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February 14, 2017


9 PST/10 MST/11 CST/12 EST/18 CET

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Agenda Items

Attending: Susan Albright and Hugh Stoddard, Co-Chairs; Terry Cameron, Sascha Cohen, Walter Fitzsimmons, Jenny Kessler, Cynthia Lybrand, Paul Schilling, and Valerie Smothers

Agenda Items

1 Review minutes (see

The minutes were accepted as submitted 

Representing EPAs in the curriculum 

Valerie provided a brief overview of the EPAs and CI document, which revised an existing document to show how EPA’s could be tied to curriculum.  Examples of performance frameworks related to being a short order cook were noted on page eight and entrustable professional activities on page ten.  The curriculum was divided into four courses: Nutrition, Basic Skills, Meal Planning and Service, with EPAs associated with each course. Events within the courses could be tied to competencies.  All this could be represented using the existing specification. In this model, the EPA is represented as a competency object and competency framework (to show EPA associations to competencies).  The competency object representing the EPA appears under expectations, and that can then be related to the curriculum.  She noted this is where the category element may become useful to indicate that the competency object is an EPA.  Susan asked if there was agreement on the definition of EPA.  Valerie answered yes and sited work by Olle ten Cate.  Although Hugh agreed with the definition in the literature of what an EPA is, he mentioned how people use it varies.   Cynthia agreed. 

Susan questioned whether assessment of EPA’s would become an issue for the AAMC.  Walter asked if EPA assessment methods for competencies could be built into the system. Hugh agreed the assessment of what someone should do infers the competency. Cynthia asked about the difference between milestones and EPA’s.  Hugh clarified milestones are steps along the way to a professional activity performed without supervision.  Hugh mentioned articles in the January Academic Medicine journal from the core EPA pilot groups may be helpful.  Susan suggested pursing this further with Terri.  She asked whether New York University was a core school.  Terri indicated they were and agreed to follow-up with Allison. Hugh will identify which articles for Valerie to send to the working group.  Valerie will check with Marc for his recommendations on EPA’s.  

3 Draft competency api 

Sascha noted that the draft circulated takes much from the UCSF API definitions and generalizes it so that it makes sense for a broader set of users and applications. He asked the group for input on what needs further clarification and additions.  Valerie suggested adding a piece to explain when you would use the competency API.  Sascha noted they used this when pulling from one system to generate context for specific outcomes and expectations. Susan asked for an example of a specific use case.  Sascha explained that UCSF has been working with the School of Pharmacy for performance testing between Illios and E-value. Curriculum data informs the evaluations that are captured.  

Cynthia noted that the API would allow different systems to speak the same language.  Susan added this provides us with guidelines for work to be done. Valerie explained that for each API there was a producer and a consumer. The consumer requests data or service, and the producer provides the data or service. Valerie provided the example of Exam Soft. The curriculum management system would be the producer, with applications like exam soft and e- value playing the role of the requester. The requester can use curriculum data to inform it services or provide context to other data. She mentioned speaking with Jose Lopez from University of Texas Health science center who has worked with Exam Soft.   She emphasized in order to be successful there has to be two parties willing to have transactions and speak the same language. 

Sasha noted that in cases where they are not able to work directly with the vendor, there are third party bridging tools that can act as mediators. Cindy noted this would reduce data entry and enhance reporting. Hugh questioned whether all vendors would comply with the MedBiquitous standard.  Valerie commented ideally many systems would implement the API’s and be part of the eco system.  Standards are needed to allow for communication, and vendors are interested in having those connections. A vendor suggested creating this standard.  Terri noted alleviating duplicate data entry would be a perfect use of the standard.  Being on the cutting edge opens doors for a more unified approach to documenting competencies in a curriculum.  Valerie provided the example of DICOM.  Imaging systems, known as picture archiving and communication system (PACS) previously had no standards. DICOM developed a standard. After the standard was developed, the VA mandated that all PACS purchased be DICOM compliant, and the industry changed overnight.  The more organized we are, the better the chance for success.  

A discussion followed on categorizing competency objects and whether the API should reflect a standard categorization method. The group discussed the categories used by UCSF. Valerie suggested adding category to Data returned and cautioned against creating standardized categories for the world.   Walter expressed concern that we may be expanding the specification to be a management system instead of information gathering system. It would be hard to find agreement with categories.  He suggested creating nested series of competencies instead.  Valerie will be creating those relationships but wanted a way to provide another tag to information brought back. 

Terri mentioned the AAMC is implementing best practice, with the definition of track following the LCME definition.  She added anything that provides flexibility is encouraged.  Valerie will circulate document to the entire working group for input.  



Action Items

  • Terri will follow-up with Allison at NYU regarding their typing of EPAs to curriculum in CORE. Valerie will check with Marc for his recommendations on EPA’s.
  • Hugh will identify which articles for Valerie to send to the working group. 
  • Sascha and Valerie will add Category to the data returned for the Expectations API call.
  • Valerie will circulate Terri’s document on the definition of track for working group input.