• MOC Assessment of Practice Performance (APP) Overview

    What is APP?

    APP focuses on practice-based learning and improvement, particularly in the competencies of patient care, interpersonal and communication skills, and professionalism.

    APP is based on diplomates’ involvement in a national, regional, or local practice improvement plan of their choice that meets ABEM’s basic requirements.  A specific goal of the APP program is to recognize quality improvement activities in which most diplomates are already participating.

    Who Participates in APP?

    Diplomates who are clinically active in any practice setting involving the practice of Emergency Medicine as defined by The Model of Clinical Practice of Emergency Medicine(EM Model), including urgent care, office-based practices, correctional facilities, and observation units are required to participate in APP.

    What Does APP Require? 

    Diplomates’ practice improvement plans must include participation in patient care practice improvement (PI) activities and communication/professionalism (CP) patient feedback programs.

    APP requirements have changed in 2011 for most current diplomates.  Clinically active diplomates must begin, complete, and attest to completion of one PI activity in years one through five of their certification, and one PI activity in years six through ten.  They must also complete one CP activity in years one through five of their certification and one CP activity in years six through ten.  During the phase-in of APP, i.e., in 2010 through 2018, requirements will vary.  Diplomates may click here to view their requirements.  They may also view their individual requirements and status by signing in to ABEM MOC Online and clicking the “View Your Requirements and Status” button.

    What is a Patient Care Practice Improvement (PI) Activity?

    Patient care practice improvement activities that meet ABEM requirements are focused on improving or maintaining clinical processes compared to established standards.  ABEM requires that diplomates follow four basic steps when completing a PI activity.  Those steps are measurement, comparison to standards, improvement, and evaluation of the improvement implemented.  See the section Patient Care Practice Improvement for details of the PI activity requirement.

    What is a Communication/Professionalism (CP) Activity?

    The communication/professionalism patient feedback activity is designed to help ensure that diplomates communicate with patients in an effective and professional manner.  ABEM requires that each CP activity include measurement of behaviors in each of three categories.  Those categories are communications/listening, providing information, and showing concern for the patient.  See the section Communication/Professionalism Feedback for details of the CP requirement.

    How do Diplomates Report Completion of APP Activities?

    Diplomates attest to completion of required activities through ABEM MOC Online.  Attestation involves using an online form to provide information about the activity completed.  Diplomates must also provide information about a person who can verify that the diplomate completed the activity within ABEM requirements.  See the section Requirements for Verification.