 Good morning. I'd like to thank Texas Heart Institute for inviting me to speak today, especially like to thank Kathy, Deb, and Anne for inviting me, and it's a pleasure speaking to you today. As you can imagine, the last few years has been a very stressful time for all of us, students, CCPs, and also the American Board. We've had to implement many changes to navigate this pandemic and I'm here to highlight some of the changes that we have made during this period for the students and the CCPs. And hopefully tell you a little about where which direction we're going in and some new things that we've been working on from the American Board. One thing I'd like to point out your title to your president to your meeting today is honoring the women and leading with the hearts. You'll recognize a few people in this photo on the left. Deb Adams is honestly all heart. That's a good way to describe her. She puts her all into everything. She doesn't judge anybody. She does. That's the way she is and she's a great person to have to mentor down there and as a friend to everybody. You are so lucky to have Deb in your program. I cannot speak enough about her. And on the right you have Anne Greco. Everybody recognizes her too. And she's currently the vice president of the American Board. And she is a strong, thoughtful, and heartfelt leader that will, this also is a very good person that you have down there. We sincerely appreciate her work and endeavors on the American Board also. And in the middle here we have Beth Richmond. She's our executive director on the American Board. And she is also that she's basically the heart and soul of the American Board. And she's been with the board since its inception. And I cannot speak enough about her leadership and her dedication to the profusionists in the country and the certification process in this country. She's unbelievable to work unbelievable to work with and a great moral model for us all. I was in honor of visiting Texas Heart a few years ago and doing a site visit for CAEP. And I was amazed by the facilities you have down there, the staff you have down there, and the education resources you have at Texas Heart. During one of my tours though I was just awestruck by this headlamp of Denton Cooley. I couldn't stop staring at it. I was just imagining what this light's shown upon and what happened in between the circle of plastic. It's just amazing to be, if you could step inside that headlight for a short period of his career. It's just awesome to imagine what went on. And it was just very interesting to see part of this little history of Texas Heart. The objectives today are to review the American Board examination challenges and actions during COVID pandemic to explore the outlook of profusion educational programs during the pandemic, and to look into the impact of the pandemic on the CCPs and review our certification stats. I've also discussed advancements and enhancements of the American Board during this adverse time. So what are some of our coronavirus actions and responses. Well, I must say that 2020 was the perfect storm and gave us many headaches. The American Board examinations were initially scheduled for March 25, and through March 28, 2020, 62 examinees were registered to take the spring examination. As you all know, our exams are administered by Prometric Testing Centers, so examinees sign up with Prometric Testing Centers to sit for our exam, and they can schedule us on their own. However, on March 16, I started knowing, or beginning of March, I started noticing on the Prometric websites that a lot of centers are starting to close because of the pandemic. We were in constant contact with Prometric and they were saying, no, the majority are open. A few have closed, not to worry about it, and we can adjust the schedule for anybody that is at a closed center. So on March 16, I expressed my concern to the National Office and they said that they contact Prometric themselves and that all Prometric Centers was still open. Suddenly, less than 24 hours later, on March 17, they informed us that all Prometric Testing Centers were closed. I almost fell off my seat at that time. I was like, we just talked to you yesterday and now you're closed today. So we had to scramble and all the examinees were immediately notified and that there could, there'll be no fees to them, no changes to them. We'll try to get their tests in as soon as possible. And also, they'll have the option of postponing their test in a follow-up examination if they prefer. So Prometric informed the American Board that on April 19, that the spring examinations will take place on June 17 through the 20th of 2020. So they kept on working on dates where they felt like the majority of the centers will be open and they can have the exam safely at this time. And all examinees were contacted and rescheduled for the June exam or given the option to sit through the exam in the October exam window. So some of the impacts on the clinical rotations. So in spring 2020, we were notified that a lot of clinical rotations were closing. So we were talking about the impact on students and sitting for the exam. We had the temporary waive, the 75 clinical case requirement for graduating students. We basically accepted the number of clinical rotation cases as is. And as is completed by March 16th in any accredited profusion program. So, you know, what we found out is that majority of cases that the students already had their 75 cases. There are a few exceptions where they had like 72, 73, you know, this is pretty close. We were willing to accept this during the time of crisis. We reviewed any examinees applications and requirements and solve their problems based on a case by case basis. For example, somebody was missing a case or two. We looked at it and decided, yes, you can sit through the examination. We also stayed ahead of the pandemic to receive regular updates bi-weekly basically from Prometric regarding the status of testing centers for the fall exam. I really wanted to make sure that this doesn't happen again where the perfect storm happens and, you know, all of a sudden a day before the exam exam it closes. We really try to avoid this and stayed in really good contact with Prometric during this period. We monitor progress of all summer graduates for any hardships and starting a career during a national crisis. For