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Longitudinal Assessment for Continuing Certification of Anesthesiologists: Utilization, Performance, and Perception of Maintenance of Certification in Anesthesiology (MOCA) Minute.

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Title: Longitudinal Assessment for Continuing Certification of Anesthesiologists: Utilization, Performance, and Perception of Maintenance of Certification in Anesthesiology (MOCA) Minute.
Authors: Sun H; Assessment Services, American Board of Anesthesiology, Raleigh, North Carolina., Lee Y; Assessment Services, American Board of Anesthesiology, Raleigh, North Carolina., Harman AE; Assessment Services, American Board of Anesthesiology, Raleigh, North Carolina., Macario A; Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California., Deiner SG; Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire., Minhaj M; Department of Anesthesia, Endeavor Health, Evanston, Illinois., Cook DA; Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota., Warner DO; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota.
Source: Anesthesiology [Anesthesiology] 2026 Sep 01; Vol. 145 (3), pp. 724-733. Date of Electronic Publication: 2026 Jun 01.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 1300217 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-1175 (Electronic) Linking ISSN: 00033022 NLM ISO Abbreviation: Anesthesiology Subsets: MEDLINE
Imprint Name(s): Publication: Philadelphia Pa : Lippincott Williams & Wilkins
Original Publication: Philadelphia : American Society of Anesthesiologists
MeSH Terms: Certification*/standards , Certification*/methods , Anesthesiologists*/standards , Anesthesiologists*/education , Anesthesiologists*/statistics & numerical data , Anesthesiology*/education , Anesthesiology*/standards , Clinical Competence*/standards , Education, Medical, Continuing*/standards, Humans ; Longitudinal Studies ; Female ; Male ; Specialty Boards ; Surveys and Questionnaires ; Perception
Abstract: Background: Longitudinal assessments are increasingly common as a component of continuing certification programs offered by medical specialty boards. The goal of this study was to understand anesthesiologists' utilization pattern, performance, and perception of the longitudinal assessment program administered by the American Board of Anesthesiology (Raleigh, North Carolina).
Methods: The authors analyzed assessment usage and survey data from all anesthesiologists who participated in the Maintenance of Certification in Anesthesiology (MOCA) Minute from January 2018 to December 2019.
Results: During the 24-month study period, 25,404 anesthesiologists completed all 120 questions assigned in at least 1 calendar year, collectively 5,801,160 responses to 1,646 unique questions. Participants were more likely to complete questions at the end of each quarter, with the highest frequency at the end of the year. Seventy-five percent of responses were first-time attempts, and 17% were first repeats. The median interval between original question presentation and first repeat was 314 days. The mean ± SD percent correct score was 68.3 ± 8.0% for first-time questions and 75.5 ± 12.6% for first repeats. The mean ± SD time to answer a first-time question was 26.8 ± 13.1 s, with shorter times for questions with correct than incorrect responses (25.0 ± 12.7 vs . 30.7 ± 13.3 s; time difference, -5.69 s; 95% CI, -5.71 to -5.66; P < 0.001). Of 5.11 million responses with ratings of relevance (88.2% of all responses analyzed), 4.86 million (95.2%) were felt to be somewhat or very relevant to practice. The percent correct scores were higher for responses with higher relevance and confidence ratings. For responses rated "not relevant," "somewhat relevant," and "very relevant," the percent correct was 58.5%, 67.6%, and 77.0%, respectively; for responses rated as "unsure," "somewhat confident," and "very confident," the percent correct was 53.6%, 67.9%, and 84.4%, respectively.
Conclusions: MOCA Minute was generally used as designed. Evidence of learning was suggested by improved performance on repeat questions.
(Copyright © 2026 American Society of Anesthesiologists. All Rights Reserved.)
