1. ® A proposed conceptualization for the standardized digital representation of competencies 2011 MedBiq Conference Timothy Willett, MD Rosalyn Scott, MD FACS Valerie Smothers Rachel Ellaway, PhD Simon Grant, PhD

2. ® MedBiquitous Competencies Working Group Rosalyn Scott and Tim Willett, co-chairs Launched in 2006 Charter: “to develop XML standards and supporting guidelines for competency data enabling educational resources and activities to be tied to a competency framework”

3. ® The big picture Competency Learning Objects Activity Report Virtual Patient Curriculum Inventory Educational Trajectory reportsaddress shows progression maps address

4. ® Definitions CompetencyA 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. 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 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. Competency Framework An organized and structured representation of a set of interrelated and purposeful competency objects.

5. ® Principles NOT a canonical competency framework Accommodate existing variety Reusability Competencies have levels/milestones

6. ® Comparison of published frameworks Accreditation Council on Graduate Medical Education (ACGME) Competencies Acute Care Nurse Practitioner Competencies American Association of Critical-Care Nurses (AACN) General Patient Care Competencies & Synergy Model American Society of Health-System Pharmacists CanMEDS 2005 CanMEDS Specialty Competencies Good Medical Practice (UK) Good Medical Practice (USA) Entrustable Professional Activities Pediatric Milestones (Am Board Ped) Royal Australasian College of Surgery The Scottish Doctor Tomorrow's Doctors Tufts University Medical, Dental and Veterinary Competencies Tuning (MEDINE) Women’s Healthcare Competencies

7. ® THE CONCEPTUAL MODEL

8. ® Statement A competency object... Relates to other competency objects... Which can relate to external resources... Learning Object Assess- ment Performance data

9. ® The “Competency Object” URL Title (statement) Description Type Metadata References

10. ® The “Competency Object” URL Title (statement) Description Type Metadata References http://example.com/competency/12345.xml Clinical Judgment Clinical reasoning, which includes clinical decision-making, critical thinking, and a global grasp of the situation, coupled with nursing skills acquired through a process of integrating formal and informal experiential knowledge and evidence- based guidelines. Type = Competency Metadata: (Publisher, date, copyright, etc.) References: None http://example.com/competency/12345.xml Clinical Judgment Clinical reasoning, which includes clinical decision-making, critical thinking, and a global grasp of the situation, coupled with nursing skills acquired through a process of integrating formal and informal experiential knowledge and evidence- based guidelines. Type = Competency Metadata: (Publisher, date, copyright, etc.) References: None From AACN Synergy Model:

11. ® The “Competency Object” URL Title (statement) Description Type Metadata References http://example.com/competency/12345.xml Collaborator As Collaborators, physicians effectively work within a healthcare team to achieve optimal patient care. Type = Professional role Metadata: (Publisher, date, copyright, etc.) References: None http://example.com/competency/12345.xml Collaborator As Collaborators, physicians effectively work within a healthcare team to achieve optimal patient care. Type = Professional role Metadata: (Publisher, date, copyright, etc.) References: None From CanMEDS 2005:

12. ® The “Competency Framework” URL Title Description Metadata List of relations

13. ® The “Competency Framework” URL Title Description Metadata List of relations Competency A Competency B Competency C Level 1 X Level 2 Y http://example.com/framework/12 345.xml AACN Synergy Model The core concept of the reconceptualized model of certified practice - the AACN Synergy Model for Patient Care - is that the needs or characteristics of patients… Metadata: (Publisher, date, copyright, etc.) A haspart B A haspart C B haslevel 1 X B haslevel 2 Y http://example.com/framework/12 345.xml AACN Synergy Model The core concept of the reconceptualized model of certified practice - the AACN Synergy Model for Patient Care - is that the needs or characteristics of patients… Metadata: (Publisher, date, copyright, etc.) A haspart B A haspart C B haslevel 1 X B haslevel 2 Y

14. ® Example: Pediatric Milestone (ABP) Competency: Patient Care Milestone: Making Informed Diagnostic and Therapeutic Decisions That Result in Optimal Clinical Judgment Anchor: Recalls and presents clinical facts… Anchor: Focuses on features of the clinical presentation… Anchor: Abstracts and reorganizes elicited clinical findings in memory… 1. The competency objects haspart haslevel 1haslevel 2haslevel 3 2. The competency framework

15. In development Next phase Out of scope

18. ® Specs and Schemas Available At: http://www.medbiq.org/working_groups/comp etencies/index.htmlhttp://www.medbiq.org/working_groups/comp etencies/index.html Open license, membership not required Thank you! twillett@royalcollege.ca