example, if they were to, you know, have a state licensure depending on if they passed the exam, we worked at the state license reports to have the students sit for the exam at a later time and also get their licensure, a temporary licensure. So our 2020 results were, we administered 461 PBSC and CAPE exams through the Prometric testing centers. The fall exams were ministers as scheduled on October 14 through 22nd on 2020. So few, we made it without a glitch. There were like, I think one or two glitches at some centers and a couple exam these were impacted. One of them just rescheduled for a later time. Another one had to go to another center, but that was dependent on the individual center. And a total of 210 examinees earned their CCP in 2020. So congratulations to those of you. If you are one of the 210 of last year that earned your CCP. Looking ahead now the 2021 exams are on scheduled at without interruption at this point. The spring exams were administered on March 24 through 27. 39 examinees took the PBSC exam, 33 passed the exam. 62 examinees took the CAPE exam, and 52 have passed the CAPE exam. The exam days are scheduled right now for October 13 through 16 at Prometric testing centers. The American board is staying ahead and connected with a provision educational programs in February the American board reached out to all the profusion program directors via the PPC to stay ahead of the COVID pandemic. And we just want to be aware of any educational or clinical requirements shortfalls throughout the programs. Two programs out of 17 responded that they will fall short on some of their clinical requirements and this is because some of their clinical rotation sites have closed or held back some of their students and they were not be able to get their clinical cases and their pediatric cases in time. However, an update is that both programs expressed that they should meet the requirements. And I just talked to the director of the PPC programs and he said that there really shouldn't be any problems with this year's graduation since we are in late May already. So, there was talk about one program may move graduation back a month or June but we have not heard anything else from this program so it looks like they're scheduled on time to have graduation happen on time. So, it seems like many programs were able to get normal clinical rotations, or they scrambled to find other ones, you know, for example myself I was contacted by Midwestern said can you please take a pediatric rotation students and this is kind of at the last minute and absolutely glad to help so we took that student in and got him in got his cases and he's graduating like next few days I think. So what adjustments did we make as the American board during COVID-19. Well, on March 17 of last year we sent an mass email to all ccps that any recertification hardships faced by the current ccps regarding clinical case or professional activity requirements, due to the COVID-19 crisis will be handled on a case by case basis as needed. And the American board will grant the final extension at no fee to the end of 2020 calendar year. So, you know, one thing about clinical cases we seen during the pandemic that a lot of hospitals slow down. They weren't doing emergent cases, or they were told to absolutely close for a while so it was hardly any cases for a while. For many perfuses and we understand this. Also professional activity. I mean, COVID-19 turned meetings like this upside down. I'm really kind of tired of presenting into a computer. I much prefer to be live and avoid like some computer glitches that I've been seeing pop up on my screen lately and speak live to everybody is a little bit better. So, you know, we've worn something along this process and that, yes, you know, see use can be attained pretty easily via staying at home and doing video presentations. But, you know, we also miss the live clinical activities. But, you know, tell you truth, there are enough professional activities out there right now to get your CV is just a lot of online learning. And hopefully we'll be back to see each other in person pretty soon. Just a 2021 update, the American board waived the rule of only allowing one extension during a three year recycle three year recertification cycle. We used to have this this rule that every three years with your refit recertification cycle, you can only have one extension. Well, we wave that now we understand that this pandemic has lasted a lot longer than we all thought. And it's probably going to affect more of us in this past year, the beginning of 2021 than anything. And so we wave that rule we also will continue to grant recertification extensions weren't one requested by the CCP and don't forget the CCP has formally request us with the American board it cannot to say I'll take care of it. You have to notify the American board about meeting an extension and you will be granted that extension because of the pandemic. So let's look at some certification numbers and stats for this year. This is all based on the annual report that was presented to you at the end of last year so numbers have changed a little bit. So far, as I mentioned before we have 210 new research a new certifications. We had 110 people that were on extended leave at the end of last year. We'll talk a little bit more about this in a little bit. We had 131 file for extension. We have a total of 4522 profuseness to the state, and we've lost only 94 profuseness last year. So let's look a little bit more into these stats 216 ccps initially signed up for a recertification extension on August 1, 2020, 131 ccps were on extension at the end of the year. And typical year we have an average number of around 94 ccps that file for an extension. So we had a slight uptick on this to be expected. In fact, I was kind of surprised it wasn't higher of these 131 ccps 67 ccps were still unable to meet the requirements, the deadline at the end of the year to file their cases or 40 cases. These people were moved to conditional certification. So to this day we have 174 ccps that are in conditional certification. And in a typical year conditional certifications are about 99 ccps a year so it's a, it's a pretty dramatic uptick in this and we'll keep on watching them and making sure people don't slip through the cracks. However, some conditional certifications are