title: Computer-based testing in family practice certification and recertification.
abstract: BACKGROUND
  The member boards of the American Board of Medical Specialties have agreed to expand the scope of certification to include assessment of medical knowledge, practice-based learning and improvement, patient care, interpersonal and communication skills, systems-based practice, and professionalism. Multiple-choice examinations provide limited ability to assess these dimensions.
  
  
  METHODS
  The American Board of Family Practice (ABFP) has developed a computer simulation system to facilitate more comprehensive candidate evaluation. The system consists of a knowledge base, a simulation program to create patient scenarios, an interface for presenting simulations to users, and an administrative database to track candidate performance and interactions with the system. The system uses population distributions for disease states to produce cases and evolves patients in response to candidate interventions, such as pharmacological and nonpharmacological therapies. We use Bayesian belief networks to model patient characteristics and comorbid condition interactions.
  
  
  RESULTS
  Simulations have been created for 7 disease states; ultimately simulations will be available for 25 to 30 disease states. Initial testing will take place in regional examination centers but will ultimately use the Internet for convenient access for certification and recertification candidates.
  
  
  CONCLUSIONS
  The ABFP will begin field-testing the system in early 2003 and will include simulations in the certification and recertification examination process in 2004.
authors.affiliation: Department of Family Practice, University of Kentucky, and Assessment Technologies, Inc, Lexington, KY 40505, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Hagen
authors.forename: Walton
authors.initials: W
authors.lastname: Sumner
authors.forename: Guy
authors.initials: G
authors.lastname: Roussel
authors.forename: Richard
authors.initials: R
authors.lastname: Rovinelli
authors.forename: Jinzhong
authors.initials: J
authors.lastname: Xu
mesh_terms: D001499:Bayes Theorem; D002568:Certification; D003198:Computer Simulation; D004521:Educational Measurement; D005194:Family Practice; D006801:Humans