References: Culley DJ, Sun H, Harman AE, Warner DO: Perceived value of board certification and the Maintenance of Certification in Anesthesiology Program (MOCA®). J Clin Anesth 2013; 25:12–9. doi:10.1016/j.jclinane.2012.09.001. (PMID: 10.1016/j.jclinane.2012.09.001)
Cook DA, Blachman MJ, West CP, Wittich CM: Physician attitudes about maintenance of certification: A cross-specialty national survey. Mayo Clin Proc 2016; 91:1336–45. doi:10.1016/j.mayocp.2016.07.004. (PMID: 10.1016/j.mayocp.2016.07.004)
Sun H, Zhou Y, Culley DJ, Lien CA, Harman AE, Warner DO: Association between participation in an intensive longitudinal assessment program and performance on a cognitive examination in the Maintenance of Certification in Anesthesiology Program®. A nesthesiology 2016; 125:1046–55. doi:10.1097/ALN.0000000000001301. (PMID: 10.1097/ALN.0000000000001301)
Schnabel S, Jones A, Brossman B, Ogrinc G: Best practices for longitudinal assessment in continuing certification: Consensus-based guidelines from American Board of Medical Specialties (ABMS) Member Boards. J Med Regul 2025; 111:31–40. doi:10.30770/2572-1852-111.2.31. (PMID: 10.30770/2572-1852-111.2.31)
Leslie LK, Turner AL, Smith AC, Dounoucos V, Olmsted MG, Althouse L: Pediatrician perspectives on feasibility and acceptability of the MOCA-Peds 2017 pilot. Pediatrics 2019; 144:e20192303. doi:10.1542/peds.2019-2303. (PMID: 10.1542/peds.2019-2303)
Turner AL, Olmsted M, Smith AC, et al.: Pediatrician perspectives on learning and practice change in the MOCA-Peds 2017 pilot. Pediatrics 2019; 144:e20192305. doi:10.1542/peds.2019-2305. (PMID: 10.1542/peds.2019-2305)
Cook DA, Blachman MJ, Price DW, West CP, Berger RA, Wittich CM: Professional development perceptions and practices among U.S. physicians: A cross-specialty national survey. Acad Med 2017; 92:1335–45. doi:10.1097/ACM.0000000000001624. (PMID: 10.1097/ACM.0000000000001624)
Kerfoot BP, DeWolf WC, Masser BA, Church PA, Federman DD: Spaced education improves the retention of clinical knowledge by medical students: A randomised controlled trial. Med Educ 2007; 41:23–31. doi:10.1111/j.1365-2929.2006.02644.x. (PMID: 10.1111/j.1365-2929.2006.02644.x)
Karpicke JD, Roediger HL III: The critical importance of retrieval for learning. Science 2008; 319:966–8. doi:10.1126/science.1152408. (PMID: 10.1126/science.1152408)
Larsen DP, Butler AC, Roediger HL III: Test-enhanced learning in medical education. Med Educ 2008; 42:959–66. doi:10.1111/j.1365-2923.2008.03124.x. (PMID: 10.1111/j.1365-2923.2008.03124.x)
Rohrer D, Pashler H: Recent research on human learning challenges conventional instructional strategies. Educ Res 2010; 39:406–12. doi:10.3102/0013189x10374770. (PMID: 10.3102/0013189x10374770)
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Zhou Y, Sun H, Culley DJ, Young A, Harman AE, Warner DO: Effectiveness of written and oral specialty certification examinations to predict actions against the medical licenses of anesthesiologists. A nesthesiology 2017; 126:1171–9. doi:10.1097/ALN.0000000000001623. (PMID: 10.1097/ALN.0000000000001623)
Zhou Y, Sun H, Macario A, et al.: Association between participation and performance in MOCA Minute and actions against the medical licenses of anesthesiologists. Anesth Analg 2019; 129:1401–7. doi:10.1213/ANE.0000000000004268. (PMID: 10.1213/ANE.0000000000004268)
American Board of Anesthesiology: MOCA MINUTE®. Available at: https://www.theaba.org/maintain-certification/moca-minute/ . Accessed January 25, 2024.
