasks (e.g., diagnosis, treatment). Descriptive statistics and Chi-square analysis were employed.\n\n\nRESULTS\nResponses from 441 review participants were analyzed. Frequency and importance ratings were aggregated as a composite statistic representing clinical relevance, and exam assembly criteria were modified to select questions, or items, addressing clinically relevant content only. Specifically, ≥88% of exam items now address high-importance topics, including ≤15% on topics that are also low frequency; and ≤12% of exam items now address medium-importance topics, including ≤3% on topics that are also low frequency. The updated blueprint has been published for test-takers and provides enhanced information on content that would and would not be tested in subsequent examinations. It is linked to more detailed feedback that examinees receive on items answered incorrectly.\n\n\nCONCLUSIONS\nThe blueprint review garnered valuable feedback from the physician community and provided new evidence for the content validity of the Cardiovascular Disease MOC exam.