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Meeting Information


September 9, 2009



Attending: Tim Willet and Rosalyn Scott, co-chairs; Susan Albright, Mary Pat Aust, Theresa Barrett, Simon Grant, Sean Hilton, Valerie Smothers.

Note: Problems with the teleconference provider kept some from gaining access to the call. We will switch to a new teleconference provider for the next call.

Agenda Items

1. Review minutes of last meeting

Teresa introduced herself. She is the Deputy Executive Vice President for the New Jersey Academy of Family Physicians. Her background is in education, and she does a lot of work in CME. She is looking forward to learning from the group.

Tim reviewed that in the last teleconference we recapped Baltimore meeting, reviewed the Medine framework, and spoke with Maria about her hospital based work in competencies. We also spoke about competency elements and decided to exclude criteria for assessment, levels of achievement, and a few other proposed elements. Susan asked if these were excluded because different people have different criteria for the same competencies. Valerie and Tim commented that they were. Two organizations may have different means by which to measure the same competence.

2. Review action items (*abms document *from David)

One action item from the last meeting was: Rosalyn will inquire about aviation industry use of competencies in training. Rosalyn commented that she has a PhD aviation industry expertise working with her, so she will be able to report on this next time. David Price did send a link to the ABMS document on maintenance of competence. Valerie commented that she was unsure exactly what David wanted to focus on in the document. Tim commented that we would defer discussion until the next time when David could join us. Maria had offered to send pharmacy competencies to the group. (Valerie distributed a link to these competencies after the call).

3. Discuss changes to competency environment

Valerie provided an overview of changes to the competencies environment document. Several additions were made to the terminology at the beginning of the paper. Several terms related to assessment were added in order to support the notion of assessment serving as evidence of competency. In addition, a definition of performance was added, defining performance as a demonstration of practice such as patient care. This also was added because performance may serve as evidence of competence.

Sean commented that the vocabulary was helpful. Tim added that there is a movement towards performance improvement and using performance as evidence of competency. Several on the call questioned the difference between performance and competence and whether the definition of performance needed further refinement.

Tim commented that his understanding was that having knowledge and skills leads to competence, which is the ability to the right thing, perhaps in a simulated environment. Competence can be measured in tests. Performance can only be measured with real patients. Sean agreed. A specific competence can be assessed in simulation and practice; performance is in practice. Susan questioned what one calls what an individual does in the simulator. The group agreed to further refine the definitions via e-mail subsequent to the call.

The next significant change in the competencies environment document on page 4 is a description of metadata. Valerie replaced the terms child and parent with broader term and narrower term, which are derived from the Simple Knowledge Organization System standard developed by the World Wide Web Consortium. The terms are also broadly used in the library and knowledge management communities. Valerie commented that she made these changes as a result of conversations with Simon and asked Simon to introduce himself.

Simon commented that he works for the UK's Joint Information Systems Committee and their Center for Educational Technology and Interoperability Standards (JISC CETIS). In particular, he has worked on a standard called the Leap 2 A, which provides interoperability for e- portfolios. Newcastle has used this for their undergraduate medical school. Susan asked if all of the medical schools in the UK had e-portfolios. Sean replied that a lot do, but not all. Newcastle are certainly the leaders. Susan asked Sean if he could provide a demonstration of St. George's system some time, and he agreed.

Valerie continued to walk through the changes in the white paper. On page 5 in the description of the conceptualization, she and Tim added the notion of competency evidence. Part of the larger concept of the architecture we are building must take into account that assessment data, performance data, and portfolio entries will serve as evidence of individual competence. She then moved page 6 and the table on potential elements within a competency object. Assessment methods, performance criteria, conditions and context, outcome criteria, and levels were all removed from the table. This is in keeping with the notion that many of these things will be defined from the competencies a replied rather than in the framework itself. The result is a much simpler competency object more aligned with the IEEE's reusable competency definition.

Simon commented that he saw on the wiki page a note regarding restricting the type of competency object one could define. He cautioned about restricting types. He explains that their different ways to use types: one can allow organizations to define themselves, or want to have a very precisely defined list. If it is precisely defined, it must be very easy for people to categorize things using the types. Otherwise people will categorize the same thing in different ways, which defeats the purpose of having a restricted list.

Tim pointed out that in medical education most of the candidate types are not well defined. He questioned whether that mattered. He concluded that having the type the optional and allowing multiple types would be a better approach. Valerie added that we could always provide a recommended list to encourage standardization without requiring it. Sean agreed that flexibility would help adoption and encourage dialogue.

Tim invited the group to discuss this further off-line. The other changes in the document relate to relationship among competencies within a framework. The group had concluded that the enabling relationship was not necessary since they would usually be a sub-competency/ narrower term.

Simon agreed and emphasized the need for relationships across frameworks as well.

4. Review specification

Valerie commented that she had not had the opportunity to revise the specification for the call. She added that the HR -- XML Consortium was in the process of balloting a new specification that included a new competency framework description. Their work may be something that this group could build on.

5. Open discussion

Rosalyn told the group that she has temporarily been assigned to the VA Central office in order to help them create a national strategy for simulation and a national center for simulation. There is a lot of funding for this effort, and it provides a wonderful opportunity to implement several MedBiquitous standards. She will be giving a talk to the VA steering committee and will include much about MedBiquitous.

Tim summarized that for the next call we would review a revised technical specification, discuss other types of relationships that may be important, and metadata for the competency framework. We will also be visit the competencies Maria brought up as well as the ABMS document distributed by David Price.


Action Items

  • Valerie will draft a revised specification and present HR-XML's work if available
  • Rosalyn's colleague to present competencies from aviation
  • David to present ABMS work
  • Tim to review pharmacy competencies from Maria
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