Validating the Test Plan Specifications for the American Board of Family Medicine's Certification Examination.

Purpose: To demonstrate the degree to which the American Board of Family Medicine's certification examination is representative of family physician practice with regard to frequency of diagnoses encounter and the criticality of the diagnoses.

Methods: Data from 2012 National Ambulatory Medical Care Survey was used to assess the frequency of diagnoses encountered by family physicians nationally. These diagnoses were also rated by a panel of content experts for how critical it was to diagnose and treat the condition correctly and then assign the condition to 1 of the 16 content categories used on the American Board of Family Medicine examination.

Prevalence and Factors Associated with Family Physicians Providing E-Visits.

Purpose: The use of telemedicine has grown in recent years. As a subset of telemedicine, e-visits typically involve the evaluation and management of a patient by a physician or other clinician through a Web-based or electronic communication system. The national prevalence of e-visits by primary care physicians is unclear as is what factors influence adoption.

Motivation for Participation in the American Board of Family Medicine Certification Program.

Background And Objectives: Board certification programs have been criticized as not relevant to practice, not improving patient care, and creating additional burdens on already overburdened physicians. Many physicians may feel compelled to participate in board certification programs in order to satisfy employer, hospital, and insurer requirements; however, the influence of forces as motivators for physicians to continue board certification is poorly understood.

Methods: We used data from the 2017 American Board of Family Medicine (ABFM) Family Medicine Certification Examination practice demographic registration questionnaire for those seeking to continue their certification, removing physicians who indicated they did not provide direct patient care.

Prevalence and practice for rare diseases in primary care: a national cross-sectional study in the USA.

Objectives: There are more than 7000 rare diseases in the USA, and they are prevalent in 8% of the population. Due to life-threatening risk and limited therapies, early detection and treatment are critical. The purpose of this study was to explore characteristics of visits for patients with rare diseases seen by primary care physicians (PCPs).

Family Medicine Residents' Debt and Certification Examination Performance.

Introduction: Previous studies have found that medical students and internal medicine residents with high educational debt perform less well on examinations. The purpose of this study was to examine the relationship between educational debt and family medicine residents' performance on initial in-training and board certification examinations.

Methods: Our study was a cross-sectional secondary analysis of American Board of Family Medicine (ABFM) data collected from residents (N=5,828) who registered for the Family Medicine Certification Examination (FMCE) in 2014 and 2015, representing 85.

The Relationship Between Board Certification and Disciplinary Actions Against Board-Eligible Family Physicians.

Purpose: Lack of specialty board certification has been reported as a significant physician-level predictor of receiving a disciplinary action from a state medical board. This study investigated the association between family physicians receiving a disciplinary action from a state medical board and certification by the American Board of Family Medicine (ABFM).

Method: Three datasets were merged and a series of logistic regressions were conducted examining the relationship between certification status and disciplinary actions when adjusting for covariates.

Board Certified Family Physician Workforce: Progress in Racial and Ethnic Diversity.

Diversification of the physician workforce has been a goal of Association of American Medical Colleges for several years and could improve access to primary care for under-served populations and address health disparities. We found that family physicians' demographics have become more diverse over time, but still do not reflect the national demographic composition. Increased collaboration with undergraduate universities to expand pipeline programs may help increase the diversity of students accepted to medical schools, which in turn should help diversify the family medicine workforce.

Development of the KOOS Platform to Measure Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction.

Background: The Knee injury and Osteoarthritis Outcome Score (KOOS) has demonstrated inferior psychometric properties when compared with the International Knee Documentation Committee (IKDC) subjective knee form when assessing outcomes after anterior cruciate ligament (ACL) reconstruction. The KOOS, Joint Replacement (KOOS, JR) is a validated short-form instrument to assess patient-reported outcomes (PROs) after knee arthroplasty, and the purpose of this study was to determine if augmenting the KOOS, JR with additional KOOS items would allow for the creation of a short-form KOOS-based global knee score for patients undergoing ACL reconstruction, with psychometric properties similar to those of the IKDC.

Hypothesis: An augmented version of the KOOS, JR could be created that would demonstrate convergent validity with the IKDC but avoid the ceiling effects and limitations previously noted with several of the KOOS subscales.

Development of the HOOS to Assess Patient-Reported Outcomes in Patients Undergoing Hip Preservation Procedures.

Background: The creation of a single patient-reported outcome (PRO) platform validated across hip preservation, osteoarthritis (OA), and total hip arthroplasty (THA) populations may reduce barriers and streamline the routine collection of PROs in clinical practice. As such, the purpose of this study was to determine if augmenting the Hip disability and Osteoarthritis Outcome Score-Joint Replacement (HOOS, JR) with additional HOOS questions would result in a PRO platform that could be used across a wider spectrum of hip patient populations.

Hypothesis: The HOOS, JR would demonstrate a notable ceiling effect, but by augmenting the HOOS, JR with additional HOOS questions, a responsive PRO platform could be created.

Frequency and Criticality of Diagnoses in Family Medicine Practices: From the National Ambulatory Medical Care Survey (NAMCS).

Background: Family medicine is a specialty of breadth, providing comprehensive health care for the individual and the family that integrates the broad scope of clinical, social, and behavioral sciences. As such, the scope of practice (SOP) for family medicine is extensive; however, over time many family physicians narrow their SOP. We sought to provide a nationally representative description of the most common and the most critical diagnoses that family physicians see in their practice.

The Single Graduate Medical Education (GME) Accreditation System Will Change the Future of the Family Medicine Workforce.

