The use of practice analysis to develop a content outline for a board certifying examination

Abstract

Background

Since the first physical medicine and rehabilitation (PM&R) board certification in 1947, PM&R's board‐certifying Part I Examinations have been created by volunteer subject matter experts (SME) in private and academic practices. The American Board of PM&R (ABPMR) relies on the SMEs to create the exam's content outline that is then used as the framework to craft questions for the exam. Although this is a rigorous process with representative specialties across the entire spectrum of PM&R, it relies on the opinions and experiences of these SMEs. Because PM&R has grown in many clinical directions, in 2023, the ABPMR determined that the content outline should more appropriately reflect an updated scope of practice for the specialty. To achieve this goal, ABPMR contracted a psychometric consulting company, with experience in high‐stakes professional credentialing, to complete a practice analysis for PM&R.

Objective

To develop an updated content outline for the PM&R Part I certifying exam that embodied the breadth of the specialty including the knowledge and skills required of a competent PM&R physician upon completion of residency training.

Design

Pursuant to this goal, the rigorous research methodology called practice analysis was employed. This article describes the process of practice analysis including project planning; use of focus groups; survey development, dissemination, and analysis; and decision making to determine content and domain weighting for the ABPMR Part I Examination. This information was used by SMEs to assemble a revised content outline to be used for future board Part I Examinations in PM&R.

Conclusion

For the first time since its inception, the content outline of the ABPMR Part I Examination was successfully updated using a practice analysis method. This report described the process to achieve this goal.

INTRODUCTION

The American Board of Physical Medicine and Rehabilitation (ABPMR) board‐certification process ensures the safe practice of physiatry by practitioners. It assures the public that board‐certified physiatrists meet an established level of competence and are capable of managing the conditions associated with the specialty. As part of the certifying process, the Part I Examination is written with validated questions for every yearly exam cycle. The questions are crafted using a content outline that is created and updated by volunteer subject matter experts (SME) in private and academic practices encompassing the spectrum of the physiatric practice. For the examination to reflect the current field, the content outline must be reviewed on an ongoing basis. The content outline was recently updated using a practice analysis, and the process is described in this article. The following historical timeline shows the development over time.

The roots of physical medicine and rehabilitation (PM&R) as a specialty date back to the early twentieth century with the first board certification recognized in 1947. In 1904, Dr R. Tait McKenzie, professor of physical education and physical therapy at the University of Pennsylvania, taught medical students the principles of exercise, massage, hydrotherapy and modalities. He published The Handbook of Physical Therapy, which was used during World War I by the American, British, and Canadian armed forces. Dr John Stanley Coulter, McKenzie's student, directed the first rehabilitation hospital in France during World War I. He also practiced occupational or industrial medicine and physical medicine while teaching at Northwestern University School of Medicine in Chicago. ¹

The ABPMR was established in 1947 under the leadership of Dr Frank Krusen. ² Dr Krusen, who suffered from tuberculosis, noted during his recovery that he and other patients were caught in cycles of physical deconditioning, leaving them dependent on institutional support rather than moving toward vocational rehabilitation. From this experience, he made it his life's mission to develop a scientifically based specialty in physical medicine. He became the dean of Temple University School of Medicine where he was a successful team physician for the Temple football team. Fans noticed how rapidly athletes returned to competition under his care, attesting to the benefits of physical therapeutic measures. ³

Dr Krusen founded the first academic department of PM&R at Temple University in 1929. Dr Krusen's extensive research, teaching, and publications in the field led to the publication of the first textbook in physical medicine in 1941. ⁴ Due to his recognized authority on physical agents, he was appointed to the American Medical Association Council on Physical Therapy. Here, he met Dr Arthur Desjardins, a professor of radiology at the Mayo Clinic. In 1935, Dr Will Mayo invited Dr Krusen to establish a department of physical therapy at the Mayo Clinic. He later chaired the inaugural Department of Physical Medicine at the Mayo Clinic with the support of the departments of radiology, orthopedics, internal medicine, and neurology. Dr Krusen, with the help of other physicians, began to market physical medicine as a specialty. Dr Louis B. Wilson, then president of the American Medical Association's Advisory Council for Medical Specialties, also agreed it was time to establish a certifying board for physical medicine. At the American Congress of Physical Therapy in 1938, Dr Krusen and nine other physicians founded the Society of Physical Therapy Physicians. One hundred physiatrists financially supported the establishment of a board, and the society became the first professional association to certify physiatrists. This eventually evolved to become the American Academy of Physical Medicine and Rehabilitation. ³

