D.W. Price is senior vice president, Research and Education Foundation, and executive director, Multispecialty Portfolio Program, American Board of Medical Specialties, Chicago, Illinois, and professor, Department of Family Medicine, University of Colorado School of Medicine, Denver, Colorado; ORCID: https://orcid.org/0000-0002-7645-0126. H. Biernacki is manager, Research Operations, American Board of Medical Specialties, Chicago, Illinois. L.M. Nora is immediate past president and chief executive officer, American Board of Medical Specialties, Chicago, Illinois.
Acad Med. 2018 Dec;93(12):1872-1881. doi: 10.1097/ACM.0000000000002338.
To summarize the findings of studies, conducted by individuals both internal and external to the American Board of Medical Specialties (ABMS) Member Boards, of the associations of Maintenance of Certification (MOC) and improvements in physicians' knowledge and patient care processes or outcomes.
The authors conducted a narrative review of studies identified by searching PubMed and Web of Science for English-language articles from the United States published between 2000 and May 2017. To be included, articles had to examine the relationship of MOC to physician knowledge, clinical practice processes, or patient care outcomes. The initial search yielded 811 articles. After two rounds of review and excluding those articles that did not fit the study criteria, 39 articles were included for analysis.
The 39 included studies were conducted by or included diplomates of 12 ABMS Member Boards. Twenty-two studies examined MOC processes that were developed by an ABMS Board; 17 examined interventions that were developed by nonboard entities but accepted for MOC credit by an ABMS Board. Thirty-eight studies examined a single component of MOC; 24 studied the improvement in medical practice component. Thirty-seven studies reported at least one positive outcome.
Most of the studies included in this review highlighted circumstances in which MOC was associated with positive impacts on physician knowledge and patient care processes or outcomes. Future collaborative research is needed to improve the relevance, helpfulness, and generalizability of continuing certification to different physicians across specialties and practice settings.
总结美国医学专业委员会（ABMS）成员委员会内部和外部个人开展的研究结果，这些研究评估了持续认证（MOC）与医生知识、患者护理流程或结果的改进之间的关联。
作者通过在 PubMed 和 Web of Science 上搜索 2000 年至 2017 年 5 月期间在美国发表的英文文章，进行了叙述性综述。纳入标准为：研究必须检验 MOC 与医生知识、临床实践流程或患者护理结果之间的关系。初始搜索产生了 811 篇文章。经过两轮评审，并排除不符合研究标准的文章后，有 39 篇文章被纳入分析。
这 39 项纳入的研究由 12 个 ABMS 成员委员会的成员或其中的院士进行，其中 22 项研究检查了由 ABMS 委员会制定的 MOC 流程；17 项研究检查了由非委员会实体制定但被 ABMS 委员会接受作为 MOC 学分的干预措施。有 38 项研究仅检查了 MOC 的一个组成部分；24 项研究研究了医学实践组成部分的改进。有 37 项研究报告了至少一项积极结果。
本综述中纳入的大多数研究都强调了 MOC 与医生知识和患者护理流程或结果的积极影响之间存在关联的情况。未来需要开展合作研究，以提高继续认证对不同专业和实践环境下的医生的相关性、有益性和普遍性。