Background: Due to the Accreditation Council for Graduate Medical Education (ACGME)/American Osteopathic Association (AOA) single-accreditation model, the specialty of family medicine may see as many as 150 programs and 500 trainees in AOA-accredited programs seek ACGME accreditation. This analysis serves to better understand the composition of physicians completing family medicine residency training and their subsequent certification by the American Board of Family Medicine.

Methods: We identified residents who completed an ACGME-accredited or dual-accredited family medicine residency program between 2006 and 2016 and cross-tabulated the data by graduation year and by educational background (US Medical Graduate-MD [USMG-MD], USMG-DO, or International Medical Graduate-MD [IMG-MD]) to examine the cohort composition trend over time.

Scope of Practice Among Recent Family Medicine Residency Graduates.

Background And Objectives: The scope of practice among primary care providers varies, and studies have shown that family physicians' scope may be shrinking. We studied the scope of practice among graduates of residencies associated with Preparing the Personal Physician for Practice (P4) and how length of training and individualized education innovations may influence scope.

Methods: We surveyed graduates 18 months after residency between 2008 and 2014.

Performance of Graduating Residents on the American Board of Family Medicine Certification Examination 2009-2016.

In response to growing concern about the declining performance on the American Board of Family Medicine Certification Examination, several strategies were employed to assist program directors with preparing their residents to take the examination. The effect of these efforts seems to have resulted in significant improvement in performance.

Workplace Factors Associated With Burnout of Family Physicians.

This study examines physician burnout using data from American Board of Family Medicine application questionaires.

Examining the Functioning and Reliability of the Family Medicine Milestones.

Background: The Family Medicine (FM) Milestones are a framework designed to assess development of residents in key dimensions of physician competency. Residency programs use the milestones in semiannual reviews of resident performance from entry toward graduation.

Objective: To examine the functioning and reliability of the FM Milestones and to determine whether they measure the amount of a latent trait (eg, knowledge or ability) possessed by a resident or simply indicate where a resident falls along the training sequence.

Impact of One Versus Two Content-Specific Modules on American Board of Family Medicine Certification Examination Scores.

Background: We consider the question of whether requiring diplomates to select only 1 content-specific module, rather than 2, would increase, decrease, or produce no change in scores among the examinee population.

Methods: Examinees' scores were computed under 3 different conditions: the examination core plus (1) both modules, (2) the module on which they scored higher, and (3) the module on which they scored lower.

Results: Although the differences in scores across the 3 conditions were relatively small, asking examinees to select only a single module would likely benefit more examinees than it would harm by a 4:1 ratio, assuming that the diplomates selected the module on which they scored higher.

Applying the Many-Facet Rasch Measurement Model to Explore Reviewer Ratings of Conference Proposals.

For academic conferences, when proposals are submit they are often judged using a rating scale on identified criterion by reviewers who have a shared interest and expertise in the area under consideration. Given the multiple and varied reviewers, an analysis of psychometric properties like rater severity and consistency are important. However, many of the problems that plague the conference proposal selection process are the same issues that plague survey research: rater bias/severity, misuse of rating scale, and the use of raw scores as measures.

The Predictive Validity of the National Board of Osteopathic Medical Examiners' COMLEX-USA Examinations With Regard to Outcomes on American Board of Family Medicine Examinations.

Purpose: To examine the predictive validity of the National Board of Osteopathic Medical Examiners' Comprehensive Osteopathic Medical Licensing Examination of the United States of America (COMLEX-USA) series with regard to the American Board of Family Medicine's (ABFM's) In-Training Examination (ITE) and Maintenance of Certification for Family Physicians (MC-FP) Examination.

Method: A repeated-measures design was employed, using test scores across seven levels of training for 1,023 DOs who took the MC-FP for the first time between April 2012 and November 2014 and for whom the ABFM had ITE scores for each of their residency years. Pearson and disattenuated correlations were calculated; Fisher r to z transformation was performed; and sensitivity, specificity, and positive and negative predictive values for the COMLEX-USA Level 2-Cognitive Evaluation (CE) with regard to the MC-FP were computed.

The Impact of Repeated Exposure to Items.

Theory: When test developers have a limited number of test questions available or when the equating design requires some item overlap across forms, psychometricians worry that examinees who encounter previously seen questions on subsequent test forms may be able to inflate their test score due to their familiarity with the repeated test questions.

Hypotheses: Prior exposure to test questions may lead to contamination and inflated scores. This research seeks to detect if examinees' scores were inflated due to prior exposure to test questions and, if so, whether those increases were significant.

The Predictive Validity of the ABFM's In-Training Examination.

Background And Objectives: Our objective was to examine the predictive validity of the American Board of Family Medicine's (ABFM) In-Training Examination (ITE) with regard to predicting outcomes on the ABFM certification examination.

Methods: This study used a repeated measures design across three levels of medical training (PGY1--PGY2, PGY2--PGY3, and PGY3--initial certification) with three different cohorts (2010--2011, 2011--2012, and 2012--2013) to examine: (1) how well the residents' ITE scores correlated with their test scores in the following year, (2) what the typical score increase was across training years, and (3) what was the sensitivity, specificity, positive predictive value, and negative predictive value of the PGY3 scores with regard to predicting future results on the MC-FP Examination.

Results: ITE scores generally correlate at about .

Creating the Individual Scope of Practice (I-SOP) scale.

Research indicates that the scope of practice for primary care physicians has been shrinking (Tong, Makaroff, Xierali, Parhat, Puffer, Newton, et al., 2012; Xierali, Puffer, Tong, Bazemore, and Green, 2012; and Bazemore, Makaroff, Puffer, Parhat, Phillips, Xierali, et al., 2012) despite research showing that areas with robust primary care services have better population health outcomes at lower costs (Starfield, Shi, and Macinko, 2005).