Longitudinal Knowledge Assessment as a driver for learning: insights from a nationwide survey of endocrinologists

Context: The American Board of Internal Medicine (ABIM) started offering the Longitudinal Knowledge Assessment (LKA) to endocrinologists as a 10-year Maintenance of Certification alternative in 2022. Participants answer 30 open-book online questions quarterly, receive real-time question-specific feedback and overall feedback via progress reports starting in year 2, and are assessed for competency every 5 years. Objective: To examine whether the LKA encouraged learning, motivated further study, and/or changed patient care. Design: We surveyed endocrinologists in 2024 who started LKA in 2022-2024 about their learning, study motivated by progress report feedback, patient care changes, and changes in the use of information resources. Results were weighted for nonresponse. Setting: Mid-career endocrinologists. Intervention: ABIM's LKA. Main outcomes: Reports of learning, motivated study, and patient care changes. Results: We surveyed 1649 endocrinologists, of whom 1015 responded to the survey (62% response). Overall, 95% of respondents reported learning while answering questions. Of those viewing their progress reports, 68% reported that they were motivated to study by the feedback. Motivated study was 17 percentage points greater for physicians with bottom vs top quartile first progress report preliminary scores. Additionally, 53% of physicians reported that LKA participation resulted in changes or planned changes to patient care. These reports were about 30 percentage points greater among physicians reporting that participation led to changes in the use of information resources, learning broader than question level, learning from question references, and study motivated by progress report feedback. Conclusion: Endocrinologists' LKA participation resulted in self-reports of patient care changes, broad learning, and motivated study.