Dr Simon Baruch, a surgeon by training, was a recognized specialist in chronic disease and wrote The Principles and Practices of Hydrotherapy. Dr Baruch's son, M. Bernard Baruch, wanted to advance his father's legacy. He approached Dr Krusen with a proposal and funding for research and teaching in physical medicine. In 1943, the Baruch Committee was formed to study the use of physical procedures in caring for the sick. They identified programs in the United States that would best advance education and training in physical medicine. The first report of the committee in 1944 recommended the formation of a central office to promote teaching and research in physical medicine and to establish centers at qualified medical schools for this purpose. This included the creation of residencies in physical medicine. Grants were awarded to select medical schools throughout the country to facilitate this research and teaching.

On November 6, 1943, Dr Krusen noted in his diary that “we must have a means of qualifying physicians who are trained as specialists in the field.” ³ B. R. Kirklin, MD, the secretary of the Advisory Board for Medical Specialties and the chairman of the Department of Radiology at the Mayo Clinic, encouraged Dr Krusen. He emphasized that many specialists recognized the need for a certifying board in physical medicine. Initially, the board for physical medicine was proposed to be part of the American Board of Internal Medicine or the American Board of Orthopedics. The American Board of Internal Medicine declined to take on physical medicine as an affiliate board and supported physical medicine's establishment as an independent board. Dr Kirklin supported the creation of the American Board of Physical Medicine with Dr Krusen. He advised the board to hold its first examinations that fall in Minneapolis, Minnesota. The first examination was crafted with a two‐page typed content outline. ⁵ The content outline covered two broad categories of basic sciences and clinical physical medicine. The basic science topics included anatomy, physics, physiology, pathology, and other fundamental sciences. The clinical physical medicine topics included thermotherapy, hydrotherapy, electrotherapy, radiation therapy, kinesiotherapy, occupational therapy, and physical rehabilitation. On August 31, 1947, 70 to 80 physicians were given ABPMR written exams on the first day, and ABPMR oral exams on the second day. Ninety‐three physicians were certified following the examination process and about 30 were certified without examination. ² , ³

Since the initial examination, Part I Examinations have been based on a content outline developed by the ABPMR. Prior to 1996, the process of creating the content outline was more informal and relied on a small group of SMEs. In 1996, the Part I Examination Committee created a more rigorous approach to developing the content outline with recruitment of SMEs from private and academic practices that encompasses the spectrum of physiatric care. The content outline topics were weighted and entered a regimented periodic review cycle. This new content outline was implemented in 1998 and continued to be used until the practice analysis.

The Part I Examination content outline consisted of two classes; each exam question corresponded to both a Class 1 and a Class 2 content area (See Figure 1). Class 1 content areas were focused on organ systems topics and included neurological disorders, musculoskeletal disorders, amputation, medical rehabilitation, rehabilitation problems and outcomes, and basic sciences. Class 1 was the basic way a physician was educated on different anatomy and conditions and focused on facts with intent to assess knowledge. Class 2 content areas were focused on patient management topics and included patient evaluation and diagnosis, electrodiagnosis, patient management, equipment and assistive technology, and applied sciences. Class 2 was developed to assess deductive and inductive reasoning on how conditions are assessed and managed in a clinical setting.

FIGURE 1.

ABPMR Part I Examination content outline prior to practice analysis. ABPMR, American Board of Physical Medicine and Rehabilitation.

These two classes were weighted for exam content percentage and used in assigning exam question writing. In the periodic vetting, the content outline was shared with program directors and various other PM&R‐related stakeholder groups for their input. The reviewed and updated content outline and weighting would then undergo a standard setting process every 5–8 years by the ABPMR Part I Examination Committee and noncommittee member PM&R SMEs.

The aim of this practice analysis is to further refine the content outline and to ensure that it realistically reflects the current practice of PM&R across the nation. This is then used to inform the weighting of content topics. This article outlines the first formal practice analysis performed for the Part I Examination by the ABPMR. A practice analysis is a rigorous, scientifically oriented job analysis that surveys and assesses practitioners' scope of practice in a specific industry. ⁶ , ⁷ , ⁸ It is an industry standard for certifying organizations and is used by several American Board of Medical Specialties board members. Prior to this practice analysis, physiatric practitioners outside of the Part I Examination Committee and noncommittee SMEs did not have input into the ABPMR exam structure or content outline.

