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Revalidation of Surgeons in Practice

  • Ajit K. SachdevaEmail author
Chapter
Part of the Innovation and Change in Professional Education book series (ICPE, volume 17)

Overview

Revalidation of surgeons in practice continues to evolve rapidly. Articulating the overall aim of revalidation as adherence to safe standards of practice, this chapter explores common goals and nuanced differences in approaches to revalidation in various countries. The different approaches are a result of disparate regulatory systems and roles of professional organizations. After describing contemporary factors affecting revalidation as an important professional consideration, its relationship to continuing professional development is explored. The author describes two types of revalidation: “Global” and “Focused.” The latter relates to changes in the practices of individual surgeons and is illustrated through three case studies. Finally, strategies to support revalidation efforts are proposed.

Keywords

Revalidation Maintenance of certification Professional practice Regulatory body Medical board Continuing professional development Patient safety Practice-based learning and improvement Quality Recertification Reentry Focused Professional Practice Evaluations Ongoing Professional Practice Evaluations Quality framework CanMEDS Continuing medical education 

Notes

Disclaimer

The opinions expressed in this chapter are those of the author and do not necessarily represent the official position of the American College of Surgeons.

References

  1. 1.
    Shaw, K., Cassel, C. K., Black, C., & Levinson, W. (2009). Shared medical regulation in a time of increasing calls for accountability and transparency: Comparison of recertification in the United States, Canada, and the United Kingdom. Journal of the American Medical Association, 302(18), 2008–2014.CrossRefGoogle Scholar
  2. 2.
    Birkmeyer, J. D., Finks, J. F., O’Reilly, A., Oerline, M., Carlin, A. M., Nunn, A. R., et al. (2013). Surgical skill and complication rates after bariatric surgery. New England Journal of Medicine, 369(15), 1434–1442.CrossRefGoogle Scholar
  3. 3.
    Buyske, J. (2016). Forks in the road: The assessment of surgeons from the American Board of Surgery Perspective. Surgical Clinics of North America, 96, 139–146.CrossRefGoogle Scholar
  4. 4.
    Hawkins, R., Roemheld-Hamm, B., Ciccone, A., Mee, J., & Tallia, A. (2009). A multimethod study of needs for physician assessment: Implications for education and regulation. The Journal of Continuing Education in the Health Professions, 29(4), 220–234.CrossRefGoogle Scholar
  5. 5.
    Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds.). (2000). To err is human: Building a safer health system. Washington, DC: National Academy Press.Google Scholar
  6. 6.
    Committee on Quality of Health Care in America, Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press.Google Scholar
  7. 7.
    Greiner, A. C., & Knebel, E. (Eds.). (2003). Health professions education: A bridge to quality. Washington, DC: National Academies Press.Google Scholar
  8. 8.
    Hager, M., Russell, S., & Fletcher, S. W. (2008). Continuing education in the health professions: Improving healthcare through lifelong learning. New York: Josiah Macy, Jr. Foundation.Google Scholar
  9. 9.
    Cuschieri, A., Francis, N., Crosby, J., & Hanna, G. B. (2001). What do master surgeons think of surgical competence and revalidation? American Journal of Surgery, 182, 110–116.CrossRefGoogle Scholar
  10. 10.
    Benson, J. A., Jr. (1991). Certification and recertification: One approach to professional accountability. Annals of Internal Medicine, 114(3), 238–242.CrossRefGoogle Scholar
  11. 11.
    Youngson, G. G., Knight, P., Hamilton, L., Taylor, I., Tanner, A., Steers, J., et al. (2010). The UK proposals for revalidation of physicians: Implications for the recertification of surgeons. Archives of Surgery, 145(1), 92–95.CrossRefGoogle Scholar
  12. 12.
    Norcini, J., & Talati, J. (2009). Assessment, surgeon, and society. International Journal of Surgery, 7, 313–317.CrossRefGoogle Scholar
  13. 13.
    Sachdeva, A. K. (2016). Continuing professional development in the twenty-first century. The Journal of Continuing Education in the Health Professions, 36(Sl), S8–S13.CrossRefGoogle Scholar
  14. 14.
    Sachdeva, A. K. (2005). The new paradigm of continuing education in surgery. Archives of Surgery, 140(3), 264–269.CrossRefGoogle Scholar
  15. 15.
    Accreditation Council for Graduate Medical Education. Milestones annual report 2016. Available at http://www.acgme.org/Portals/0/PDFs/Milestones/MilestonesAnnualReport2016.pdf. Accessed 2 May 2019.
  16. 16.
    American Board of Medical Specialties. Based on core competencies. Available at http://www.abms.org/board-certification/a-trusted-credential/based-on-core-competencies/. Accessed 2 May 2019.
  17. 17.
    The Royal College of Physicians and Surgeons of Canada. About CanMEDS. Available at http://www.royalcollege.ca/rcsite/canmeds/about-canmeds-e. Accessed 2 May 2019.
  18. 18.
    Horsley, T., Lockyer, J., Cogo, E., Zeiter, J., Bursey, F., & Campbell, C. (2016). National Programmes for validating physician competence and fitness for practice: A scoping review. BMJ Open, 6, 1–10.CrossRefGoogle Scholar
  19. 19.
