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TRANSCRIPT
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10/5/2016
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Update from NCCPA
Denni J. Woodmansee, MS, PA-CChair, NCCPA Board of Directors
Presentation Outline
About NCCPA
The Certification Maintenance Process Focus on Recent Changes to CME Requirements
The Latest on Potential Changes to PANRE
A Brief Overview of NCCPA
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About NCCPA
Only national certifying body for PAs
Certifying PAs since 1975
Passionate about PAs and the patients you serve
Promote qualifications and roles of certified PAs to various audiences (physicians, employers, state medical boards, public, etc.)
Engage in significant communications/PR efforts on your behalf: www.PAsDoThat.net
Our Current Board of Directors
10 PAs, 6 physicians and 2 public members, including nominees from...
American Academies of:
Family Physicians
Pediatrics
Physician Assistants
American College of Physicians
American Medical Association
American Osteopathic Association
Association of American Medical Colleges
Federation of State Medical Boards
PA Education Association
US Department of Veterans Affairs
But thats only part of the story
PA Involvement with NCCPA Adds Up!
77 PA item writers serve on item writing committees, writing questions that appear on PANCE, PANRE and the CAQ exams
In 2015, NCCPA hosted 34 PA team meetings to develop and validate exam questions, set passing standards
59 PAs spent three days with us working to identify content that represents core medical knowledge
15 PAs serve on promotion and publicity councils, supporting our efforts to generate story ideas and press coverage for the profession
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PA Involvement with NCCPA Adds Up!
72 PAs served on 2015 Practice Analysis workgroups, helping identify the knowledge, skills and abilities that were included on that survey
Approximately 16,000 PAs responded to the Practice Analysis survey
Nearly 100,000 PAs have completed the PA Professional Profile
In 2015, 29 PAs participated in a 3-day focus group to talk about PANRE
More than 30,000 participated in survey of all certified PAs about proposed new PANRE model
PAs Do That!Help us tell others about the great work you do!
Share What You Do In Practice!
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Certification Maintenance Process
Certification Maintenance Process
100 CME credits every two years
50 Category 1 credits
Self-assessment CME and PI-CME are now optional
PANRE every 10 years
Reasons for the Latest Changes
NCCPA heard the concerns from PAs about the burdens of the certification maintenance process
Conducted an in-depth review of existing SA/PI activities with particular emphasis on the gaps in availability of practice-relevant options for so many PAs
Found inadequate coverage of self-assessment in 31 specialty areas and of PI-CME in 13 specialty areas.
That means we ran the risk of PAs pursuing CME activities with little or no relevance for them just to meet this NCCPA requirement never what we intended.
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Reasons for the Latest Changes
Based upon those findings, the NCCPA Board voted to make changes:
SA and PI-CME are no longer required now optional
SA and PI activities are valuable, so NCCPA will begin awarding additional credit weighting SA and PI-CME more heavily than regular Category 1 CME
Some Specifics
All approved self-assessment CME activities will be awarded 50% bonus credits by NCCPA
In each 2-year CME cycle, the first 20 PI-CME credits logged will be doubled
The weighting will be applied by NCCPA and will be retroactive
You will see these changes on your certification dashboard later this year
Weighting will apply to all PAs who complete (or have completed) SA/PI activities whether on the 6-year cycle or the 10-year cycle
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What Is Self-Assessment (SA)?
Self-assessment is the process of conducting a systematic review of ones own performance, knowledge base or skill set for the purpose of improving future performance, expanding knowledge, or honing skills.
2012 study concluded that more than 20% of core information guiding clinical practice is changed within one year based on new evidence or guidelines.
What Is Performance Improvement (PI) CME?
PI-CME is a process of active learning and the application of learning to improve your practice and ultimately to enhance patient care
What is Performance Improvement (PI) CME?
A traditional, approved PI-CME activity includes three stages for which you can earn CME credit:
Stage A - Identify evidence-based measure and assess practice (5 PI-CME credits)
Stage B - Intervention(s) (5 PI-CME credits)
Stage C - Re-measure; document improvement (5 PI-CME credits)
Completing all 3 stages (bonus of 5 PI-CME credits)
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Finding Self-Assessment and PI-CME Activities
Currently over 200 Self-Assessment and over 50 PI-CME activities in many different specialty areas (with more under review)
Prices range from FREE to $400 depending on the sponsor and the number of credits offered. Ongoing efforts to ensure lowest cost possible
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More on PI-CME
Can be done in partnership with PAs, physicians, and others in your practice
Most board-certified physicians also have this requirement
What are the options for identifying a PI-CME activity for me?