METHODS

The methods section outlines a multistep process that was used to achieve the practice analysis and craft a pertinent content outline that, for the first time, reflected the scope of physiatry practice based on comprehensive input from the field of PM&R. Prior to this, input was only periodically garnered from small groups of SMEs. A concurrent, similar process was also performed for the pediatric rehabilitation medicine examination. ⁹ The goal was to develop an updated content outline for PM&R that embodied the breadth of the specialty including the knowledge and skills required of a minimally qualified candidate in PM&R upon completion of residency training.

The ABPMR engaged with a well‐recognized psychometric consulting firm with expertise in “design, development, and evaluation” of assessments. An ABPMR Practice Analysis Steering Committee was created and included the current and immediate‐past chairs of the Part I Examination Committee; ABPMR director of psychometrics and research; and two senior reviewers on the Part I Examination Committee. The steering committee later invited 14 SMEs to participate in Phase 2 and 4 as outlined later. The SMEs were randomized by medical degree, specialty practice scope, practice geographic location, academic versus private practice setting, gender, relative experience in terms of years of practice, and previous experience with ABPMR panels. One SME withdrew secondary to illness. Table 1 outlines the background of the 13 SMEs who were able to participate. The consulting firm provided two senior psychometricians with extensive knowledge on high‐stake certifying examinations and >2 decades of experience working in the assessment industry. These psychometricians facilitated the practice analysis process and provided guidance to the ABPMR Steering Committee. An institutional ethics board review was not necessary as the study did not collect or use any personal identifiers from participants.

TABLE 1.

Practice analysis SME demographics.

Degree	State	Years in practice	Practice setting	Practice area	Practice focus	Phase 2 SME panel	Phase 4 SME panel
MD	NJ	18	Hospital‐based, academic	Outpatient	SCIM	Yes	Yes
MD	PA	1	Private practice	Outpatient	MSK, pain	Yes	Yes
MD	FL	29	Academic	Outpatient	BIM, stroke	Yes	Yes
MD	IL	1	Academic	Inpatient	BIM, med complex, PRM, SCIM	Yes	Yes
MD	ID	28	Private practice	Outpatient	BIM, EMG, MSK, sports	Yes	Yes
MD	CA	8	Academic	Outpatient	BIM, MSK, SCIM, stroke	Yes	Yes
DO	CA	2	Private practice	Outpatient	MSK, pain	Yes	Yes
MD	AL	29	Academic, nonclinical	Inpatient	BIM, med complex, stroke	Yes	Yes
MD	AK	2	Academic	Outpatient	Sports		Yes
MD	OH	20	Academic	Inpatient	PRM	Yes	Yes
MD	AL	1	Academic	Inpatient	BIM	Yes	Yes
MD	MN	15	Hospital‐based, academic	Outpatient	MSK		Yes
DO	IN	18	Academic	Outpatient	MSK, pain, sports, stroke		Yes

Abbreviations: BIM, brain injury medicine; EMG, electromyography; MSK, musculoskeletal; PRM, pediatric rehabilitation medicine; SCIM, spinal cord injury medicine; SME, subject matter expert.

The practice analysis was organized into four phases as shown in Figure 2.

FIGURE 2.

ABPMR practice analysis process. ABPMR, American Board of Physical Medicine and Rehabilitation.

Phase 1: Kickoff and project planning

In May 2023, ABPMR sponsored a project kickoff. Participants included the Part I Examination Committee chair and immediate‐past chair, Part I Examination senior reviewers, ABPMR director of psychometrics and research, and psychometricians from the consulting firm. The ABPMR Steering Committee provided the content expertise, and the consulting firm provided process facilitation. The meeting focused on determining the ABPMR goals for the study and developing an outlined process and timeline for the project. The previous Part I content outline was reviewed and updated by the ABPMR Steering Committee. The consultants, with the goals identified, then developed the roadmap necessary to carry out the practice analysis.

Phase 2: Focus group meetings

With the consultants' guidance, ABPMR Steering Committee invited a panel of 14 SMEs to participate in the focus group meeting. Key demographics for the SME panel included representation of those working in the field, educators, diplomates who recently passed the exam, and those who work with or supervise professionals entering the field. Practice location, practice setting, and specialty focus were also considered. Table 1 shows the demographics of the participants in the SME panel.

