March 24, 2011
8 PDT/11 EDT/15 GMT/23 SGT
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Attending: Susan Albright & Marc Triola, co-chairs; Valerie Smothers, staff; Michael Awad, Adrian Ballard, Terri Cameron, Chris Candler, Charles Conway, Christie Ferguson, Rachel Ellaway, Erica Friedman, Josh Jacobs, Heather Hageman, Heidi Hayes, Cindy Lybrand, Chandler Mayfield, Dan Nelson, Robby Reynolds, Brian Rutledge, Al Salas, Paul Schilling, Juliane Schneider, Rosalyn Scott, Kevin Souza, Peter Speltz, Hugh Stoddard, Britta Thompson, Tim Willett.
Note: Several people accessed the call late due to inadequate teleconference ports at the beginning of the call. Those who have indicated they called in have been added to this list, even if they did not announce themselves publicly. In addition, we’ve raised the number of ports to 40 to avoid having this problem in the future.
1 Review minutes of last meeting
Susan welcomed the group. The minutes were approved.
2 AAMC update, Terri Cameron
Terri commented that AAMC has determined priorities for coming year, and this project is a high priority. They are now working in parallel on an LCME database process. That will help schools do all 5 sections of LCME accreditation. Policy data from the LCME questionnaire will be used to populate the new LCME database. This data should be 100% accurate data and can be used in conjunction with content information from the curriculum inventory portal (CIP). Data from CIP will be preloaded into the LCME database. They are looking at all places where AAMC requests information from the school. The LCME database will be pre-populated with that data. Once there are appropriate amounts of data, they will be able to offer benchmarking and performance tools.
Susan clarified that curriculum inventory data would seed the database and therefore be an important part of the accreditation process, significantly “upping the ante” for CIP participation.
Marc commented that the slide set showed a list of potential data elements on slide 5. He asked how concretely AAMC is thinking about those data elements. That would inform the standard.
Terri commented that the list represents feedback from focus groups. They have taken the presentation to regional meetings. It’s a good representation of what they would like to capture. There are some things missing – year, history, etc. But those are the major datasets.
Marc asked Terri if AAMC had thought about what competency set would be used.
Terri replied that they will use the MedBiquitous standard for competencies. The ultimate goal is to look at all of the competencies for health professions and match them up. ACGME, MSOP, individual school objectives… they want a master set so if you link to one it knows the others. Schools would have to match their individual objectives on their own.
3 Review of competency use cases, Tim Willett
Tim explained that use cases are descriptions of human uses of a system. When you consider trying to build a standard, what will the system allow humans to do? Envision the task a human will want to accomplish. The use case describes the humans who want to interact, the goal of the interaction, what assumptions there are about the interaction, and what the system does behind the scenes, ie the transactions. It shows what standards are necessary and identifies what specifications might exist to help. We provide an id, a title, and the task to be accomplished. Actors are the humans involved. In the first use case, it lists an Assumption that a competency framework exists and the LMS wants to import it. Then there is a description of what would happen.
Doing the use cases helps define the scope and priorities. It also allows you to test the standard to see if you have accomplished what you set out to do.
4 Discussion of potential use cases for curriculum inventory and proposed use cases and scenarios
Tim walked through the use cases he drafted. The first would transfer a curriculum structure to a national database, such as the CIP. The second would allow the user to associate parts of the curriculum with specific competencies using the national system aggregating curricula. The third would transfer the curriculum, the competency framework, and the links between them to the national database. Use case 4 addresses how you might query for competencies, ie what competencies does this course address. Use case 5 is also a use case of the competencies working group – mapping one set of competencies to another. In the competencies working group, it became clear that there is overlap and complementary competencies across frameworks. It is a tremendous amount of work to create a curriculum map. Once you have it mapped against one competency framework is another year of work. A better solution is to map one competency framework to another. Then remapping is not necessary. The competency working group has been working on the individual competency statements and how they interrelate in a framework. How they map is planned for future development. Number 6 looks for curricular components that address a particular competency. There may be an interest in seeing to what extent a session supports a competency, or how. Number 8 gets at comparing curricula. Perhaps each comparison should be expressed as a different use case.
Susan thanked Tim for his tremendous amount of work. She asked the group to think about what other use cases might be used.
Terri offered to convert some scenarios and upload them before the next meeting.
