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A proposed conceptualization for the standardized digital representation of competencies

2011 MedBiq Conference

Timothy Willett, MDRosalyn Scott, MD FACSValerie SmothersRachel Ellaway, PhDSimon Grant, PhD

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MedBiquitous Competencies Working Group• Rosalyn Scott and Tim Willett, co-chairs• Launched in 2006• 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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DefinitionsCompetency

A statement describing a specific ability, or set of abilities, requiring specific knowledge, skill and/or attitude. Competencies are used to set performance standards that must be met.

Competency Object

An umbrella term used by the CWG to describe any abstract statement of learning or performance expectations, and information related to the statement. Statements can be learning outcomes, competencies (per se), learning objectives, professional roles, topics, classifications, collections, etc.

The Object is abstract in the sense that it does not inherently contain information about connections of the statement to individuals or events or other objects.

Competency Framework

An organized and structured representation of a set of interrelated and purposeful competency objects.

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Principles

• NOT a canonical competency framework

• Accommodate existing variety

• Reusability

• Competencies have levels/milestones

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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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THE CONCEPTUAL MODEL

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Statement

A competency object . . .

Relates to other competency objects . . .

Which can relate to external

resources . . .

Learning Object

Assess-ment

Performance data

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The “Competency Object”

• URL• Title (statement)• Description• Type• Metadata• References

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The “Competency Object”

• URL• Title (statement)• Description• Type• Metadata• References

http://example.com/competency/12345.xml

Clinical Judgment

Clinical reasoning, which includes clinical decision-making, critical thinking, and a global grasp of the situation, coupled with nursing skills acquired through a process of integrating formal and informal experiential knowledge and evidence-based guidelines.

Type = Competency

Metadata: (Publisher, date, copyright, etc.)

References: None

From AACN Synergy Model:

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The “Competency Object”

• URL• Title (statement)• Description• Type• Metadata• References

http://example.com/competency/12345.xml

Collaborator

As Collaborators, physicians effectively work within a healthcare team to achieve optimal patient care.

Type = Professional role

Metadata: (Publisher, date, copyright, etc.)

References: None

From CanMEDS 2005:

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The “Competency Framework”

• URL• Title• Description• Metadata• List of relations

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The “Competency Framework”

• URL• Title• Description• Metadata• List of relations

Competency

A

Competency

BCompetency

C

Level 1

XLevel 2

Y

http://example.com/framework/12345.xml

AACN Synergy Model

The core concept of the reconceptualized model of certified practice - the AACN Synergy Model for Patient Care - is that the needs or characteristics of patients…

Metadata: (Publisher, date, copyright, etc.)

A haspart BA haspart CB haslevel 1 XB haslevel 2 Y

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Example: Pediatric Milestone (ABP)

Competency: Patient Care

Milestone: Making Informed Diagnostic and Therapeutic Decisions That Result in Optimal Clinical Judgment

Anchor: Recalls and presents clinical facts…

Anchor: Focuses on features of the clinical presentation…

Anchor: Abstracts and reorganizes elicited clinical findings in memory…

1. The competency objects

haspart

haslevel 1 haslevel 2 haslevel 3

2. The competency framework

In development

Next phase

Out of scope

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Specs and Schemas Available At:• http://www.medbiq.org/working_groups/comp

etencies/index.html

• Open license, membership not required

Thank you!

• twillett@royalcollege.ca