American Board of Anesthesiology: Content Outline: Continuing Certification in Anesthesiology. Available at: https://www.theaba.org/wp-content/uploads/2023/01/MOCA&#95;Content&#95;Outline.pdf . Accessed January 25, 2024.
Sun H, McLoughlin TM Jr, Macario A: Clinical practice profiles of anesthesiologists certified in or after the year 2000 participating in maintenance of certification in the United States. J Clin Anesth 2020; 64:109810. doi:10.1016/j.jclinane.2020.109810. (PMID: 10.1016/j.jclinane.2020.109810)
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Entry Date(s): Date Created: 20260601 Date Completed: 20260811 Latest Revision: 20260811
Update Code: 20260812
DOI: 10.1097/ALN.0000000000006178
PMID: 42224071
Database: MEDLINE
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  Data: Background: Longitudinal assessments are increasingly common as a component of continuing certification programs offered by medical specialty boards. The goal of this study was to understand anesthesiologists&#39; utilization pattern, performance, and perception of the longitudinal assessment program administered by the American Board of Anesthesiology (Raleigh, North Carolina).&lt;br /&gt;Methods: The authors analyzed assessment usage and survey data from all anesthesiologists who participated in the Maintenance of Certification in Anesthesiology (MOCA) Minute from January 2018 to December 2019.&lt;br /&gt;Results: During the 24-month study period, 25,404 anesthesiologists completed all 120 questions assigned in at least 1 calendar year, collectively 5,801,160 responses to 1,646 unique questions. Participants were more likely to complete questions at the end of each quarter, with the highest frequency at the end of the year. Seventy-five percent of responses were first-time attempts, and 17% were first repeats. The median interval between original question presentation and first repeat was 314 days. The mean &#177; SD percent correct score was 68.3 &#177; 8.0% for first-time questions and 75.5 &#177; 12.6% for first repeats. The mean &#177; SD time to answer a first-time question was 26.8 &#177; 13.1 s, with shorter times for questions with correct than incorrect responses (25.0 &#177; 12.7 vs . 30.7 &#177; 13.3 s; time difference, -5.69 s; 95% CI, -5.71 to -5.66; P &amp;lt; 0.001). Of 5.11 million responses with ratings of relevance (88.2% of all responses analyzed), 4.86 million (95.2%) were felt to be somewhat or very relevant to practice. The percent correct scores were higher for responses with higher relevance and confidence ratings. For responses rated &quot;not relevant,&quot; &quot;somewhat relevant,&quot; and &quot;very relevant,&quot; the percent correct was 58.5%, 67.6%, and 77.0%, respectively; for responses rated as &quot;unsure,&quot; &quot;somewhat confident,&quot; and &quot;very confident,&quot; the percent correct was 53.6%, 67.9%, and 84.4%, respectively.&lt;br /&gt;Conclusions: MOCA Minute was generally used as designed. Evidence of learning was suggested by improved performance on repeat questions.&lt;br /&gt; (Copyright &#169; 2026 American Society of Anesthesiologists. All Rights Reserved.)