    American Board of Medical Specialties. Continuing board certification: Vision for the future final report. Available at http://www.abms.org/media/194956/commission_final_report_20190212.pdf. Accessed 2 May 2019.
  20. 20.
    American Board of Medical Specialties. CertLink delivers longitudinal assessment online. Available at http://www.abms.org/initiatives/certlink/. Accessed 2 May 2019.
  21. 21.
    American Board of Surgery. Continuous certification. Available at http://www.absurgery.org/default.jsp?exam-moc. Accessed 2 May 2019.
  22. 22.
    American College of Surgeons. CME state requirements. Available at https://www.facs.org/education/cme/state-mandates. Accessed 2 May 2019.
  23. 23.
    Campbell, C. M., & Parboosingh, J. (2013). The Royal College Experience and plans for the maintenance of certification program. The Journal of Continuing Education in the Health Professions, 33(S1), S36–S47.CrossRefGoogle Scholar
  24. 24.
    Royal College of Physicians and Surgeons of Canada. A concise guide to maintenance of certification. Available at http://www.royalcollege.ca/rcsite/documents/continuing-professional-development/moc-short-guide-e.pdf. Accessed 3 May 2019.
  25. 25.
    Federation of Medical Regulatory Authorities of Canada. Position statement on professional revalidation of physicians. Available at http://fmrac.ca/professional-revalidation-of-physicians/. Accessed 2 May 2019.
  26. 26.
    Levinson, W. (2008). Revalidation of physicians in Canada: Are we passing the test? [Editorial]. Canadian Medical Association Journal, 179(10), 979–980.CrossRefGoogle Scholar
  27. 27.
    Boulet, J., & van Zanten, M. (2014). Ensuring high-quality patient care: The role of accreditation, licensure, specialty certification and revalidation in medicine. Medical Education, 48, 75–86.CrossRefGoogle Scholar
  28. 28.
    Archer, J., & de Bere, S. R. (2013). The United Kingdom’s experience with and future plans for revalidation. The Journal of Continuing Education in the Health Professions, 33(S1), S48–S53.CrossRefGoogle Scholar
  29. 29.
    Archer, J., de Bere, S. R., Nunn, S., Clark, J., & Corrigan, O. (2015). “No one has yet properly articulated what we are trying to achieve”: A discourse analysis of interviews with revalidation policy leaders in the United Kingdom. Academic Medicine, 90, 88–93.CrossRefGoogle Scholar
  30. 30.
    Federation of Surgical Specialty Associations, The Royal College of Surgeons of Edinburgh, The Royal College of Surgeons of England, The Royal College of Physicians and Surgeons of Glasgow. Revalidation: Guide for surgery. January 2014.Google Scholar
  31. 31.
    Sachdeva, A. K., Flynn, T. C., Brigham, T. P., Dacey, R. G., Jr., Napolitano, L. M., Bass, B. L., et al. (2014). Interventions to address challenges associated with the transition from residency training to independent surgical practice. Surgery, 155(5), 867–882.CrossRefGoogle Scholar
  32. 32.
    The Joint Commission. (2013). Standards BoosterPak™ for focused professional practice evaluation/ongoing professional practice evaluation (FPPE/OPPE). Oakbrook Terrace, IL: The Joint Commission.Google Scholar
  33. 33.
    Sachdeva, A. K., & Russell, T. R. (2007). Safe introduction of new procedures and emerging Technologies in Surgery: Education, credentialing, and privileging. Surgical Clinics of North America, 87(4), 853–866.CrossRefGoogle Scholar
  34. 34.
    Sachdeva, A. K., Blair, P. G., & Lupi, L. K. (2016). Education and training to address specific needs during the career progression of surgeons. Surgical Clinics of North America, 96(1), 115–128.CrossRefGoogle Scholar
  35. 35.
    Sachdeva, A. K. (2005). Acquiring skills in new procedures and technology: The challenge and the opportunity. Archives of Surgery, 140(4), 387–389.CrossRefGoogle Scholar
  36. 36.
    Bass, B. L., Polk, H. C., Jones, R. S., Townsend, C. M., Whittemore, A. D., Pellegrini, C. A., et al. (2009). Surgical privileging and credentialing: A report of a discussion and study Group of the American Surgical Association. Journal of the American College of Surgeons, 209(3), 396–404.CrossRefGoogle Scholar
  37. 37.
    American Board of Surgery. Guidelines on re-entry to surgical practice. Available on http://www.absurgery.org/default.jsp?policypracticereentry. Accessed 2 May 2019.
  38. 38.
    Holmboe, E. S., Wang, Y., Meehan, T. P., Tate, J. P., Ho, S. Y., Starkey, K. S., et al. (2008). Association between maintenance of certification examination scores and quality of Care for Medicare Beneficiaries. Archives of Internal Medicine, 168(13), 1396–1403.CrossRefGoogle Scholar
  39. 39.
    Lipner, R. S., Hess, B. J., & Phillips, R. L., Jr. (2013). Specialty board certification in the United States: Issues and evidence. The Journal of Continuing Education in the Health Professions, 33(S1), S20–S35.CrossRefGoogle Scholar
  40. 40.
    Sachdeva, A. K., Pellegrini, C. A., & Johnson, K. A. (2008). Support for simulation-based surgical education through American College of Surgeons-accredited education institutes. World Journal of Surgery, 32(2), 196–207.CrossRefGoogle Scholar
  41. 41.
    American College of Surgeons. Accredited education institutes. Available on https://www.facs.org/education/accreditation/aei. Accessed 2 May 2019.

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Division of EducationAmerican College of SurgeonsChicagoUSA

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