Applying the Performance Framework Data Model August 15, 2013.

Applying the Performance Framework Data Model

August 15, 2013

Performance Framework

Metadata: lom, EffectiveDate, RetiredDate, Replaces, IsReplacedBy, SupportingInformation

PerformanceScale: id, LeastCompetent, MostCompetent

Component• id• Title• Abbreviation• Competency (reference to

a competency object)

• Author• Reviewer• AdditionalInformation

1+

ComponentReference: id of a nested Component 0+

PerformanceLevelSet 0 or 1

or

PerformanceScaleReference (reference to a LevelScale id) 1

PerformanceLevel 2+

• DisplayOrder• Label

• AdditionalInformation

Indicator: id, Description, AdditionalInformation 1+

Score: SingleValue OR Range (MinScore, MaxScore) 1

Internal Medicine Example• Title: The Internal Medicine Milestone Project • Identifier:

– Catalogue: URI– Entry: http://www.acgme-nas.org/assets/InternalMedicineMilestones

• Description: The Milestones are designed only for use in evaluation of resident physicians in the context of their participation in ACGME accredited residency or fellowship programs…

• Contributions:– Role: Author– Entity: William Iobst, M.D.– Role: Author– Entity: Eva Aagaard, M.D.

• Effective date: 2013-01-30

Internal Medicine Continued

• Supporting Information– This document presents milestones designed for

programs to use …• Performance Scale

– 1 to 5 (1 least competent, 5 most competent)– 1 to 3 (1 least competent, 3 most competent)

Internal Medicine Component

• ID: 12345• Title: Gathers and synthesizes essential and

accurate information to define each patient’s clinical problem(s).

• Competency: Description: http://www.example.org/im_milestones/PC1.xmlType: http://ns.medbiq.org/competencyobject/v1/

• Competency:Description: http://www.example.org/im_framework.xml Type: http://ns.medbiq.org/competencyframework/v1/

Note: likely to change

http://www.example.org/im_milestones/PC1.xml

http://ns.medbiq.org/competencyobject/v1

http://www.example.org/im_framework.xml

http://ns.medbiq.org/competencyframework/v1

Internal Medicine Component (continued)

• Threshold– Title: Entrustment– Description: The threshold for the entrustment

decision with regard to this competency– MinimumAcceptableScore: 4

Performance level set• Performance Scale Reference: 1 to 5

Position: 1 Score: Single Value: 1

Label: Critical Deficiencies

Indicator (id = i1_1): Does not collect accurate historical data

Indicator (id = i1_2): Does not use physical exam to confirm history

Indicator (id = i1_3): Relies exclusively on documentation of others to generate own database or differential diagnosisIndicator (id = i1_4): Fails to recognize patient’s central clinical problems

Indicator (id = i1_5): Fails to recognize potentially life threatening problems

This would allow indicator to be tracked as on/off.


Label:

Indicator (id = i2_1): Inconsistently able to acquire accurate historical information in an organized fashion Indicator (id = i2_2): Does not perform an appropriately thorough physical exam or misses key physical exam findingsIndicator (id = i2_3): Does not seek or is overly reliant on secondary data

Indicator (id = i2_4): Inconsistently recognizes patients’ central clinical problem or develops limited differential diagnoses

Position: 3 Score Single Value: 3

Label:

Indicator (id = i3_1): Consistently acquires accurate and relevant histories from patientsIndicator (id = i3_2): Seeks and obtains data from secondary sources when neededIndicator (id = i3_3): Consistently performs accurate and appropriately thorough physical examsIndicator (id = i3_4): Uses collected data to define a patient’s central clinical problem(s)


Label: Ready for unsupervised practice

Indicator (id = i4_1): Acquires accurate histories from patients in an efficient, prioritized, and hypothesis-driven fashionIndicator (id = i4_2): Performs accurate physical exams that are targeted to the patient’s complaints Indicator (id = i4_3): Synthesizes data to generate a prioritized differential diagnosis and problem listIndicator (id = i4_4): Effectively uses history and physical examination skills to minimize the need for further diagnostic testing

Position: 5 Score Single Value:5

Label: Aspirational

Indicator (id = i5_1): Obtains relevant historical subtleties, including sensitive information that informs the differential diagnosis;Indicator (id = i5_2): Identifies subtle or unusual physical exam findings

Indicator (id = i5_3): Efficiently utilizes all sources of secondary data to inform differential diagnosis Indicator (id = i5_4): Role models and teaches the effective use of history and physical examination skills to minimize the need for further diagnostic testing

Internal Medicine Component

• Competency: Description: http://www.example.org/im_milestones/PC.xmlType: http://ns.medbiq.org/competencyobject/v1/

