American Board of Internal Medicine Nephrology Procedure Requirements for Initial Certification: Time for a Change and Pursuing Consensus in the Nephrology Community.

In 1988, the American Board of Internal Medicine (ABIM) defined essential procedural skills in nephrology, and candidates for ABIM certification were required to present evidence of possessing the skills necessary for placement of temporary dialysis vascular access, hemodialysis, peritoneal dialysis, and percutaneous renal biopsy. In 1996, continuous renal replacement therapy was added to the list of nephrology requirements. These procedure requirements have not been modified since 1996 while the practice of nephrology has changed dramatically.

Which Outreach Modes Improve Response Rates to Physician Surveys? Lessons from an Experiment at the American Board of Internal Medicine.

Physicians are a notoriously difficult group to survey due to a low propensity to respond. We investigate the relative effectiveness of reminder phone calls, pre-notification postcards, mailed paper surveys, and $1 upfront incentives for boosting survey response rate by embedding a randomized experiment into a mixed-mode operational survey at the American Board of Internal Medicine in 2019. Expected response rates and average marginal effects for each follow-up method were computed from a logistic regression model.

Remind Me Again: Physician Response to Web Surveys: The Effect of Email Reminders Across 11 Opinion Survey Efforts at the American Board of Internal Medicine from 2017 to 2019.

For survey researchers, physicians in the United States are a difficult-to-reach subgroup. The purpose of this study is to quantify the effect of email reminders on web-based survey response rates targeting physicians. We conducted a retrospective analysis of 11 American Board of Internal Medicine surveys from 2017 to 2019.

Changes in Stress and Workplace Shortages Reported by U.S. Critical Care Physicians Treating Coronavirus Disease 2019 Patients.

Objectives: Eleven months into the coronavirus disease 2019 pandemic, the country faces accelerating rates of infections, hospitalizations, and deaths. Little is known about the experiences of critical care physicians caring for the sickest coronavirus disease 2019 patients. Our goal is to understand how high stress levels and shortages faced by these physicians during Spring 2020 have evolved.

How Physicians Prepare for Maintenance of Certification Exams: A Qualitative Study.

Purpose: Little is known about how board-certified physicians prepare for their periodic maintenance of certification (MOC) examinations. This qualitative study explores how physicians experience MOC exam preparation: how they prepare for the exams and decide what to study and how exam preparation compares with what they normally do to keep their medical knowledge current.

Method: Between September 2016 and March 2017, the authors interviewed 80 primary care physicians who had recently taken either the American Board of Family Medicine or American Board of Internal Medicine MOC exam.

How hospitalists work to pull healthcare teams together.

Purpose: The purpose of this paper is to document everyday practices by which hospitalist physicians negotiate barriers to effective teamwork.

Design/methodology/approach: Ethnographic observation with a sample of hospitalists chosen to represent a range of hospital and practice types.

Findings: Hospitals rely on effective, interprofessional teamwork but typically do not support it.

Assessing interprofessional teamwork: pilot test of a new assessment module for practicing physicians.

Introduction: Teamwork is a basic component of all health care, and substantial research links the quality of teamwork to safety and quality of care. The TEAM (Teamwork Effectiveness Assessment Module) is a new Web-based teamwork assessment module for practicing hospital physicians. The module combines self-assessment, multisource feedback from members of other professions and specialties with whom the physician exercises teamwork, and a structured review of those data with a peer to develop an improvement plan.

Professionalism and maintenance of certification: using vignettes describing interpersonal dilemmas to stimulate reflection and learning.

Introduction: Physicians do not always agree on "rules" governing behavior in professionally challenging situations. Little is known about contextual factors that influence physician approaches in these situations. We explored the individual-, social-, and societal-level factors that physicians consider when responding to 2 common professional dilemmas.

A new tool to give hospitalists feedback to improve interprofessional teamwork and advance patient care.