The SME panel was asked to review and update the diagnostic procedures and conditions that an entry‐level physiatrist, a minimally qualified candidate (MQC), would be expected to perform or treat. The focus group discussed the changes in the practice of physiatry over the previous 5 years, the process and outcomes from previous standard setting sessions, the purpose and process for the current practice analysis, and the criteria for content blueprints. Based on their expertise, the SME panel was further divided into three core PM&R practice specialty areas: neurological rehabilitation, musculoskeletal rehabilitation, and medical rehabilitation. In the subgroups, they reviewed the content of a recent exam specifically focused on their area of practice. The SME panel then reconvened to share their recommended updates. They then completed an evaluation of their orientation, education, and the process of the meeting. The purpose of this was to make sure that each SME participant clearly understood the purpose and the process of the practice analysis. It improved the efficiency of the process and ensured that their collective decisions more precisely reflect the scope of physiatric practice. This is reflected in Table 2.

TABLE 2.

Focus group evaluation results.

Evaluation question and response scale	Average response
How would you rate the training provided for this practice analysis? Very appropriate = 4, Appropriate = 3, Somewhat appropriate = 2, Not at all appropriate = 1	3.6
2 How would you rate your understanding of each aspect of the training? Strong understanding = 4, Moderate understanding = 3, Weak understanding = 2, No understanding = 0
The purpose and focus of each exam within the certification program	4.0
The purpose of practice analysis	3.8
The MQC	3.7
The process for reviewing and refining task statements	3.6
3 How would you rate the success of each aspect of the meeting? Very successful = 4, Moderately successful = 3, Somewhat successful = 2, Unsuccessful = 1
Large group discussion of MQC	3.4
Small group review of task statements	4.0
Large group review of task statements	3.9
4 To what extent do you agree that the changes made to the current blueprints more accurately reflect the current practice in PM&R? Strongly agree = 4, Agree = 3, Disagree = 2, Strongly disagree = 1	3.3
5 How would you rate the time allocated to each activity? Too much time = 4, Sufficient time = 3, Barely enough time = 2, Not enough time = 1
Large group discussion of MQC	3.1
Small group review of task statements	3.0
Large group review of task statements	3.1

Abbreviation: MQC, minimally qualified candidate.

Phase 3: Survey

Using the feedback from the SME panel and the focus group phase, an updated content outline for the Part I Examination was created. A survey incorporating the new content outline was created by the consulting firm to assess the scope of practice in PM&R. This was beta‐tested with a second group of selected SMEs (Table 1). The survey was then updated to incorporate the SME feedback. The final survey outline included:

1. Introduction by the ABPMR

2. Screening questions to verify the qualifications of participants

3. Demographic questions

   1. Years in practice
   2. Description of practice such as full time, part time, etc.
   3. Percentage of time in different practice settings such as academic, private, combination
   4. Percentage of time in each type of practice such as inpatient or outpatient
   5. Percentage of time in each subspecialty focus such as neurological, musculoskeletal, etc.
   6. Practice activities such as amputation, spinal cord injury, etc.
   7. Practice location
   8. Size of community where practice is located
4. Survey respondents were asked to review the list of topics in the now updated content outline (Figure 1), essentially assessing the scope of physiatric practice. They were then asked to rate the frequency of their engagement with these conditions or diagnoses, the frequency that they would use any of the listed diagnostic procedures, and the frequency of use of various listed assistive technologies or devices in their patients.

   1. The measurement scale used was:

      • 0 – never.
      • 1 – rarely (once or twice a year).
      • 2 – sometimes (once or twice a month).
      • 3 – often (once or twice a week).
      • 4 – frequently (daily or almost daily)
5. Survey respondents were then asked to delineate the treatment options that they used for various conditions.

   1. The options included:

      • Refer to another provider
      • Nonpharmacologic such as therapies (physical, occupational, speech and recreational therapy), modalities, bracing, psychology, adaptive equipment, and assistive equipment
      • Pharmacologic such as spasticity medications, pain medications, neurostimulants, and antidepressants
      • Procedure such as intrathecal baclofen pump, urodynamics, transcranial magnetic stimulation, functional electrical stimulation, and percutaneous electrical nerve stimulation

The practice analysis survey was emailed to 11,458 registered diplomates of the ABPMR. A social media push was initiated via Facebook and Instagram to increase awareness. Finally, a personal appeal approach via email was sent to the PM&R Chair Council and the Residency and Fellowship Program Directors Council asking them to forward the message further to their colleagues.

