A Smarter Path to Continuous Learning
By Chris Lundeen, MS, CAE, ICE-CCP
ABFAS Director of Examinations
In the ever-evolving field of healthcare, staying current with research, treatments, and best practices is essential for board-certified physicians. While traditional recertification exams measure knowledge at a single point in time, they are less effective at supporting ongoing learning. However, longitudinal assessments—a type of formative assessment—address this gap by providing periodic, low-stakes evaluations that reinforce learning over time.
The American Board of Foot and Ankle Surgery (ABFAS) Longitudinal Education and Assessment for Diplomates (LEAD) program does just that by providing online assessments with immediate scoring after each question, rationales that clarify correct and incorrect answers, and suggested professional development resources.
Benefits of Longitudinal Assessments
Longitudinal assessments enhance knowledge retention by reinforcing learning over time. Unlike traditional recertification exams that encourage last-minute cramming, longitudinal assessments present questions at regular intervals, requiring Diplomates to recall and apply previously learned material. This repeated exposure strengthens long-term memory and improves clinical decision-making.1
Continuous improvement is another key benefit. Regular feedback helps Diplomates identify areas where they need to strengthen their knowledge, allowing them to address gaps before they become significant. If a Diplomate answers a question incorrectly, the system may introduce similar questions later to reinforce learning.
Longitudinal assessments also provide greater flexibility and convenience. Questions are presented at regular intervals, and physicians can complete them at their own pace, eliminating the need to travel to testing centers or take time off work. This format reduces exam anxiety by eliminating the pressure of high-stakes testing.
Furthermore, longitudinal assessments are highly adaptable, allowing certification boards to introduce questions that reflect emerging topics or advancements. Many longitudinal assessments allow Diplomates to customize the assessment to better fit their day-to-day practices as well. For example, ABFAS Diplomates can select practice areas so that their LEAD assessment aligns more closely with their own practice.
Preference of Longitudinal Assessments
Recent trends show physicians prefer longitudinal assessments over traditional recertification exams for Maintenance of Certification (MOC). For example, 80 percent of the Diplomates of the American Board of Internal Medicine (ABIM) choose to take the Longitudinal Knowledge Assessment (LKA) rather than their traditional 10-year MOC exam. Like the ABFAS LEAD program, the LKA offers several advantages, including immediate feedback, relevant study resources, and more flexibility over traditional MOC exams.2
The American Board of Medical Specialties (ABMS) and its member boards have emphasized that longitudinal assessments are designed to support continuous learning rather than serving as mere testing mechanisms. These assessments encourage the application of knowledge in clinical practice and help physicians identify knowledge gaps while providing structured feedback and learning resources.3
Learning That Lasts
As the healthcare professions continue to embrace lifelong learning, longitudinal assessments are proving to be a forward-thinking solution that supports physicians' ongoing professional development. Programs like LEAD exemplify how these assessments not only maintain the high standards and credibility of board certification but also promote continuous improvement, flexibility, and relevance to daily clinical practice.
By shifting the focus from high-stakes recertification testing to sustained learning, longitudinal assessments empower healthcare professionals to stay current, confident, and support the delivery of high-quality patient care.