Tim asked for feedback from AAMC. Terri said they all look great.
Rachel asked to take another stab at the use cases. She recommended talking about a curriculum management system in more generic terms. For example, it may not be a national database that brings data together. In addition, we should clearly identify what goes over the wire concentrate on what we can do in terms of transport.
Editorial note: Some of the use cases presented describe functionality that would take place in a central system that receives the data; others describe when and for what purpose curriculum data would be transmitted. Use cases describing what takes place in the central system may or may not impact what goes into the standard. We should be careful in our use case scope to include those use cases that will impact what goes into the standard.
Rache; added that there are integrated curricula, those with longitudinal themes, other forms. Looking at the slides, they talk about an American model. In Canada, many curricula do not fit well with that model. We need to accommodate broader range of expression.
Susan replied that Tim has taken a first stab. The issues raised are excellent. Not only should everyone think about additional use cases, she encouraged them to consider the draft use cases, whether or not they agree with this, and any modifications that might be necessary. Valerie encouraged an email conversation for the comments.
Valerie agreed to work with Terri to develop use cases around the scenarios she provided for distribution.
Susan also recommended that the group develop a glossary of terms for the use cases. She recommended starting with LMS and curriculum management and go onto other things cited in the use cases.
Terri added that we need to keep in mind the concept of milestones. She questioned how we would fit that into curriculum management and systems as a whole.
Valerie commented that the Educational Trajectory working group would be working on an Educational Achievement specification that would document evidence of competence and achievement of milestones. Tim added that both milestones and achievement would be relevant to this standard.
Rachel commented that all the things that need to be reported that don’t look like curricula. There are logistical details as well. It may be worth looking at standards for organizational capacity. Otherwise we won’t look at all of the accreditation requirements.
Terri commented it might be out of scope for this working group. Robby agreed, adding that this specification is not intended to be inclusive of the LCME database. A future spec may address those requirements. Schools can enter additional info not captured in this system.
Rachel replied that some areas are blurred. ER36, for example, relates to curriculum and logistics. Robby replied that data would come from the LCME survey and will be available to pre-populate the LCME database.
Rachel commented that should be a defining factor for this work. We need to be clear we aren’t doing all of the things in LCME.
Susan recommended having that in the parking lot to keep an eye on as we move through our work.
5 Discussion of curriculum schematics
Susan commented that this topic grew out of recommendations from first call. By uploading our schematics, we can see the issues we need to deal with. Susan asked as many people as possible to put their schemas up. The better this info, the better our standard will be.
Terri commented that AAMC had asked LCME to stop using the terms preclinical and clinical. LCME has switched to year 1, 2, 3, 4. But many schools have different structures – 18 month blocks. Interprofessional health education, community based education, etc, and that needs to be addressed. We want to see where something occurs, defining that “where” is a challenge.
Susan added that at Tufts they have the concept of parent and child courses. We need to flesh out the idiosyncrasies.
Robby added that the LCME is working with them and may make changes based on their input. We can be creative when going through the process.
Marc commented that we talked about competencies. AAMC lists topics, assessment methods, and educational methods as data to include in the curriculum inventory, and those would require controlled vocabularies, which is a challenge.
Terri agreed. They would come up with standardized terms. They could set one up and require schools to match, or we could look for synonyms.
Susan commented that in the competency working group we left aside assessment. She asked if it would be revisited.
Tim commented that an assessment takes place when a competency is implemented. A judgement may determine whether someone is competent or not, so that is external to the work of the Competency Working Group. Valerie clarified that the Educational Trajectory working group would be defining specifications related to achieving competency in its Educational Achievement work, which is about to start up.
Marc commented that we could have a yes/no as to whether an educational event has an assessment component.
Tim asked Rachel if the METRO project could provide some taxonomies.
Rachel commented that the vocabulary didn’t get them anywhere. She recommended more abstract, accommodating terms.
Marc agreed that even whether or not something was a lecture could be disputed.
Terri commented that some schools link sessions to the assessment method used in the course. Kevin added that their system links sessions to assessment methods used in their courses. Chris added that they are doing same.
6 Open discussion
- The group will provide feedback on the use cases submitted and submit additional use cases for consideration.
- Valerie will add to the glossary preface to the use cases and work with Terri to convert AAMC scenarios to use cases.
- The group will upload curriculum schematics for consideration.