The Royal College of Physicians and Surgeons of Canada (RCPSC) maintenance of certification is divided into three sections:

1. Section 1 – Group Learning
2. Section 2 – Self Learning
3. Section 3 – Knowledge Assessment

All Fellows and MOC Program participants are required to complete a minimum of 25 credits in each section of the MOC Program during their 5-year MOC cycle. The MOC Program has supported assessment (Section 3) as an educational imperative for lifelong learning in practice.

There are 2 categories to consider in the context of development of CPD activities to qualify for section 3 credits:

1. Knowledge Assessment: Self-assessment programs E.g. Multiple choice questions with feedback on correct and incorrect answers.
2. Performance Assessment: Simulation E.g. Hi-fidelity, task trainers, virtual, standardized patients or Direct Observation of skills

Both categories result in 3 Credits per hour of learning.

KNOWLEDGE ASSESSMENT

Self-assessment programs are tools to enable physicians to assess aspects of their knowledge or practice to identify opportunities to enhance their competence through further learning activities.

Assessment items, such as multiple-choice questions and short answer questions can be used during a live group event or online programs.

The following features must be included for all self-assessment programs:

1. A thorough review of key knowledge areas.
2. Assessment items that allow participants to review their current knowledge in relation to current scientific evidence.
3. A process by which the assessment item(s) are recorded by participants and submitted to program organizers.
4. Feedback to participant on which answers are correct and incorrect.
5. References to facilitate review of the evidence for each assessment item answered incorrectly.

PERFORMANCE ASSESSMENT

Organizers of these activities must include strategies to provide feedback to participants on their performance to enable them to develop a learning plan to address areas of improvement. Feedback is based on assessment of performance as measured against learning objectives, competencies, and practice standards supported by evidence. Tools to help structure participants’ reflection on their performance as well as time for personal reflection is encouraged. Simulation (e.g. hi-fidelity, task trainers, standardized patients) reflects or approximates real life situations to enable participants to demonstrate and receive feedback related to their application of knowledge, clinical reasoning, communication, problem solving and or ability to collaborate and work effectively within a health care team. It can be a stand-alone program or embedded within a broader educational program. Observers of simulation do not qualify for MOC Section 3, but can record their participation under section 1, group learning.

Live simulation-based activities:

• There must be an established process for how participants will receive feedback on their performance. For example verbally or through an evaluation form.
• Participants must be able to receive feedback after the completion of the scenario. This feedback must include references justifying the appropriate answer.

Feedback for direct observation of skills should include a written performance analysis with the following features:

• An overall score.
• Identification of appropriate alternative responses.
• A detailed breakdown by tested areas.
• Comparison of the score to established norms or the aggregated score for the peer group (optional).