– Name: Ref
  Label: References
  Group: RefInfo
  Data: Culley DJ, Sun H, Harman AE, Warner DO: Perceived value of board certification and the Maintenance of Certification in Anesthesiology Program (MOCA&#174;). J Clin Anesth 2013; 25:12–9. doi:10.1016/j.jclinane.2012.09.001. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2210%2E1016%2Fj%2Ejclinane%2E2012%2E09%2E001%22&quot;&gt;10.1016/j.jclinane.2012.09.001)&lt;/searchLink&gt;&lt;br /&gt;Cook DA, Blachman MJ, West CP, Wittich CM: Physician attitudes about maintenance of certification: A cross-specialty national survey. Mayo Clin Proc 2016; 91:1336–45. doi:10.1016/j.mayocp.2016.07.004. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2210%2E1016%2Fj%2Emayocp%2E2016%2E07%2E004%22&quot;&gt;10.1016/j.mayocp.2016.07.004)&lt;/searchLink&gt;&lt;br /&gt;Sun H, Zhou Y, Culley DJ, Lien CA, Harman AE, Warner DO: Association between participation in an intensive longitudinal assessment program and performance on a cognitive examination in the Maintenance of Certification in Anesthesiology Program&#174;. A nesthesiology 2016; 125:1046–55. doi:10.1097/ALN.0000000000001301. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2210%2E1097%2FALN%2E0000000000001301%22&quot;&gt;10.1097/ALN.0000000000001301)&lt;/searchLink&gt;&lt;br /&gt;Schnabel S, Jones A, Brossman B, Ogrinc G: Best practices for longitudinal assessment in continuing certification: Consensus-based guidelines from American Board of Medical Specialties (ABMS) Member Boards. J Med Regul 2025; 111:31–40. doi:10.30770/2572-1852-111.2.31. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2210%2E30770%2F2572-1852-111%2E2%2E31%22&quot;&gt;10.30770/2572-1852-111.2.31)&lt;/searchLink&gt;&lt;br /&gt;Leslie LK, Turner AL, Smith AC, Dounoucos V, Olmsted MG, Althouse L: Pediatrician perspectives on feasibility and acceptability of the MOCA-Peds 2017 pilot. Pediatrics 2019; 144:e20192303. doi:10.1542/peds.2019-2303. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2210%2E1542%2Fpeds%2E2019-2303%22&quot;&gt;10.1542/peds.2019-2303)&lt;/searchLink&gt;&lt;br /&gt;Turner AL, Olmsted M, Smith AC, et al.: Pediatrician perspectives on learning and practice change in the MOCA-Peds 2017 pilot. Pediatrics 2019; 144:e20192305. doi:10.1542/peds.2019-2305. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2210%2E1542%2Fpeds%2E2019-2305%22&quot;&gt;10.1542/peds.2019-2305)&lt;/searchLink&gt;&lt;br /&gt;Cook DA, Blachman MJ, Price DW, West CP, Berger RA, Wittich CM: Professional development perceptions and practices among U.S. physicians: A cross-specialty national survey. Acad Med 2017; 92:1335–45. doi:10.1097/ACM.0000000000001624. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2210%2E1097%2FACM%2E0000000000001624%22&quot;&gt;10.1097/ACM.0000000000001624)&lt;/searchLink&gt;&lt;br /&gt;Kerfoot BP, DeWolf WC, Masser BA, Church PA, Federman DD: Spaced education improves the retention of clinical knowledge by medical students: A randomised controlled trial. Med Educ 2007; 41:23–31. doi:10.1111/j.1365-2929.2006.02644.x. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2210%2E1111%2Fj%2E1365-2929%2E2006%2E02644%2Ex%22&quot;&gt;10.1111/j.1365-2929.2006.02644.x)&lt;/searchLink&gt;&lt;br /&gt;Karpicke JD, Roediger HL III: The critical importance of retrieval for learning. Science 2008; 319:966–8. doi:10.1126/science.1152408. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2210%2E1126%2Fscience%2E1152408%22&quot;&gt;10.1126/science.1152408)&lt;/searchLink&gt;&lt;br /&gt;Larsen DP, Butler AC, Roediger HL III: Test-enhanced learning in medical education. Med Educ 2008; 42:959–66. doi:10.1111/j.1365-2923.2008.03124.x. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2210%2E1111%2Fj%2E1365-2923%2E2008%2E03124%2Ex%22&quot;&gt;10.1111/j.1365-2923.2008.03124.x)&lt;/searchLink&gt;&lt;br /&gt;Rohrer D, Pashler H: Recent research on human learning challenges conventional instructional strategies. Educ Res 2010; 39:406–12. doi:10.3102/0013189x10374770. 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        Text: English
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        StartPage: 724
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      – SubjectFull: Humans
        Type: general
      – SubjectFull: Longitudinal Studies
        Type: general
      – SubjectFull: Female
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              Text: 2026 Sep 01
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              Y: 2026
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