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Competencies Working Group

09 May 2011

Co-chairs:Rosalyn Scott, MD FACSTimothy Willett, MD

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Agenda

1. Introductions 

2. Overview of conceptual model and work to date 

3. Discuss levels, milestones and other outstanding issues

4. Open discussion

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MedBiquitous Competencies Working Group• Charter:

• “to develop XML standards and supporting guidelines for competency data enabling educational resources and activities to be tied to a competency framework”

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The big picture

Competency

LearningObjects

ActivityReport

Virtual Patient

CurriculumInventory

EducationalTrajectory

reports address

shows progression

maps

address

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WORK TO DATE

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Use Cases and SurveyUse Case Mean

score (scale 1-7)

Record performance data as evidence of competence for learning or assessment 6.0

Search a system to find curricular components (for example learning activities or assessments) addressing a particular competency

5.8

Record activities related to and evidence of competence within a portfolio that details the expected competencies and how the individual has progressed relative to each competency

5.8

Search a system to develop a report that details what competencies are addressed in the curriculum 5.7

Direct a clinician to learning based on gaps in competence (remediation) 5.5

Qualify the link between a competency/ontology and a person or curricular component, (e.g. the degree to which a learner has demonstrated a competency)

5.5

Index a competency framework against a controlled vocabulary, terminology, or ontology 5.4

Compare competence data for a clinician against a benchmark (gap analysis) 5.3

Export a portfolio or portion of a portfolio 5.3Map one set of competencies to another 5.1Use a machine readable set of competencies or learning outcomes developed by a collaboration or another organization (import it into the system)

4.6

Subsequent to the survey, two additional use cases were identified:

Using competencies as part of federated search strategies for finding articles, resources or activities linked to competencies

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Reprivileging of hospital staff, as required by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), by linking performance/educational data for each staff member to defined competencies

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Comparison of published frameworks• Accreditation Council on Graduate Medical Education (ACGME) Competencies• Acute Care Nurse Practitioner Competencies • American Association of Critical-Care Nurses (AACN) General Patient Care Competencies &

Synergy Model• American Society of Health-System Pharmacists • CanMEDS 2005• CanMEDS Specialty Competencies • Good Medical Practice (UK) • Good Medical Practice (USA)• Entrustable Professional Activities• Pediatric Milestones (Am Board Ped)• Royal Australasian College of Surgery• The Scottish Doctor• Tomorrow's Doctors• Tufts University Medical, Dental and Veterinary Competencies• Tuning (MEDINE)• Women’s Healthcare Competencies

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Conceptual Model

• Competency Object• Competency

Framework• Extra-Competency

Relationships

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CURRENT STATUS

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Current issues

• Draft specifications:• Competency Object• Competency Framework

• Details (elements, structure)• XML binding

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Competency Object

• lom• Identifier (URL)• Title• Description• Publisher/author• Copyright• Target audience (profession)• Target audience (specialty)• Keyword• Context

• Category (type)• References• XtensibleInfo

• Exclude:• Assessment methods• Performance criteria• Level• Degree of

competence to be met (expectations/ standard)

• Conditions of performance / context

• Outcome criteria• Relationships

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Competency Framework• lom

• Identifier (URL)• Title• Description• Version• Publisher/author• Copyright• Target audience (profession)• Target audience (specialty)• Context

• (vocabulary: “undergraduate professional education”; “graduate professional education”; “continuing professional development”)

• SupportingInformation• Link• xhtml:div

• Relation• Internal relations only• Types:

• “haspart” = sub-competency• “haslevel” + # = level/milestone/performance• “relatedto” = unspecified relation (e.g. see also)

• Exclude:• External relations• Cross-mapping• Links to objects /

activities

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Comp Ob

Comp Ob Comp Ob

Comp ob Comp ob Comp ob

haspart haspart

Haslevel 1 Haslevel 2 Haslevel 3

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Comp Ob

Comp Ob Comp Ob

Comp ob

Comp ob

Comp ob

haspart haspart

Haslevel

before

before

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Comp Ob

Comp Ob Comp Ob

Milestone set

Comp ob

Comp ob

haspart haspart

Haspart

2

Comp ob1

3

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CURRENT ISSUES

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Issues

• Levels & milestones• Types: Static or contextual?• Re-using objects• Frameworks as objects and objects as

frameworks• How other objects refer to CompObj’s and

CompFwk’s• Cross-mapping frameworks

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Levels

• Do only the “leafs” have levels?• Other terms for levels/milestones• Structure of levels

• Can they be represented as CompObj?

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Type of CompObj

• CompObj has ‘category’ element• Is the category/type…

• Static – stays with the CompObj

OR• Contextual – Type may change if CompObj used

in another framework

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Re-Using CompObjs

• Developers of CompFwk 1 want to include previously-published CompObj X from CompFwk 2.• Decided:

• Only A gets included, NOT relations of A• If want to include relations, must re-state

• Are external objects mapped to A now mapped to CompFwk 1?

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Object-as-framework & vv.

CompFwk

haspart

CompObj

CompFwk

haspart

CompFwk

CompObj

haspart

CompFwk

CompObj

haspart

CompObj

? ?

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Referencing CompObjs

RLO

Metadata CompFwk 1

CompObj A

CompObj B CompObj C

addresses

How does a system ‘know’ that CompObj B belongs to CompFwk 1?

What if CompObj B belongs to more than one CompFwk?

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Cross-Mapping Frameworks

CompFwk 1

CompObj A

CompObj B CompObj C

CompFwk 2

CompObj X

CompObj Y CompObj Z

Cross-mapping

document

exactmatch

narrowermatch