MedBiquitous Competency Object
Specifications and Description Document

 

 

 

 

Version: 0. 4 3

Date: May 20 September 14 , 2010

Author: Valerie Smothers

Author email: valerie.smothers@medbiq.org vsmothers@jhmi.edu

 

 

 

 

Version History

 

Version No.

Date

Changed By

Changes Made

0.1

11 Feb 2010

Valerie Smothers

Initial draft

0.2

24 Mar 2010

Valerie Smothers

URI’s required for identifier, eliminated overlap with lom, required certain lom elements. Added sample xml.

0.3

20 May 2010

Valerie Smothers

Changed structure of category element to be similar to Atom category element.

0.4

14 Sep 2010

Valerie Smothers

Added Supporting Information element. Filled out Data Elements section.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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Acknowledgements

 

The MedBiquitous Consortium wishes to acknowledge the help of  the MedBiquitous Competencies Working Group members, invited experts, and other individuals that contributed to the creation of this document, including:

 

  • Rosalyn Scott, M.D., Department of Veterans Affairs, Co-Chair
  • Tim Willet, M.D., CRI Critical Care Education Network, Co-Chair

 

  • Susan Albright, Tufts University
  • Mary Pat Aust, American Association of Critical-Care Nurses
  • Theresa Barrett , New Jersey Academy of Family Physicians
  • Chris Candler, M.D., Association of American Medical Colleges
  • Allan Cumming, M.D., University of Edinburgh
  • Tom Doyle, METI
  • Rachel Ellaway, Ph.D., Northern Ontario School of Medicine
  • Maria Esquela, Advanced Informatics
  • Vladmir Goodkovsky, University of Virginia
  • Simon Grant, Ph.D., Jisc Cetis JISC-CETIS
  • David Hadden, TheraSim
  • David Hananel, METI
  • Ted Hanss, University of Michigan
  • Ronald Harden, M.D., IVIMEDS
  • Sean Hilton, M.D., St. George’s University of London
  • Matt Lewis, Outcomes, Inc.
  • Michael Mintzer, M.D., Department of Veterans Affairs
  • David Price, M.D., American Board of Family Medicine
  • Carla Pugh, M.D, Northwestern University
  • Doris Quinn, Vanderbilt University
  • Isarin Sathitruangsak, Tufts University
  • Valerie Smothers, MedBiquitous
  • Lesley Southgate, M.D., St. George's University of London
  • David Stern, M.D., University of Michigan
  • Lana Vukovljak, American Association of Diabetes Educators
  • Jeff Williamson, American Medical Informatics Association
  • Nabil Zary, Karolinska Institute

 

 

Specification authors also received technical guidance from members of the MedBiquitous Technical Steering Committee.

 

  • Joel Farrell , IBM, Technical Steering Committee Chair
  • James Fiore, American Board of Surgery
  • Andrew Rabin, CECity
  • Dan Rehak, Learning Technologies Architect

 

 

This specification would not be possible without the previous work of Claude Ostyn, in particular the Proposal for a Simple Reusable Competency Map. Claude paved the way for this specification and others related to advanced uses of learning technologies. For access to Claude’s work, visit: http://www.ostyn.com/resources.htm

 

 


Introduction

 

This document describes MedBiquitous Competency Objects specification in detail. It is intended for use by anyone who wants to develop tools or implement electronic systems for defining and uniquely identifying competencies. The status of the document is indicated at the bottom of the page; draft documents are subject to review and approval through the MedBiquitous and ANSI standards development processes (see http://www.medbiq.org/working_groups/consortium_process/MedBiquitousANSIProcess.pdf ).

 

The use of outcome and competency frameworks is a growing part of healthcare education and maintenance of certification. Many nations or states have accreditation frameworks for health professions schools and programs as well as requirements to demonstrate lifelong learning and competency in medical specialties/subspecialties .  Currently, there is no standard way to represent these competencies in healthcare, and therefore no easy way to import/export competencies across systems. Once competencies are expressed in a common format, they can be used as the backbone of education and performance management systems, enabling the following:

 

  • Learners and educators able to search for learning resources addressing a particular competency
  • Educators able to determine where specific competencies are addressed in a curriculum
  • Boards and hospitals able to track and manage competency data for the professional.
  • Administrators are able to map one competency framework to another.

