Cognitive Perspectives on Maintaining Physicians' Medical Expertise: I. Reimagining Maintenance of Certification to Promote Lifelong Learning
Cognitive Research: Principles and Implications (07/24/23) Vol. 8, No. 46 Rottman, Benjamin M.; Caddick, Zachary A.; Nokes-Malach, Timothy J.; et al.
Experts present a theoretical framework for longitudinal assessment of physicians' clinical knowledge in relation to the medical boards' transition to lifelong learning. An analysis of cognitive perspectives on longitudinal assessment in maintaining the quality of doctors' knowledge and expertise highlights the need to keep their cognitive skills current. The authors cite clinical experience gained over time, cognitive aging and changing standards of care as parallel factors reinforcing the need for lifelong learning. Moreover, self-assessment is not always sufficient for keeping clinicians' skills and knowledge current, sometimes demanding supplementary and objective tools such as continuing certification programs. The researchers also find longitudinal assessment can augment clinicians' learning and knowledge retention through testing. The goals and consequences of testing can further encourage physicians to learn when the perceived advantages offset the disadvantages. Given that learners' knowledge and skills tend to suffer from insufficient feedback, "we expect that better learning through testing with feedback should improve both accuracy and metacognitive understanding of one's abilities," the authors write. An assessment of various lifelong learning options reveals trade-offs with each, with continuing medical education's encouragement of self-directed learning a key benefit. "It seems to us that longitudinal assessment fills a similar role as traditional certification in that they both provide retrieval practice and consequences, but longitudinal assessment provides a superior learning opportunity through its use of feedback, spaced learning and potentially being somewhat self-directed," the researchers write. They also highlight the potential for collaboration between cognitive and learning disciplines and medical boards "to conduct studies of longitudinal assessment programs that both test ways to improve learning within longitudinal assessment and advance the basic science of learning."
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