destined to leave the field via retirement or other reasons. And so, and others might have life events and need to consider extended leave. For example, military duty, having a baby, family issues. So these people can, these ccps can be on extended leave for this moments of crisis, or family changes. And please don't forget, extensions conditional and extended leave status is not punitive. The CCP is still American board certified during these periods. If you're on extension, you're still certified. If you're on extended leave, you're still certified. If you're unconditional, you're still certified we stand behind you during these times. The American board does expect further hardships. In fact, I think they'll probably last another year or two, before we get a climb out of this and get back to normal. So the American board will keep on studying everything and make adjustments as necessary. And don't forget, every COVID related extension will be handled on a personal and case by case basis. The American board were very proud of our national office and the outreach that they do and if you pick up the phone and call them, you'll get a live happy person on the phone and willing to help you and they're very informed, they're very knowledgeable. And you could always find a friendly voice on the phone if you call the national office with a with a problem. In 2021, we did have 94 CCPs lose certification. On average, it's about 85 per year, and this is another kind of stunning number that I thought would be a lot higher last year. So, again, I think this recertification period, we're going to have to watch a little bit closer we probably have some more that lose certification because of the pandemic and life changes because of the pandemic. And also, you know, the pandemic might be delaying life plans, retirement or CCPs from leaving the field. So, you know, it seems like some people are just willing to stay put right now. Recently we had at my institution, a job posting and we got maybe about 10 applicants, 10 viable applicants I should say, and I was surprised that we didn't get more. We had a time when we did a search before for perfusion as we got a lot more applicants so I think many people are just willing to stay put and kind of write out the pandemic or don't want to move their family around during a time of crisis. Also, we did hear some stories of perfusionists, older perfusionists that were being guided to retirement because of crowed related decline in cases. It was unfortunate happenings because of the pandemic that some programs and some perfusion companies decided to kind of call the herd a little bit and get rid of some of their older CCPs, because our case numbers were down. So we really feel for these perfusionists that were impacted by this. Also, to note there is an interesting article in the Chicago Tribune the other day or last fall that as COVID-19 surges so do Illinois teacher retirement so it seems like some professions have taken advantage of this pandemic and kind of solid writing on the wall and like I said, I'm done and I'm going to retire early. Coincidentally our hospital offered early retirement to a lot of employees this past year to kind of ease a burden of COVID related financial impact on the hospital so maybe this year we'll definitely have to watch more CCPs leaving the field. So at the last 10 years of growth as you can see we've had steady CCP growth so we're still retaining many CCPs and there's schools are still putting out good numbers of CCPs. So a little bit more in depth with this is a graph of the green line is gains in CCPs and this is loss in CCPs of red line. So you can see we do have a nice gap here and a few years ago, there's a lot of talk of, you know, we're going to get inundated with retirements and we're going to be on there so it seems like we improved this gap a little bit. However, I think we really need to watch these numbers more, and I don't think we should overreact I would hate to flood the field and have the marketplace dry up and salaries dry up. However, I think we need to be cautious about ignoring this problem to and in some areas and some centers there is a shortage and we have to think about that and consider it. We really need better data and this is an example of some of the data that we've collected and about retirement in 2016, our survey said about 38% will retire within the next 10 years. In 2017, the American board also with the ACP committee did a survey and about 39% said they're going to have retired be going to be retired within the next 10 years. Again, actually retirement dates may vary due to factors such as economy, personal decision, and of course, a surprise pandemic. Also, our age force is aging. When we took this last survey 29% of us are ages 50 to 59 15.3 are 60 years and older, and I wouldn't I was I didn't show the stat but there are profusals in their 70s, still pumping cases, I mean, hats off to them. So, I just didn't all night or a night ago and it's hard to do. It's just getting older in this profession is just tougher and tougher and tougher so my hats off to them and keep on pumping. We are going to have another workforce survey this year when you do your recertification. And this is a collaborative effort with the Academy of cardiovascular profusion. We'll be looking at recertification data will also be looking at and asking you questions about how COVID-19 impacted your workforce and your your working conditions. So when you recertify this year, please pay attention to your survey that is offered after you pay. It's really vital information for us, and it also impacts you. So please answer these questions in good faith, and past surveys are available at our website at abcbp.org. So as you can see from our surveys. We can only tell attrition rates. We can only I analyze supply we cannot analyze complex marketplace demands. We cannot predict what's going to happen in the future. So this is going to require a lot more involvement from the provision community itself. But you know we can tell how many ccps are coming in that door. We just can't tell what happens with them. And we're going to need other metrics in combination with the American board data to really study employee supply and demand. So here you're going to find some new things that we've been working on. We have updated the online filing system. We