 

The objective of the specification is to provide a consistent format and data structure for defining a competency a competency object. This specification is meant to be used in concert with complementary specifications, including the MedBiquitous Competency Framework specification.

 

 


Documentation Conventions

 

This document uses the following conventions.

 

Documentation Conventions

Convention

Description

monospaced type

 

Sample XML tags, code, schema, or portion thereof

BoldText

When used with an XML tag name, indicates that the element contains sub-elements

Italicized Text

When used in an XML tag description, an attribute of the XML tag.

Tag description

Shading indicated that the tag is further described elsewhere in the document

 

The following graphical standards are used for the XML diagrams in this document.

 

 

Graphical Standards from TIBCO’s Turbo XML, Copyright TIBCO Software Inc.

 


Terminology

Much of the terminology in this area is ill-defined or ambiguous, often employed differently (and sometimes interchangeably) by different professionals. [i]   To ensure clarity and consistency we provide working definitions of the terminology we use in the context of this paper:

 

  • Competence – possession of sufficient and necessary knowledge, skill and attitude by an individual to allow her to safely and effectively perform a specific job.
  • Competency – a statement describing a specific ability, or set of abilities, requiring specific knowledge, skill and/or attitude.  Competencies are used to set performance standards that must be met. [ii]
  • Competency Framework – an organized and structured representation of a set of interrelated and purposeful competency objects.
  • Competency Object – an umbrella term used by the CWG to describe any abstract statement of learning or performance expectations, and information related to the statement.  Statements can be learning outcomes, competencies per se, learning objectives, professional roles, topics, classifications/collections, etc.  The Competency Object may include additional data to expand on or support the statement.  The Object is abstract in the sense that it does not inherently contain information about connections of the statement to individuals or events or other objects.
  • Learning Objective – the intended aggregate learner endpoint for an activity, typically directly linked to the means by which it is to be achieved.  Learning objectives may be derived from competencies or learning outcomes.
  • Learning Outcome – the intended aggregate learner endpoint for a program, typically independent of the means by which the outcome is achieved.  Used to identify, define and communicate the skills and qualities graduates should have. [iii]
  • Learning Object – a digital resource used to support learning.
  • Performance – a demonstration of practice, such as patient care. Can be used as evidence of one or more competencies.

 

Data Elements

 

The Competency Object schema includes the following elements. In some cases these elements have subelements.

 

  1. CompetencyObject
  2. Lom
  3. Category
  4. References
  5. etc SupportingInformation
  6. XtensibleInfo

 

The root element is CompetencyObject.

 

Other Schema Referenced

 

The Competency Framework leverages the IEEE Standard for Learning Technology-Extensible Markup Language (XML) Schema Definition Language Binding for Learning Object Metadata, 1484.12.3-2005, http://ieeexplore.ieee.org/servlet/opac?punumber=10263 (reference lom and healthcare lom).

 


Competency Object Schema Grammar

 

The following sections explain the Competency Object Schema grammar. Values in bold under XML Tags column indicate that the element has sub-elements.

 

All the elements having sub-elements will be defined in separate sections. All elements without sub-elements will be defined within the appropriate element sections that use them.

 

1         CompetencyObject

CompetencyObject is the root element. It contains subelements that define and uniquely identify a competency. CompetencyObject must occur once within a competency object document.

 

 

 

 

 

 


CompetencyObject Element Information

Element

Description

Required

Multiplicity

Datatype

CompetencyObject

CompetencyObject is the root element. It contains subelements that define a single competency in detail.

Required

1

Container

 

lom

lom is the subelement of CompetencyObject. It contains subelements that define identifier, title, description, publisher, and other descriptive information about this competency.

The lom element is defined in the Healthcare Learning Object Metadata standard defined by MedBiquitous. Please see the Healthcare Learning Object Metadata Specifications and Description document and the IEEE Standard for Learning Technology-Extensible Markup Language (XML) Schema Definition Language Binding for Learning Object Metadata, 1484.12.3-2005, http://ieeexplore.ieee.org/servlet/opac?punumber=10263 for more information on the sub-elements of lom.