Teamwork is a vital skill for health care professionals, but the fragmented systems within which they work frequently do not recognize or support good teamwork. The American Board of Internal Medicine has developed and is testing the Teamwork Effectiveness Assessment Module (TEAM), a tool for physicians to evaluate how they perform as part of an interprofessional patient care team. The assessment provides hospitalist physicians with feedback data drawn from their own work of caring for patients, in a way that is intended to support immediate, concrete change efforts to improve the quality of patient care.

The ABIM's clinical supervision practice improvement module and its effect on faculty's supervisory skills.

Purpose: Inadequate supervision of medical trainees hampers education and patient care. The authors examine the use of the American Board of Internal Medicine's Clinical Supervision Practice Improvement Module (CS-PIM) to determine whether it facilitated and enhanced faculty's skills in direct observation, providing feedback, identifying errors, and auditing medical records.

Method: In this descriptive cohort study, module satisfaction was assessed using a five-point Likert scale.

Ambulatory office organization for internal medicine resident medical education.

Purpose: Residents will most effectively learn about ambulatory, systems-based practice by working in highly functional ambulatory practices; however, systems experiences in ambulatory training are thought to be highly variable. The authors sought to determine the prevalence of functional-practice characteristics at clinics where residents learn.

Method: In 2007, the authors conducted a national survey of medical directors of resident continuity clinics using a comprehensive, Web-based instrument that included both a residency clinic assessment and a practice system assessment (PSA).

Ambulatory-based education in internal medicine: current organization and implications for transformation. Results of a national survey of resident continuity clinic directors.

Background: Many have called for ambulatory training redesign in internal medicine (IM) residencies to increase primary care career outcomes. Many believe dysfunctional, clinic environments are a key barrier to meaningful ambulatory education, but little is actually known about the educational milieu of continuity clinics nationwide.

Objective: We wished to describe the infrastructure and educational milieu at resident continuity clinics and assess clinic readiness to meet new IM-RRC requirements.

Aging: adding complexity, requiring skills.

The role of systems in addressing the needs of elderly and chronically ill populations remains a far from universal way of thinking, much less practice, in health care. Re-engineering the current fragmented system to align providers, patients and payment models to facilitate proactive management of conditions associated with advanced age and/or one or more chronic diseases - rather than responding to costly consequences of a health care system optimized for acute care conditions - will be a major challenge for all stakeholders. There are, however, promising success stories that are taking place in the United States today that may provide a model for improvement.

Prevalence and functionality of electronic health records in internal medicine continuity clinics.

Purpose: Health information technology (HIT), particularly electronic health records (EHRs), will become universal in ambulatory practices, but the current roles and functions that HIT and EHRs play in the ambulatory clinic settings of internal medicine (IM) residents are unknown.

Method: The authors conducted a Web-based survey from July 2007 to January 2008 to ascertain HIT prevalence and functionality. Respondents were directors of one or more ambulatory clinics where IM residents completed any required outpatient training, as identified by directors of accredited U.

Teaching and evaluating point of care learning with an Internet-based clinical-question portfolio.

Introduction: Diplomates in the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) program satisfy the self-evaluation of medical knowledge requirement by completing open-book multiple-choice exams. However, this method remains unlikely to affect practice change and often covers content areas not relevant to diplomates' practices. We developed and evaluated an Internet-based point of care (POC) learning portfolio to serve as an alternative.

The role of physician engagement on the impact of the hospital-based practice improvement module (PIM).

Background: Physicians play an important role in hospital quality improvement (QI) activities. The Hospital-Based Practice Improvement Module (Hospital PIM) is a web-based assessment tool designed by the American Board of Internal Medicine (ABIM) to facilitate physician involvement in QI as a part of maintaining certification.

Objective: The primary objective of this study is to explore the impact of the Hospital PIM on physicians participating in hospital-based QI.

Measurement in Veterans Affairs Health Services Research: veterans as a special population.

Objective: To introduce this supplemental issue on measurement within health services research by using the population of U.S. veterans as an illustrative example of population and system influences on measurement quality.