Microsoft Word - July 2020 - RLET 873 - proof - returned.docx SKIN July 2020 Volume 4 Issue 4 Copyright 2020 The National Society for Cutaneous Medicine 328 RESEARCH LETTERS A Survey-Based Study on Maintenance of Certification Programs during Grand Rounds at UT Southwestern Medical Center Anisha Guda1, Travis Vandergriff, MD2, Melissa M. Mauskar, MD2 1UT Health San Antonio Long School of Medicine, San Antonio, TX 2Department of Dermatology, UT Southwestern Medical Center, Dallas, TX To the Editor: Maintenance of Certification (MOC) is a recertification program required by the American Board of Dermatology (ABD) for dermatologists.1 The program was created to supplement continuing medical education (CME) by giving physicians the opportunity to participate in meaningful practice improvement and self-assessment compared to their peers while also providing a mechanism for physician self-regulation. One component of MOC is a periodic self- assessment where dermatologists are required to complete three 100-question self-assessment modules over a 10-year period.2 MOC programs assess knowledge, communication, patient safety, and practice performance.3 In many cases, these activities are obtained at national meetings or through practice improvement modules. The American Academy of Dermatology has attempted to make the process of obtaining MOC credit easier by providing JAAD ABSTRACT Background: Maintenance of Certification (MOC) is a recertification program required by the American Board of Dermatology (ABD). The program was created because continuing medical education (CME) was viewed as inadequate in keeping physicians’ knowledge up to date. In July 2016, UTSW incorporated MOC content into Grand Rounds. Objective: To identify whether dermatologists at UTSW find MOC Grand Rounds to be useful and whether this process could be utilized in other institutions. Methods: A five question survey was piloted by a few dermatologists at UTSW. The survey was emailed to dermatologists who attended the MOC Grand Rounds. Three questions were scored on a scale of 1-6 (1= strongly disagree, 2=moderately disagree, 3= neutral, 4= mildly agree, 5= moderately agree, 6=strongly agree) with 2 free response questions. Results: 13/20 dermatologists responded to the survey (65% response rate). 11/13 dermatologists (84.6%) reported that MOC at Grand Rounds is valuable to them. 11/13 dermatologists (84.6%) reported that other dermatology programs should incorporate this method of obtaining MOC credit. 9/13 dermatologists (69.2%) reported audience response sessions improve the Grand Rounds experience. Conclusion: Dermatologists found the MOC content to be useful when incorporated into Grand Rounds. SKIN July 2020 Volume 4 Issue 4 Copyright 2020 The National Society for Cutaneous Medicine 329 Table 1. Survey Results on Likert Scale Regarding MOC Grand Rounds at UTSW quizzes, case challenges, and questions of the week.1 Most academic medical centers have regular clinical conferences (Grand Rounds) where both faculty and residents discuss difficult cases. These conferences are the ideal avenue for obtaining Self-Assessment MOC (SA MOC) credit given the inherent nature of discussion: application of multi- generational clinical experiences and identification of ways to improve patient care. In June 2016, we applied to receive SA MOC 2 credit at monthly Grand Rounds. From July 2016 to July 2017, the University of Texas at Southwestern Medical Center (UTSW) incorporated SA MOC content into Grand Rounds. Once a month, interesting clinical cases were presented to the group. At the end of each patient case, there were at least three multiple choice clinical questions presented to the audience. The audience then responded using poll everywhere (an internet-based audience response system) to see how they answered compared to their peers. Participants could earn up to 10 credits in 1 hour for their participation. After a 12-month pilot period, a survey was sent to participants to identify whether this activity was useful and if they felt this method of obtaining MOC credit could be utilized in other institutions. A five-question survey was developed and piloted by the authors and emailed to dermatologists who attended MOC Grand Rounds at UTSW Medical Center. The survey questions consisted of three questions that were scored on a Likert scale of 1-6 (1= strongly disagree, 2=moderately disagree, 3= neutral, 4= mildly agree, 5= moderately agree, 6=strongly agree) and 2 free response questions. Results were collected and analyzed through Survey Monkey. 13 out of 20 dermatologists responded to the survey (65% response rate). The survey questions and responses are shown in Table 1 and Figure 1. Respondents reported that they liked Grand Rounds oriented to MOC. 11 out of 13 dermatologists (84.6%) reported that MOC at Grand Rounds is of value to them. 11 out of 13 dermatologists (84.6%) reported that other dermatology programs should incorporate this method of obtaining MOC credit. Additionally, 9 out of 13 dermatologists (69.2%) reported that audience response sessions improve the Grand Rounds experience. It should be noted that the percentages mentioned were summations of those who chose 4 (mildly agree), 5 (moderately agree), or 6 (strongly agree) on the Likert scale for each question. Dermatologists also mentioned that they desired more live patient presentations, faculty present, and audience participation 1 Strongly Disagree 2 Moderately Disagree 3 Neutral 4 Mildly Agree 5 Moderately Agree 6 Strongly Agree Audience response sessions improve the Grand Rounds experience. 0% 0% 30.77% 23.08% 23.08% 23.08% Maintenance of Certification at Grand Rounds is of value to me. 0% 0% 15.38% 23.08% 30.77% 30.77% I would recommend other dermatology programs incorporate this method of obtaining MOC credit into their Grand Rounds. 0% 7.69% 7.69% 30.77% 15.38% 38.46% SKIN July 2020 Volume 4 Issue 4 Copyright 2020 The National Society for Cutaneous Medicine 330 during Grand Rounds. Other suggestions to improve Grand Rounds included more discussion about common diseases and treatment options, more content on cutting edge treatment and evaluation, more outside speakers, usage of dermatologic medications in the elderly and modifications in dosing/considerations in caring for the extremely aged, wound care materials and their evidence, discussion on the effect of sunscreens on coral reefs and evidence, updates on chemoprophylaxis of skin cancers and their indications, usage of white boards, and having someone write out descriptions in real time. The intended goal of Maintenance of Certification is to help dermatologists improve their overall patient care. Departmental Grand Rounds offers a convenient and beneficial way to receive qualifying credits for MOC. Dermatologists are able to engage in educational discussion on clinical cases and meet the essential goals of MOC. Future studies on how other institutions view Departmental Grand Rounds would help determine whether it should be an established practice at academic programs. Figure 1. Graphical Representation of Survey Results Conflict of Interest Disclosures: None Funding: None Corresponding Author: Anisha Guda, BS UT Health San Antonio Long School of Medicine 7703 Floyd Curl Drive, San Antonio TX Email: gudav@livemail.uthscsa.edu References: 1. Maintenance of Certification. American Academy of Dermatology. Retrieved from < https://www.aad.org/education/moc>. 2. Horn T. Program for Maintenance of Certification by the American Board of Dermatology. Cutis. 2017;99(6):376-377. 3. Stratman E, Kirsner RS, and Horn TD. Maintenance of Certification in dermatology: What we know, what we don’t. JAAD. 2013;69(1):e1-e11. DOI: https://doi.org/10.1016/j.jaad.2013.03.033 Audience response sessions improves the Grand Rounds experience 1 2 3 4 5 6 Maintenance of Certification at Grand Rounds is of value to me 1 2 3 4 5 6 I would recommend other dermatology programs incorporate this method of obtaining MOC credit into their Grand Rounds 1 2 3 4 5 6