Phase 4: Analysis and decision making

The ABPMR Steering Committee, the prior SME panel, three additional SMEs and the consulting team reconvened to analyze the survey results. The SMEs who were included in Phase 2 were invited back, in addition to three newly invited SMEs, to provide clinically oriented perspectives and increase the validity of the assessment development process. The process for this phase included the following five focus areas:

1. Review the characteristics and demographics of the survey respondents

2. Review and recommend each topic in the content outline (Figure 1)

3. Review and reconcile “flagged topics” (Table 3)

4. Review survey comments about topics that may be missing from the list

5. Recommend subdomain level weights

“Flagged topics” were content outline topics that occurred at high frequency or low frequency on the survey. They were flagged so that they could be reviewed and recommendations provided on what to do with each of these specific topics. Table 3 outlines the criteria. For instance, a topic was designated as a low‐frequency topic when ≥50% of all respondents did not select that topic or ≥30% respondents who worked in that arena did not select that topic. After reviewing the survey outcome, the SMEs were tasked with assisting with the revision of the Part I Examination content outline based on the feedback received from the national survey. During the review, the SMEs made determinations for each low‐frequency flagged topic and each high‐frequency flagged topic. For the low‐frequency flagged topics, the options were to (1) include as is, (2) revise, (3) combine with another task, or (4) remove from the content outline. For each high‐frequency flagged topic, the SMEs were asked to determine if the topic required further explanation or whether it needed to be split into more granular topics.

TABLE 3.

Flagging criteria.

% of responses for frequency of engagement or use of each content outline topic	All respondents	Respondents who primarily work in this area	Review questions
Low frequency
% of never responses	≥50%	≥30%	Given the low frequency, should this be included on the exam as is? Revised? Combined with another topic?
% of never + rarely responses	≥70%	≥50%
High frequency
% of often + frequently responses	≥85%	≥95%	Given the frequency, should this be included as‐as? Separated into multiple topics?

Once the content outline was refined, the SME panel developed domain‐level weighting for each domain of the content outline. The process included (1) review of prior weights of each domain, (2) discussion of reasoning for acceptance versus adjustment of that domain's weight; and (3) recommendations for final domain weights for each domain of the content outline. An updated, new Part I Examination content outline was then created. For completeness and transparency of the process, the SME panel was asked to complete an evaluation of the Phase 4 process.

RESULTS

In September 2023, the Part I Examination practice analysis survey was sent by email to 11,458 board‐certified physiatrists. For the emails delivered, there was a 4% bounce‐back rate due to either incorrect or inactive email address. Twenty‐five percent of recipients did not open the email delivered. Of the total 11,458 emails sent, 2511 recipients responded representing a 22% response rate. Of these 2511, 2109 completed all portions of the survey and 402 completed some portions of the survey. Demographic characteristics of respondents who provided complete responses were compared to those who provided incomplete responses. The demographics of those who completed the survey showed a median 14 years in practice; 87.2% of reported working full time, 42.5% were private practitioners, 64.6% were working in an outpatient setting, and 49.3% identified that their practice focus was on musculoskeletal medicine. Please see Appendix A in Data S1 for complete survey results and Appendix C for the list of questions included in the survey.

There were no significant differences noted between the two groups in terms of years practicing as a physiatrist, clinically active status, inpatient or outpatient practice, practice type, practice focus, practice description, primary location of practice, or practice location in population of <100,000 residents.

Demographic information was used to evaluate variances in the respondent sample compared to the larger population of practitioners. Breadth of practice was demonstrated in areas including average years of experience, private practice versus academic, outpatient versus inpatient setting, musculoskeletal focus versus neurologic focus, and practice in a setting with population <100,000 versus >100,000.

Survey results were analyzed to determine how frequently respondents encountered patients with each condition and used various types of procedures and treatments. Based on average frequency ratings, items of low frequency and high frequency were flagged for further analysis. SMEs reviewed each flagged task. The results of this analysis are included in Table 3.

SME review of comments regarding tasks that may be missing was also conducted. Domain and subdomain level weights were reviewed in Table 4.

TABLE 4.

Recommended domain‐level weights.

Domain	Recommended weights
Foundational concepts	10%
Diagnostic procedures	2%
Treatments	3%
Adaptive or assistive technology	3%
Applied science	2%
Electrodiagnostic medicine	10%
Neurological rehabilitation	30%
Conditions	12%
Spasticity and dystonia	3%
Rehabilitation management conditions	15%
Musculoskeletal rehabilitation	33%
Musculoskeletal and occupational medicine	20%
Amputation	5%
Rehabilitation management conditions	8%
Medical rehabilitation	17%
Conditions	5%
Rehabilitation management conditions	12%

Based on a final review, the final task list that was generated was reviewed by ABPMR and formatted into the current Part I Examination content outline. Please see Appendix B in Data S2.