are hoping to make this more streamlined efficient and user friendly. This new platform is multi platform you use on your phone or tablets, your computer. We just wanted to make it accessible to everybody and easy to get done with the case. I'm going to put my phone here. I'm going to put my case in right now. So it's easy to do it is an ongoing pro ongoing project right now, and we're going to continue to listen to the profusion community to see what they want from an online filing system, and we will continue to improve it. In fact, we are making an almost daily improvements to this new online filing system. We did have a few hiccups to begin with. First of all, the company that we hired is kind of a smaller IT company, and they were also impacted by the pandemic to they had to release some of their employees because of the pandemic. They had to work from offsite to so there was a lot of, there was a period of shutdown for them and scrambling for them also. The American board has been in existence for quite a long time so to pull over all these files from all the perfusionists and all their clinical data all their professional data they transferred over 5 million files to the new online filing system so this is quite a task. And what they found out there is many errors in the old system. There's many like abbreviations if you put ST instead of street it didn't come over there's lots of problems with transfer of data over so this took quite a time and there was significant hiccups with this. However, this spring we kind of did a soft launch of the online filing system the new online filing system, and we'll be having more online tutorials and people will be speaking about it at meetings just like I am right now to you. So, we're going to look into this a little bit more quickly this, you know, just a sky view of this new application that we came up with. First of all, you have to update your IDs and your your profile when you get in the new system. You need to reset your password and please do not use your social security number. Our site is secure, however, you know that all the hacking that's going on so please do not we've had many people use their secure social security number in the past and we always encourage them. Not to do this not a good idea. You will update your personal profile on this page and you will also have to annual electronically sign information authorization release. This is in case you get audited and they will contact your supervisor at hospital and to verify that yes you did do these cases. And American Board ethical standard agreement. Just one note to this happening about a month ago we realized that this new system doesn't is not compatible with Internet Explorer. So if you use Internet Explorer, like many hospitals use Internet Explorer, please do not Internet Explorer has a lot of issues and should be staring away from it anyway. So this is a dashboard this is basically your homepage after you sign in everything you will go to your homepage and one good thing about it is it's your main navigation page you can actually see how many cases you filed already your professional activity. Your account or filing history. There's also instruction see and calendars to where you can say hey did I go to that meeting I can't remember the day you click on that, and you can see a calendar of one those meetings were, it will tell you your cycle number here to. And there's some more information up here but I blurred out because that's my personal information. So also another good thing is there's a help button here too so you can click on that help button, it will email the American board directly and you can state what your issue is, and we will get back to you on that. As far as payment to we've increased our payment I will show you payment screen pretty soon but it will store credit card if you want to and we also accept PayPal now, which is a kind of a big complaint from us before that we didn't do this before. So I'm going to look at the dashboard. So how do I enter a clinical case. Well, for my dashboard I will hit add edit, and I will go to add new. And then first of all I have to say which hospital I was at so again this automatically stores from a drop down list the first time you enter it yes you'll have to manually type it in after that. It will store so if I put luri children's if I click L it should pop up everything should self populate, you can move on. My designated authority will also pop up once I entered it. I will then enter my new clinical case. I will click the case date the surgeon and the case category. And remember the old online filing system we have type of case you know cabbage times one times two times three with the valve. We no longer require this and the reason for this is that this data is basically junk data to us. Any profusionist can enter any case they want to into the online filing system you only 40 cases. So you put any 40 you want. I told the story of when I first became a profusionist that I would enter the 40 nastiest toughest longest cases, I could just impress the American board. So I would just go through my cases for the years like oh that's a bad one. I'm putting that in there, you know, thinking off. It's going to impress somebody. They didn't look at it. They just looked to make sure that you have 40 cases that are bonafide in your record. And well, maybe those tough cases didn't work because I am the president American board right now so maybe in the long term it did have a good effect but honestly it was junk data. So what we really care about is what kind of category you're using to recertify. So if you're using cardiopulmonary bypass cases, ECMO cases, VADS, you know combination of standbys, VEX vivo cases. So that's we're more interested in a type of cases that you're doing than the actual clinical case that you're doing. So after this, you will click submit surgeon will be saved, and you'll move on. So how do I enter professional activity will basically the same way you will click add edit. You will say I'm going to add a new professional activity. You go to the category again there's a dropdown list of categories and I'm sorry I don't have it on the slide. You can pick and choose if you are an author for a journal you can use that as a CEO. If you are clinical affiliate you get a you get three CEOs per year for this. So