The following sub-elements of lom are required in a competency object:

identifier

Defines a unique identifier for the competency. For competency objects, identifers must be in the form of a URI.

title

Defines the title for this competency in one or more languages.

The description element is recommended to provide a description of the competency in one or more languages should a description be necessary.

Required

1

Container

For more information, see  ANSI/MEDBIQ LO.10.1-2008 Healthcare Learning Object Metadata Specifications and Description Document and healthcarelom.xsd.

Category

Category is the subelement of CompetencyObject. It is modeled after the Atom category element and defines a category associated with this competency. Category has the following attributes:

term
The category for this competency object. The term attribute is required.

scheme
A URI for the categorization scheme. As a best practice, category definitions may be posted at the URI referenced.

label
A human-readable label for the term that may be displayed in end user applications.

Example:

<category term= " measurable outcomes " scheme= " http://tinyurl.com/2fosonk " />

 

Optional

0 or more

Empty

References

References is the subelement of CompetencyObject. References contains subelements that define specific references to the literature related to this competency. See section References element for more information.

Optional

0 or 1

Container

SupportingInformation

SupportingInformation is the subelement of CompetencyObject. It contains subelements that include or link to supporting information, such as formatted or lengthy descriptions of the competency object . See section SupportingInformation for more information.

Optional

0 or more

Container

XtensibleInfo

XtensibleInfo contains sub-elements defined by the organization implementing the schema. See section XtensibleInfo for more information.

Optional

0 or 1

Container

 

Example:

 

< CompetencyObject xmlns =" http://ns.medbiq.org/competencyobject/v1/ " xmlns:lom =" http://ltsc.ieee.org/xsd/LOM " xmlns:ex =" http://ltsc.ieee.org/xsd/LOM/extend " xmlns:ag =" http://ltsc.ieee.org/xsd/LOM/unique " xmlns:voc =" http://ltsc.ieee.org/xsd/LOM/vocab " xmlns:a =" http://ns.medbiq.org/address/v1/ " xmlns:hx =" http://ns.medbiq.org/lom/extend/v1/ " xmlns:hv =" http://ns.medbiq.org/lom/vocab/v1/ " xmlns:xsi =" http://www.w3.org/2001/XMLSchema-instance " xsi:schemaLocation =" http://ns.medbiq.org/competencyobject/v1/_object.xsd ">

< lom:lom >

< lom:general >

< lom:identifier >

< lom:catalog > URI </ lom:catalog >

< lom:entry > http://www.example.org/competency/12345 </ lom:entry >

</ lom:identifier >

< lom:title >

< lom:string language =" en "> Professionalism </ lom:string >

</ lom:title >

< lom:description >

< lom:string language =" en "> Exhibiting character, spirit, and standing suitable to the profession. </ lom:string >

</ lom:description >

</ lom:general >

</ lom:lom >

< Category term = "role" / > >

< References >

< Reference > Advancing education in medical professionalism: Anresource from the ACGME Outcome Project, The Accreditation Council for Graduate Medical Education, 2004. Accessed online 24 March 2010 at: http://www.acgme.org/outcome/implement/profm_resource.pdf</Reference >

</ References >

</ CompetencyObject >

 


2         References Element

References contains subelements that define specific references to the literature related to this competency.

 

 

 

References Element Information

Element

Description

Required

Multiplicity

Datatype

References

References is the subelement of CompetencyObject. References contains subelements that define specific references to the literature related to this competency.

Optional

0 or 1

Container

Reference

Reference is the subselement of References. Each Reference contains a single reference to the literature related to this competency.

Optional

0 or more

Non-null string

 

Example:

 

< References >

< Reference > Advancing education in medical professionalism: Anresource from the ACGME Outcome Project, The Accreditation Council for Graduate Medical Education, 2004. Accessed online 24 March 2010 at: http://www.acgme.org/outcome/implement/profm_resource.pdf</Reference >

< Reference >Embedding Professionalism in Medical Education: Assessment as a Tool for Implementation. National Board of Medical Examiners, 2002. Accessed online 24 March 2010 at: http://www.nbme.org/PDF/NBME_AAMC_ProfessReport.pdf

</ References >

 

 

Supporting Information Element

 

SupportingInformation includes or links to supporting information, such as descriptions of the rationale for developing the framework and its intended use.