1. A traditional PI CME activity (like METRIC or EQIPP)
2. An activity or project that has been developed by an employer or institution and approved by AAPA (e.g. Cleveland Clinic, MD Anderson) -- could also be a QI activity that a PA is already doing
3. An activity or project that has been developed by an individual PA or group of PAs and approved by AAPA
Hospital and Health System Quality Improvement
Allows PAs to organize QI activities in their own practice settings, or formalize their involvement in existing QI projects and receive PI-CME credits
Requires official involvement with organizations QI Department
Define project goals and quality measures used
Define team and resources
Define criteria for meaningful participation
Submit data package in specified format
Separate application type on AAPA CME application site institutional fee is $250, no charge to individual PAs
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AAPAs PI Builder
Allows an individual PA to customize her/his own PI-CME module by selecting clinical measures from a library
Process facilitated online
3 options for participation
Option 1: Choose measures from a measure library
Option 2: Submit your own measures for approval
Option 3: Document your involvement in a completed QI project
$75 for AAPA members, $150 for non-members
PI-CME on Patient Safety
Johns Hopkins-developed online certificate course
Approved for 20 PI-CME Category 1 credits
Can be completed by PAs in any specialty or practice area
Can also be completed by PAs who are not in clinical practice at all
Given the recent NCCPA BOD action, completing this activity would count for 40 Category 1 credits
Latest on Potential Changes to PANRE
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NCCPAs Responsibility
It is critical to NCCPAs mission to provide a certification/recertification program that is:
meaningful and relevant provides assurance for patients, employers, state
licensing boards, and others regarding PAs knowledge and skills
To do this, NCCPA must continuously monitor and evolve the certification process because things change:
advances in technology rapid changes in medicine changes in the PA profession
2016 NCCPA. All rights reserved.
Why Consider Changes to PANRE?
PA practice has changed (more than 70% practicing in specialties other than primary care)
Are we still most effectively fulfilling our obligation to the public with the current format for PANRE?
PAs have asked for change
Desire to be tested on content relevant to their current role
Questions about the difficulty of PANRE
Cost and time required to prepare for todays PANRE
Key Messages from the Public Comment Period
PAs are very concerned about maintaining their ability to change specialties and do not want to see that threatened
PAs are very concerned about the cost and time required to maintain certification (CME and exam requirements)
If they must take an exam, PAs would prefer one that is more relevant to their practice than todays PANRE
Exams matter to the public and to state medical boards (other stakeholders not yet surveyed)
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Challenges for NCCPA
Maintain the generalist nature of the PA-C
Protect PAs flexibility to change specialties (seen by most PAs as a very important aspect of the profession)
Improve the relevance and value of the exam by addressing its content and its educational value
Should facilitate lifelong learning
Maintain the integrity and appropriate rigor of the process
Validity in the eyes of external stakeholders to the certification process
Our Response Thus Far
Analyzed the availability and cost of self-assessment and PI-CME, found the options lacking, and eliminated those requirements
Launched an effort to define core medical knowledge so we can increase PANREs focus on assessing core knowledge that is foundational to all PA practice
To strengthen our position that the PA-C should continue to be viewed as and relied on as a generalist credential: We are considering a core medical knowledge exam
as the capstone event of the 10-year cycle. We are exploring other ways to integrate practice-
related elements into the process
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The Current Controversy
Some are arguing for the elimination of the recertification exam, saying it has no real value
In fact, evidence shows that recertifying by exam
Supports knowledge retention
Illuminates areas of knowledge deficiency that many are unable to self-identify
Improves practice to a greater degree than CME alone
Matters to the public and other stakeholders
Represents the high standards of the PA profession that have contributed to the professionssuccess for > 40 years
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Consider the Consequences
No one likes exams, but if there was no PANRE, how would state licensing boards, employers, insurers, payers and patients view that lowering of standards?
Would the profession be more credible or less credible?
Would PAs do a better or worse job at keeping up to date on medical knowledge?
Would it be easier or harder for PAs to change specialties?
Would our malpractice insurance rates be lower or higher?
Would the fight for full practice authority be easier or harder?
Would patients be safer or less safe?
For More Information
Read NCCPA News, our monthly e-newsletter
Visit our website --- specifically:
https://www.nccpa.net/panre-model
Bibliography of references:
http://www.nccpa.net/Uploads/docs/TheEvidenceBase.pdf
Thank You!Questions?
www.nccpa.net