it's a it's a good way to click it and go. You will say what kind of meeting it was or type of see you event it was the date the sponsor and location, and you will click submit. So how do I submit my activity to the American board someone you're all done entering all your cases again clinical activity, 40 cases are required 45 CEOs are required. You have a running tally on your dashboard. Once you're done, you can see you can just submit it to the American board via the submit button. Submit a button to file and pay because it is confusing to some people that are using this new online filing system what submit they think it's like the daily submit of a clinical case so we are clarifying this button a little bit more now. However, it will take you to your summary all your information personal information will come up in this blank area. I left it blank for obvious reasons because it's mine. And it will take you to your payment page and will show you your fees, your recertification fees, and if you had to pay any additional fees for that year. You will then click submit, and you will get a verification that you submitted everything, you can always go back and look to see in your history when you submitted it, and I have a full record of all your submissions throughout the years. That's for the online filing system so really where I mentioned to you that we're going to listen to you. We're going to listen to what you say about the new online foot filing system seen what works what doesn't what can be improved. And again this is a work in progress this is something we're really invested in technology for the future. So one thing we're thinking about to is having professional activity. You record of professional activity recorded via a QR code. So for example, if I signed up for the Texas heart meeting, we would assign a QR code for the Texas heart meeting. And once you registered you would get that QR code you click out on your phone, and it automatically download into your online filing system. So this is that's something that we're really looking into for the future. We're hoping that will come up in the next year or two where you'll make it so much easier for you for you and for the administrators of these meetings to do this. We also working on at base communications from American board so along with our online filing system have surveys or information or communications from the American board go directly to your phone. And we're also thinking about having a storage system too so you can show your employer or anybody interested your certificate and your license automatically on your phone. And please tell us what you think about it again it's a work in progress you appease please be patient with this. It is quite a task and it doesn't. It doesn't go smoothly as plan, as you can expect with life. So what else is the American board been up to. Well, we were active in our subcommittees to investigate address and collaborate with other organizations and ever changing perfusion isn't static is changing all the time and pretty fast. So we've developed a subcommittee of ECMO bad and new technology to keep ahead of all this and how to implement it into the exam process and the recertification process also. This past pandemic has taught us we need a subcommittee to look more into the covert 19 pandemic and how it affects the perfusionist and our students. So right now, if you have a problem with your clinical cases or anything, and you email the national office and say hey I got a problem with the, I can't make my recertification this year, it automatically goes to the subcommittee for evaluation. And again, everything is handled on a case by case basis we don't make breaking statements for everybody. We like to be personable and work with everybody on the pandemic and any problems they may have. Another progress is ex vivo organ perfusion is now considered a primary clinical case and see the book of information for more information on requirements of ex vivo organ perfusion. We've heard from a lot of centers that this should be because it takes a vast majority of time requires a lot of skill and basic perfusion maneuvers. So we agreed with this and is now a primary clinical case. Excuse me, exam development, we are focusing on adding more ECMO bad questions, we are fortifying and updating pediatric questions. Technology changes techniques changes so we really need to go back and update a lot of questions. We added many new PDSE and Kate questions to the exam recently to is ever changing and never growing. We also working with simulation centers to accept their criteria for clinical cases. We have 12 simulation centers throughout the United States that met the criteria to be recognized as a simulation centers. As I said, these centers can be used for clinical case credit. Similar cases can be used as a secondary credit for up to 15 per year. Basically a secondary event. So see the American Board website for more details on this information. Another great thing that we did this last thing was less few years is having emeritus CCPs and honoring CCPs that have a 20 plus years of dedicated service that are retiring. We currently have 655 CCP emeritus is out there was a great honor to recognize these people have served the community for so long. In addition, we've added a memorandum section to remember the CCPs who have passed on again, you know, just looking at this list of you can just pick out people that you know, or, or, you know, even if you don't know very well you saw the meeting and get a good time with them and share the laugh with them. It's good to remember these people that came before us. And we should have some more news coming out this summer or later this fall about more advancements in the American Board processes. Again, I would like to remind you that the American Board will constantly monitor the COVID-19 crisis and affects our profession, our educational system, and the individual CCP. The American Board will adapt to make any necessary certification changes during this difficult time. It's been a tough year for all of us and the CCPs have continued to advance despite adversity and COVID pandemic and can't thank you enough for all your dedication to profession and staying with each other during this time of crisis. Thank you. Please stay safe out there. I will take any questions. Thank you.