That Clock is Really Big

To the Editor: This year, rather than recertifying my diplomat status as I have in the past by sitting for the recertification examination, I am participating in the American Board of Family Medicine (ABFM) longitudinal pilot recertification test. The ABFM is experimenting with allowing diplomates to take 25 questions every 3 months rather than sit for a day long recertification test. This iteration is an example of the ABFM incorporating best pedagogical practices, which excites my educator heart. Test-takers are permitted to use sources and 5 minutes per question. During the first iteration of these 25 questions, I struggled mightily as the clock was quite large and the countdown numbers changed every second, literally (eg, 5:00, 4:59, 4:58). It was excruciating. I have never had test-taking anxiety, but this technology aspect threw me. My prior experience with diplomat testing included 1 article, scantron rendition, and 1 computerized rendition. I had adjusted to the computer and the inability to circle keywords in the question, despite appreciating article and pencil. The moving, oversized clock led to my missing the first 5 questions; I was completely unable to access my knowledge or various on-line resources. Finally, I covered the clock so that I could not see it and started to get questions correct. I found my rhythm. I focused and put serious energy into not looking at the giant moving clock on the screen. I submitted my concerns about the gargantuan clock after I completed the testing.

I was filled with relief and gratitude when I took the next quarter's 25-question set months later and found that the giant clock was reduced in size and moved to the top of the screen. I had logged on ready with a clock strategy (covering the clock with a Post-it note). With the clock dethroned, I found my rhythm immediately. I am grateful as an educator for this experience; this reminds me that every learner, including patients, all have their own metaphoric moving, giant clocks. I am also grateful to the ABFM for hearing me and others who gave feedback about the challenges of the clock.