1. ® Competencies Working Group 09 May 2011 Co-chairs: Rosalyn Scott, MD FACS Timothy Willett, MD

2. ® Agenda 1.Introductions 2.Overview of conceptual model and work to date 3.Discuss levels, milestones and other outstanding issues 4.Open discussion

3. ® 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”

4. ® The big picture Competency Learning Objects Activity Report Virtual Patient Curriculum Inventory Educational Trajectory reportsaddress shows progression maps address

5. ® WORK TO DATE

6. ® Use Cases and Survey Use CaseMean score (scale 1-7) Record performance data as evidence of competence for learning or assessment6.0 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 curriculum5.7 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 ontology5.4 Compare competence data for a clinician against a benchmark (gap analysis)5.3 Export a portfolio or portion of a portfolio5.3 Map one set of competencies to another5.1 Use 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- 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 -

7. ® 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

8. ® Conceptual Model Competency Object Competency Framework Extra-Competency Relationships

9. ® CURRENT STATUS

10. ® Current issues Draft specifications: Competency Object Competency Framework Details (elements, structure) XML binding

11. ® 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

12. ® 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

13. ® Comp Ob Comp ob haspart Haslevel 1Haslevel 2Haslevel 3

14. ® Comp Ob Comp ob haspart Haslevel before

15. ® Comp Ob Milestone set Comp ob haspart Haspart 2 Comp ob 1 3

16. ® CURRENT ISSUES

17. ® 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

18. ® Levels Do only the “leafs” have levels? Other terms for levels/milestones Structure of levels Can they be represented as CompObj?

19. ® 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

20. ® 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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23. ® Object-as-framework & vv. CompFwk haspart CompObj CompFwk haspart CompFwk CompObj haspart CompFwk CompObj haspart CompObj ??

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27. ® Referencing CompObjs RLO Metadata CompFwk 1 CompObj A CompObj BCompObj C addresses How does a system ‘know’ that CompObj B belongs to CompFwk 1? What if CompObj B belongs to more than one CompFwk?

28. ® Cross-Mapping Frameworks CompFwk 1 CompObj A CompObj BCompObj C CompFwk 2 CompObj X CompObj YCompObj Z Cross- mapping document exact match narrower match