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Competency Working Group, April 18, 2007

Attending: Chris Candler and Roslyn Scott, cochairs, Susan Albright, Charlie Atkinson, Robin Bay, Norm Berman, James Dalziel, Mark Edelstein, Rachel Ellaway, Dennis Glenn, Lucas Huang, Jack Kues, Rachel Makleff, Dick Moberg, Valerie Smothers, Tim Willet

The group began with introductions and an overview of the working group's charter and work plan. Chris provided a definition of competency: any educational objective or educational outcome that results from knowledge, skills, or beliefs. Roslyn explains that the working group had discussed this at length and decided that this was the definition to go with.

Valerie described that the group seeks to create technology standards for competency frameworks, which can be used across the continuum of medical education. The IEEE has developed a specification for describing a single competency, but what is missing is a framework for describing many competencies and how they relate to one another. For example, many medical schools are implementing the ECG and need competencies, but it is often difficult to track learning activities and resources against these competencies. I technical framework for describing the competencies and mapping the content to the competencies would facilitate this process.

The IEEE does have a study group comprised of many different standards development organizations in major stakeholders that is exploring the possibility of developing new standards in this area. MedBiquitous staff and members of the working group participate in this study group. we intend to leverage whatever they develop, but also develop any healthcare specific specifications that are required. The main activity of this group right now is in gathering requirements as to what is necessary for describing a competency framework.

The group then review use cases drafted by Rachel Ellaway. The first use cases implementing an external learning outcomes framework. Rachel provided the example that at the University of Edinburgh, they are required to implement the Scottish doctor learning outcomes as well as government only required learning outcomes or competencies. Edinburgh uses a system to track which courses map to which competencies and outcomes. This will assist them with developing reports that show how specific learning outcomes are being addressed and where any gaps are. Rachel pointed out that this use case presupposes that a MedBiquitous standard exists.

Lucas Huang asked how application developers will know which competency vocabularies to use. Rachel replied that each individual community would have to decide on the vocabulary. The vocabulary used in Scotland will not be the same as the vocabulary used in the United States because of differing regulations and requirements. In the US the AAMC may work with others to develop vocabularies.

Tim Willet added that it's difficult to map things consistently. At University of Dundee, they are creating an ontology for healthcare education, and the competencies map to that ontology. This facilitates consistent mapping across one or more institutions.

James echoed that the mapping is a very hard problem. You fall back to a simpler level and develop a competency container, which is how the IEEE has handled it.

Charles asked if competencies are internal or external to a learning object. Chris replied yes. The content can reference or include the competency.

Tim described the challenge that he had in trying to map learning objects into their system. The competencies existed is only a text document with tabs used to visually represent the hierarchy. The learning system couldn't understand that it was a hierarchy and was unable to reflect that. That is why a technical standard is necessary.

Chris commented that several ontologies have been developed by the specialties. Geriatrics is going through the process. They are each organized and structured in a different way.

Rosalyn added that we need to settle out the use cases. We will distribute a template similar to Rachel's, we'll get submissions and take them to a more detailed level. Looking at simulation and integrating how simulation is used in education would be one worth exploring. Integrating specialty certification as a use case is important, too.

Susan commented that currently they have silo driven courses. The idea is to have integrated courses and then decide what the learning outcomes are. Educators need to decide how to assess whether an outcome has been achieved and need to develop portfolios to enable tracking of progress towards achieving those learning outcomes. We need a language to describe all of that.

Roslyn commented that this is similar to the issues with maintenance of certification. David Price's presentation talked a lot about family med doing things online.

Rachel Makleff suggested that in addition to circulating a use case template that we include some key questions to ask the use case developers to stimulate their thinking.

Ros - we'll make a call for use cases and send a template. Conference calls are very 6 weeks. We'll send schedule for next six calls. We can flesh out use cases on our next call.

Ross compared competencies and evidence of competence to merit badges and expressed interest in the consumer empowerment world to show that. Patients want to know someone has a recent competency review in a particular area.

We will circulate minutes and templates for use cases.


Chris Candler, co-chair,
Roslyn Scott, co-chair,
Susan Albright,
Charlie Atkinson,
Robin Bay,
Norm Berman,
James Dalziel,
Mark Edelstein,
Rachel Ellaway,
Dennis Glenn,
Lucas Huang,
Jack Kues,
Rachel Makleff,
Dick Moberg,
Valerie Smothers,
Tim Willet,

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