The short answer is that after more than 30 years of basically the same certification maintenance process, we felt that we could improve things to more directly impact patient care while engaging certified PAs in more meaningful activities that encompass a broader range of PA competencies. We think that engaging in the thoughtful reflection that self-assessment evokes will help busy PAs to sometimes make more informed decisions about how they spend their limited CME time and dollars. We believe that taking time to review an aspect of practice, to identify an opportunity to improve it and then to make that change will have a real impact on your practice and – in many cases – your patients’ health.
The longer answer is that this started in 2003, when NCCPA launched an initiative to define PA competencies. In 2005, NCCPA, AAPA, PAEA and ARC-PA endorsed a document entitled Competencies for the PA Profession that had been developed cooperatively by those four organizations over a two-year period. The purpose of the Competencies document, as noted in its introduction, is “to communicate to the PA profession and the public a set of competencies that all physician assistants regardless of specialty or setting are expected to acquire and maintain throughout their careers.” It continues, “This document serves as a map for the individual PA, the physician-PA team and organizations that are committed to promoting the development and maintenance of these professional competencies among physician assistants.”
The document describes six categories of areas in which PAs should demonstrate competencies: medical knowledge, patient care, interpersonal and communication skills, professionalism, systems-based practice, and practice-based learning and improvement.
Since the adoption of the Competencies document in 2005, NCCPA has been considering whether and how to incorporate a broader range of the competencies described in that document into the PA certification maintenance process. Over the last several years, we considered a wide range of possibilities, ultimately focusing most closely on physician boards’ implementation of the maintenance of certification (MOC) requirements mandated in 2000 by the American Board of Medical Specialties. The ABMS MOC is a four-part model that includes requirements in the categories of (1) licensure and professional standing, (2) lifelong learning and self assessment, (3) cognitive expertise, and (4) practice-based improvement.
Drawing both from what the physician boards implemented and the lessons they learned during the process, NCCPA's Certification Committee—composed of certified PAs and physicians—developed recommendations that were shared with a number of national organizations and all certified PAs for comment. Discussions then continued for almost two more years during which one new concept was pilot tested and additional information was collected and considered. Today, NCCPA leaders believe that we have developed a process that will facilitate the process of lifelong learning and improvement in a way that benefits PAs and patients.