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Osteopathic Continuous Certification (OCC)
Component 4: Practice Performance Assessment


Component 4: Practice Performance Assessment - NEW! INFORMATION BELOW*

*Please note: The AOA OCC platform, My OCC, is in the process of being updated with these new AOBP requirements. We appreciate your patience during this process.  In the meantime, if you have any questions regarding My OCC, you may reach the AOBP via email at aobp@osteopathic.org, or phone at (312) 202-8267.

  • The AOBP, in compliance with the AOA Bureau of Osteopathic Specialists, requires that the osteopathic pediatrician successfully complete a minimum of two (2) PPA projects in each nine (9) year OCC cycle to fulfill component 4 requirements. The following approved modules are the AOA CAP, NBOME OPAIM, or O-CAT communications module. These modules may be completed at any time during the nine (9) year OCC cycle.
  • The AOBP requires that the osteopathic pediatrician demonstrate competency in quality improvement (QI). Competency is defined as the ability to assess and improve the quality of care provided to patients by having knowledge of quality improvement methods and implementing QI methods in practice. Successful completion of a PPA module should result in improvement in patient care and development of additional medical knowledge and skills.
  • Standards for the PPA modules address:
    • Relevance to clinical practice
    • Focused improvement goals
    • Use of standard quality improvement methods
    • HIPAA compliance and ethical issues
  • The BOS Policies and Procedures state the following under Article XII. Osteopathic Continuous Certification, Section 5. OCC Component 4: Practice Performance Assessment and Improvement:
    • Diplomates must engage in continuous quality improvement through comparison of personal practice performance as measured against national benchmarks for the medical specialty or condition. The Standards Review Committee has set minimum standards for each practice performance assessment activity as follows:
      • Minimum of 10 patient charts extracted for a designated condition, disease or procedure.
      • All patient chart information submitted by the diplomate must be from patients treated by the diplomate, rather than from other physicians in a group practice.
      • The diplomate provides the extracted patient data to his/her Specialty Certifying Board in a specified format.
      • Diplomate data will be compared to accepted national benchmarks. These benchmarks must be identified and included with the Board’s submission the Standards Review Committee.
      • Benchmarks and associated criteria must be clearly defined prior to the diplomate engaging in the process. Some Specialty Certifying Boards must establish benchmarks based upon accepted standards of care, as national benchmarks may not exist for the specialty.
      • Certifying Board provides the findings and comments to the diplomate.
      • If the diplomate did not meet benchmarks, a remediation plan is developed.
        • If remediation is necessary, the diplomate will engage in a remediation program as specified or approved by the Board. The remediation must be completed with appropriate evidence submitted within the time frame established by the Board.
        • After a specified period of time, the diplomate extracts patient data from a minimum of 10 new charts again.
      • An analysis of improvement or maintaining of benchmarks is performed.
      • All individual data are confidential. Only aggregate data may be made public and only with prior permission of the BOS and AOA.
      • Specialty Certifying Boards must own the data diplomates submit for OCC Component 4 and be the entity that provides the feedback report to the individual.
      • Specialty Certifying Boards may audit a given percentage of diplomates’ Component 4 activities; chart data collected as part of each activity must be retrievable in the event of an audit.
    • The Standards Review Committee reviews each practice performance assessment activity for each of the boards to ensure that it meets the minimum criteria established by the BOS.


  • Practice Performance Assessment (PPA) modules have been developed and approved by the AOA from 3 vendors: American Osteopathic Association Clinical Assessment of Practice (AOA CAP), National Board of Osteopathic Medical Examiners Osteopathic Performance Assessment and Improvement Modules (NBOME OPAIM), and Osteopathic Continuous Assessment and Training (O-CAT) for use by the osteopathic pediatrician to meet OCC component 4 requirements.
    • AOA CAP
      • AOA CAP is available at DOCMEonline.com. The following modules are approved by the AOBP:
        • Pediatric Newborn Assessment
    • NBOME OPAIM
      • NBOME OPAIM is available at opaim.nbome.org. The following module is approved by the AOBP:
        • Medication Safety Communications OPAIM
    • O-CAT
      • This module provides OCC and CME credits
      • O-CAT is available at osteopathic-cat.com.
        • One of the modules in each nine (9) year OCC cycle must be the O-CAT communications module.
        • PLEASE NOTE: During registration, when you get to a page that asks for a voucher code, leave this area blank, and select ‘DO NOT USE VOUCHER CODE TO REGISTER.’  This will then bring you to the next steps in the registration process.
  • There will be a fee charged to the diplomate to participate in each PPA. These charges are made directly to the AOA, NBOME or O-CAT vendors.
  • PPA modules may be used by the general pediatrician as well as the pediatric sub-specialist.

Component 4, Non-AOA Projects

  • Pediatricians boarded by the AOBP are encouraged to participate in AOA sponsored PPA activity for OCC component 4 credit. Individuals who may be involved in quality improvement activities developed by other healthcare entities may apply for OCC credit if they meet the following criteria:
    • The QI project must be sponsored by a recognized healthcare entity.
    • The QI project must be approved by the American Board of Pediatrics and must qualify for a minimum of 25 points for MOC part 4 activity.
    • The individual must demonstrate meaningful participation in the project. Patient information from the individual’s practice must be entered into the project database. This information must be evaluated and compared to established standards and reported to the individual. The individual must meet or exceed those standards. Individuals who do not meet basic standards will not receive credit for that project.
    • The project should have an osteopathic component.
    • Data from a minimum of ten (10) patients must be used.
  • An application must be submitted to and approved by the AOBP and the BOS SRC prior to submission of completed project data.
    • The AOBP Practice Performance Assessment Pre-Approval form is located in the OCC Forms tab
  • Upon completion, an attestation form must be submitted from the individual and the project manager confirming meaningful individual participation and demonstrate that the individual met or exceeded minimum standards.
    • The AOBP QI Project for OCC: Attestation Form and Local Leader Acknowledgement Form is located in the OCC Forms tab
  • Each approved project will be the equivalent to one (1) PPA module. OCC component 4 requirements remain the same: one (1) PPA project plus the O-CAT communications module must be completed during the nine (9) year OCC cycle.

Content Disclaimer: The information provided in the American Osteopathic Board of Pediatrics (AOBP) web site is provided for information purposes only and does not constitute a legal contract between the AOBP and any person or entity unless otherwise specified. Information on the AOBP website is subject to change without prior notice. Although every reasonable effort is made to present current and accurate information, the AOBP makes no guarantees of any kind.

©2013, American Osteopathic Board of Pediatrics
Operating under the authority of the American Osteopathic Association