DISCUSSION

Since the initial administration of the Part I Examination in 1947, the field of PM&R has continued to grow and expand. The need to provide board certification that appropriately measures the clinical changes in physiatry knowledge, practice pattern, and population served has been a consistent goal for the ABPMR. The Part I Examination, taken at the completion of PM&R residency training, is a measure of a candidate's core PM&R knowledge. Crafting an appropriate and relevant Part I Examination for the certification process in PM&R is important for the specialty. To demonstrate validity, the examination must comprehensively assess the knowledge and skills necessary for effective practice by a typical general physiatrist.

The aim of this project was to create an updated Part I Examination content outline that serves the goals of assessing knowledge through the current scope of a practicing physiatrist. The content outline is then imperative for a valid and reliable assessment process that covers the breadth and the relative distribution of physiatry practice patterns. The industry standard of a practice analysis assists in achieving this goal. ⁵ , ⁶ In this article, we describe the rigorous research process of practice analysis that was used in a novel way, to assess the scope of physiatry practice with the end goal of creating a valid content outline that mirrors the current practicing pattern of physiatrists, for the Part I Examination.

A practice analysis is considered the cornerstone for demonstrating validity of exam development processes. The ABPMR partnered with a psychometric consulting firm to complete the Part I Examination practice analysis. This was done in four phases: project planning, focus group meeting, survey and analysis, and decision making. From this process and national survey, a trend was noted in the practicing patterns of physiatrists. We updated the examination content outline to include five categories with corresponding subcategories: foundational rehabilitation concepts, electrodiagnostic medicine, neurological rehabilitation, musculoskeletal rehabilitation, and medical rehabilitation. Based on current practice patterns, the content outline was also updated to remove post‐polio, sexuality, and reproductive disorders as these conditions are no longer being managed by the general physiatrist.

Strengths of this process included a systematic approach to gathering information on current PM&R practice; use of SMEs with diverse expertise across the field of PM&R to provide feedback; and the variable length, types, and settings of physiatric practice experiences. The survey tool was psychometrically created to capture a representative sample of practicing physiatrists in various practice environment across the country. The tool performed exceptionally well, and the survey was remarkably representative of the population of practicing physiatrists when compared with prior published data. ¹⁰ Challenges included potential response bias. Additionally, a response rate of 22% is relatively low; however, this is consistent with the usual capture of data by a survey tool. Furthermore, because this specific survey took approximately 20 minutes to complete, we feel that achieving a complete response by 2109 participants is quite remarkable. Future research is indicated to assess if a practice analysis is required for each cycle of updates. Furthermore, assessing the disruption to practice patterns by technology would be useful.

As noted previously, the content outline has been crafted by the practice analysis and national survey to be more reflective of practicing patterns of general physiatry. Interestingly, the new content outline remains highly correlated with the previous content outline crafted solely by SMEs. Going forward, the ABPMR will use the new content outline to produce Part I Examinations that are more closely aligned with practice patterns. We will repeat the practice analysis over time to reassess any changes to the practice patterns in physiatry.

CONCLUSION

A practice analysis was completed with the purpose of updating the Part I Examination content outline and weighting to reflect current PM&R practice. This was accomplished by using a facilitating psychometric firm in combination with experts from ABPMR and SMEs across the field of PM&R. The new Part I Examination content outline consists of five broad content areas with subcategories within each broader category. This new outline will be used for Part I Examination question development and evaluation of testing questions and by candidates to focus their exam preparation.

Having achieved a comprehensive assessment of the breadth of practice pattern, specialization, diagnostic conditions, and practice type across the specialty, the study will ensure that the assessment of a physiatrist, upon completion of training, will be rigorous and valid. This ensures the safe practice and provision of high‐quality care for patients engaged with PM&R.

FUNDING INFORMATION

The practice analysis was funded by the American Board of PM&R.

DISCLOSURE

Vu Q. C. Nguyen, Carolyn Geis, and Kevin Krafft are ABPMR volunteers. Mikaela M. Raddatz is an ABPMR employee.

Supporting information

Data S1. Supporting Information.

Data S2. Supporting Information.

Data S3. Supporting Information.

DATA AVAILABILITY STATEMENT

Data may be provided through direct contact with the ABPMR.