ABPath’s plans for transparency, competency pilot

“If everyone knows the material, great!” he says. “Congratulations. I don’t want a certain percentage of people to have to fail. Let’s turn out a lot of great pathologists into the community.”

The ABPath isn’t the first to do this, he notes, citing dermatology, radiology, and pediatrics as examples of where detailed content outlines are in place. All these boards have clear content outlines, “which is in sync with modern education theory,” he says.

He can’t predict a completion date but he’s hoping for late 2024.

The third initiative, one Dr. Procop says is “further down the road,” is a voluntary, formative, competency-based in-training assessment pilot that will enable performance feedback. “Learners won’t have to wait to take a high-stakes exam and find out they have significant deficiencies in their ability. We would much rather people know their educational gaps ahead of time and have a chance to fill those gaps, then pass the Board exam and go out and be successful in the community.” The pilot, he says, will help inform ABPath with respect to the possible incorporation of competency-based assessment into the certification process.

He stresses that the ABPath is not creating another RISE exam. Instead, it is competency the ABPath wants to zero in on. “The ability to sit down at a microscope and make a diagnosis,” he explains. Breast pathology will be the focus of the pilot, “with a library of virtual microscopic slides that contain important breast pathology diagnoses.” When a program director agrees that a resident is prepared fully for a breast pathology sign-out, then the resident will be able to log in to the ABPath website to do a simulated sign-out “and test their mettle,” Dr. Procop says. The cases will be presented in a random manner; the resident will get a random selection—15 of 100 cases, for example. “They won’t know what’s in the stack of slides,” whether a breast cancer or a benign lesion, an infection or normal tissue.

They will be expected to be able to make every diagnosis in their simulated sign-out, “just like in actual practice. They’ll get the diagnoses right or wrong, and what they’ll also get is an educational critique that accompanies the slides. The idea is we want people to know where their gaps are so they can fill them prior to certification and independent practice.”

He likens it to a batting cage: “If you want people to be able to hit the ball hard and far, then let them get in the batting cage as much as they like.” How often can a person do the simulated sign-out? “As many times as possible. If you really want good pathologists, let them practice in the ‘flight simulator’ as much as needed to master the skills required for safe and effective practice.”

“It’s all about where learning meets assessment,” he says, but it’s about testing more than book knowledge. “And competency-based assessment goes hand in glove with competency-based education, which is a hot topic in the pathology education community.”

The theme of the changes that are underway is that the ABPath is a partner in lifelong medical education, Dr. Procop says, from residency to continuing certification, “and in helping pathologists be their best. We’re going to keep pushing in that direction.”

Valerie Neff Newitt is a writer in Audubon, Pa.