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Knowledge Self-Assessment Engagement and Family Medicine Board Examination Outcomes
Peter M Wingrove1, Andrew W Bazemore2,3, Ting Wang3
1Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA.
Family Medicine
|June 17, 2025
Summary
Engaging with the American Board of Family Medicine (ABFM) Continuous Knowledge Self-Assessment (CKSA) formative tool is linked to better performance on high-stakes summative assessments for physicians. Consistent and early participation, especially on challenging questions, correlates with higher scores.
Area of Science:
- Medical Education Research
- Physician Professional Development
- Assessment and Evaluation
Background:
- Limited evidence exists on the link between formative assessment engagement and summative outcomes in practicing physicians.
- The American Board of Family Medicine (ABFM) offers the Continuous Knowledge Self-Assessment (CKSA) as a formative tool.
Purpose of the Study:
- To evaluate the relationship between engagement in the ABFM CKSA and performance on high-stakes summative assessments.
- To identify specific engagement metrics within formative assessments that correlate with improved summative outcomes.
Main Methods:
- A retrospective cohort study analyzed 24,926 ABFM diplomates from 2017-2023.
- CKSA engagement metrics (quarters completed, time, confidence) were analyzed against summative assessment z scores.
- Multivariable regression controlled for demographics and prior performance.
Main Results:
- Higher CKSA engagement strongly correlated with better summative assessment performance.
- Completing all four CKSA quarters significantly increased summative assessment z scores (P<.001).
- Early completion and time spent on low-confidence questions positively correlated with both CKSA and summative scores (P<.001).
Conclusions:
- Formative assessment engagement, including early, consistent participation and reviewing challenging questions, is associated with improved high-stakes assessment outcomes.
- Future research should investigate the mechanisms and consider an engagement index for at-risk physicians.
- Integrating longitudinal self-assessments into certification could enhance continuous learning and exam readiness.
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