The Effect of Spaced Repetition on Learning and Knowledge Transfer in a Large Cohort of Practicing Physicians.

Purpose: Spaced repetition is superior to repeated study for learning and knowledge retention, but literature on the effect of different spaced repetition strategies is lacking. The authors evaluated the effects of different spaced repetition strategies on long-term knowledge retention and transfer.

Method: This prospective cohort study, conducted from October 1, 2020, to July 20, 2023, used the American Board of Family Medicine Continuous Knowledge Self-Assessment (CKSA) to assess learning and knowledge transfer of diplomates and residents.

Performance Evaluation of the Generative Pre-trained Transformer (GPT-4) on the Family Medicine In-Training Examination.

Objective: In this study, we sought to comprehensively evaluate GPT-4 (Generative Pre-trained Transformer)'s performance on the 2022 American Board of Family Medicine's (ABFM) In-Training Examination (ITE), compared with its predecessor, GPT-3.5, and the national family residents' performance on the same examination.

Methods: We utilized both quantitative and qualitative analyses.

COVID-19 Impact on Family Medicine Residents Exam Performance.

Background And Objectives: The COVID-19 pandemic began interrupting family medicine residency training in spring 2020. While a decline in scores on the American Board of Family Medicine In-Training Examination (ITE) has been observed, whether this decline has translated into the high-stakes Family Medicine Certification Examination (FMCE) is unclear. The goal of this study was to systematically assess the magnitude of COVID-19 impact on medical knowledge acquisition during residency, as measured by the ITE and FMCE.

Differences in Physician Performance and Self-rated Confidence on High- and Low-Stakes Knowledge Assessments in Board Certification.

Introduction: Evidence links assessment to optimal learning, affirming that physicians are more likely to study, learn, and practice skills when some form of consequence ("stakes") may result from an assessment. We lack evidence, however, on how physicians' confidence in their knowledge relates to performance on assessments, and whether this varies based on the stakes of the assessment.

Methods: Our retrospective repeated-measures design compared differences in patterns of physician answer accuracy and answer confidence among physicians participating in both a high-stakes and a low-stakes longitudinal assessment of the American Board of Family Medicine.

Racial/Ethnic Group Trajectory Differences in Exam Performance Among US Family Medicine Residents.

Background And Objectives: Racial/ethnic score disparities on standardized tests are well documented. Such differences on the American Board of Family Medicine (ABFM) certification examination have not been previously reported. If such differences exist, it could be due to differences in knowledge at the beginning of residency or due to variations in the rate of knowledge acquisition during residency.

The American Board of Family Medicine's 8 Years of Experience with Differential Item Functioning.

Introduction: Differential item functioning (DIF) procedures flag examination questions in which examinees from different subpopulations who are of equal ability do not have the same probability of answering it correctly. Few medical certification boards employ DIF procedures because they do not collect the needed data on the examinee's race or ethnicity. This article summarizes the American Board of Family Medicine's (ABFM) combined use of DIF procedures and an expert panel to review certification questions for bias.

Racial/Ethnic Representation Among American Board of Family Medicine Certification Candidates from 1970 to 2020.

Background: Because improved patient outcomes and experiences have been associated with health care workforce diversity, efforts to create a diverse family physician workforce have increased. However, a metric that could properly measure family physician representation in various contexts has seldom been studied.

Objective: The goal of this study is to propose a new metric logRQ and use it to examine the diversification progress of American Board of Family Medicine (ABFM) certification candidates relative to national, state, and historic populations, as well as medical school matriculants.

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.

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.

Comparative Analysis of the American Board of Family Medicine and American College of Osteopathic Family Physicians In-Training Examinations.

Background And Objectives: Family medicine residency programs accredited by the Accreditation Council for Graduate Medical Education and the American Osteopathic Association typically require their residents to take the American Board of Family Medicine's In-Training Examination (ITE) and the American College of Osteopathic Family Physicians' In-Service Examination (ISE). With implementation of the single accreditation system (SAS), is it necessary to administer both examinations? This pilot study assessed whether the degree of similarity for the construct of family medicine knowledge and clinical decision making as measured by both exams is high enough to be considered equivalent and analyzed resident ability distribution on both exams.

Methods: A repeated measures design was used to determine how similar and how different the rankings of PGY-3s were with regard to their knowledge of family medicine as measured by the ISE and ITE.

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.

Prevalence of Burnout in Board Certified Family Physicians.

Physician burnout has become a critical issue in a rapidly changing health care environment and is reported to be increasing. However, little is known about the prevalence of this problem among board-certified family physicians. Using an abbreviated burnout survey, we found a lower prevalence of this problem than has been previously reported.

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.