 

 

Element

Description

Required

Multiplicity

Datatype

SupportingInformation

SupportingInformation is the subelement of CompetencyFramework. It contains subelements that include or link to supporting information, such as descriptions of the rationale for developing the framework and its intended use.

Optional

0 or more

Container

Link

Link is the subelement of SupportingInformation. It provides a URL or URI reference to a supporting resource, such as a pdf or html file describing the purpose of the framework in detail.

Link must contain a valid URI.

Either Link or xhtml:div is required

0 or 1

Restricted

xhtml:div

A div element is a mixed type element referenced from XHTML. The div element can include a mix of text and XHTML tags as specified by the XHTML schema.

For more information, see “ XHTML™ 1.0 The Extensible HyperText Markup Language” at: http://www.w3.org/TR/xhtml1/  

Either Link or xhtml:div is required

0 or 1

Container

 

 

 

Example:

 

<SupportingInformation>

<Link>http://www.example.org/co mpetencyobject1_formatted</Link>

</SupportingInformation>

 

Or

 


<SupportingInformation>

<xhtml:div>

<h1> P rofessionalism</h1>

< p > Respect </ p >

< ol >

< li > Respects institutional staff and representatives; respects faculty during teaching sessions </ li >

< li > Respects patient rights/dignity (privacy/confidentiality, consent); knocks on door, introduces self, drapes   appropriately, and shows respect for patient privacy needs </ li >

< li > Demonstrates tolerance to a range of behaviors and beliefs </ li >

< li > Does not disturb small group sessions </ li >

</ ol >

< p > Caring and Compassion </ p >

. . .

</xhtml:div>

</SupportingInformation>

 

 

 

 


Sample XML Document s

 

 

< CompetencyObject xmlns =" http://ns.medbiq.org/competencyobject/v1/ " xmlns:lom =" http://ltsc.ieee.org/xsd/LOM " xmlns:ex =" http://ltsc.ieee.org/xsd/LOM/extend " xmlns:ag =" http://ltsc.ieee.org/xsd/LOM/unique " xmlns:voc =" http://ltsc.ieee.org/xsd/LOM/vocab " xmlns:a =" http://ns.medbiq.org/address/v1/ " xmlns:hx =" http://ns.medbiq.org/lom/extend/v1/ " xmlns:hv =" http://ns.medbiq.org/lom/vocab/v1/ " xmlns:xsi =" http://www.w3.org/2001/XMLSchema-instance " xsi:schemaLocation =" http://ns.medbiq.org/competencyobject/v1/_object.xsd ">

< lom:lom >

< lom:general >

< lom:identifier >

< lom:catalog > URI </ lom:catalog >

< lom:entry > http://www.example.org/competency/12345 </ lom:entry >

</ lom:identifier >

< lom:title >

< lom:string language =" en "> Professionalism </ lom:string >

</ lom:title >

< lom:description >

< lom:string language =" en "> Exhibiting character, spirit, and standing suitable to the profession. </ lom:string >

</ lom:description >

</ lom:general >

< lom:lifeCycle >

< lom:contribute >

< lom:entity > BEGIN:VCARD\nFN:Center for Really Good DocsEND:VCARD </ lom:entity >

</ lom:contribute >

</ lom:lifeCycle >

</ lom:lom >

< Category term = " role " / > >

< References >

< Reference > Advancing education in medical professionalism: Anresource from the ACGME Outcome Project, The Accreditation Council for Graduate Medical Education, 2004. Accessed online 24 March 2010 at: http://www.acgme.org/outcome/implement/profm_resource.pdf </ Reference >

</ References >

</ CompetencyObject >

 

 


References

 

To be completed


[i] Harden RM.  Learning outcomes and instructional objectives: is there a difference?  Medical Teacher 2002; 24(2):151-5.

[ii] Albanese MA, Mejicano G, Mullan P, Kokotailo P and Gruppen L.  Defining characteristics of educational competencies.  Medical Education 2008; 42(3):248-55.

[iii] Harden RM, Crosby JR, Davis MH and Friedman M.  AMEE Guide No. 14: Outcome-based education: Part 5 – From competency to meta-competency: a model for the specification of learning outcomes.  Medical Teacher 1999; 21(6):546-52.