• Competency:Description: http://www.example.org/im_framework.xml Type: http://ns.medbiq.org/competencyframework/v1/

• ID: 23456• Title: Patient Care• Additional Information (label = background): The

resident is demonstrating satisfactory development of the knowledge, skill…

http://www.example.org/im_milestones/PC.xml




Performance levels• Performance Scale Reference: 1 to 3


Label: Yes

Indicator (id = pc1): The resident is demonstrating satisfactory development of the knowledge, skill, and attitudes/behaviors needed to advance in training. He/she is demonstrating a learning trajectory that anticipates the achievement of competency for unsupervised practice that includes the delivery of safe, timely, equitable, effective and patient-centered care.


Label: No

Indicator (id = pc2): The resident is demonstrating unsatisfactory development of the knowledge, skill, and attitudes/behaviors needed to advance in training. He/she is not demonstrating a learning trajectory that anticipates the achievement of competency for unsupervised practice that includes the delivery of safe, timely, equitable, effective and patient-centered care.

Performance levels


Label: Marginal

Indicator (id = pc3): The resident is demonstrating marginal development of the knowledge, skill, and attitudes/behaviors needed to advance in training. He/she is marginally demonstrating a learning trajectory that anticipates the achievement of competency for unsupervised practice that includes the delivery of safe, timely, equitable, effective and patient-centered care.

Pediatrics Example

• Title: The Pediatrics Milestone Project• Identifier:

– Catalog: URI– Entry:

http://www.acgme-nas.org/assets/PediatricsMilestones• Contributions:

– Role: Author– Entity: Carol Carraccio, M.D.– Role: Reviewer– Entity: Richard Antonelli, MD, MS


Pediatrics Continued

• Supporting Information– http://www.acgme.org/acgmeweb/Portals/0/PFAssets/

ProgramResources/320_PedsMilestonesProject.pdf

• Performance Scale– 1 to 4 (1 least competent, 4 most competent)– 1 to 5 (1 least competent, 5 most competent)– 1 to 6 (1 least competent, 6 most competent)

Pediatrics Component• ID: 12345• Title: Gather essential and accurate information about the patient• Competency:

Description: http://www.example.org/peds_milestones/PC1.xmlType: http://ns.medbiq.org/competencyobject/v1/

• CompetencyDescription: http://www.example.org/peds_milestones.xml Type: http://ns.medbiq.org/competencyframework/v1/

• Author: Daniel Schumacher, MD • Additional Information (label = background):

Early Development of Information-Gathering Skills In the early stages of clinical reasoning, learners must rely upon their knowledge of basic pathophysiology and …

http://www.example.org/peds_milestones/PC1.xml




Pediatrics Component Continued• Additional Information (label = reference, position = 1): Schmidt HG,

Norman GR, Boshuizen HPA. A cognitive perspective on medical expertise: theory and implications. Academic Medicine. 1990;65:611-621.

• Additional Information (label = reference, position = 2): Carraccio CL, Benson BJ, Nixon LJ, Derstine PL. From the educational bench to the clinical bedside: translating the Dreyfus Developmental Model to the learning of clinical skills. Academic Medicine. 2008;83:761-767.

• Additional Information (label = reference, position = 3): Eva K. What every teacher needs to know about clinical reasoning. Medical Education. 2004;39:98-106.

• Additional Information (label = reference, position = 3): Schmidt HG, Boshuizen HPA. On acquiring expertise in medicine. Educational Psychology Review. 1993;5:205-221.

• Etc…

Performance level set• Performance Scale: 1 to 5

Position: 1 Score:Single Value: 1

Label:

Indicator (id = pc_i1): Either gathers too little information or exhaustively gathers information following a template regardless of the patient’s chief complaint, with each piece of information gathered seeming as important as the next. Recalls clinical information in the order elicited,7 with the ability to gather, filter, prioritize, and connect pieces of information being limited by and dependent upon analytic reasoning through basic pathophysiology alone.


Label:

Indicator (id = pc_i2): Clinical experience allows linkage of signs and symptoms of a current patient to those encountered in previous patients. Still relies primarily on analytic reasoning through basic pathophysiology to gather information, but the ability to link current findings to prior clinical encounters allows information to be filtered, prioritized, and synthesized into pertinent positives and negatives as well as broad diagnostic categories.

Free text reference

No formatting


Label:

Indicator (id = pc_i3): Advanced development of pattern recognition leads to the creation of illness scripts, which allow information to be gathered while it is simultaneously filtered, prioritized, and synthesized into specific diagnostic considerations. Data gathering is driven by real-time development of a differential diagnosis early in the information-gathering process.8


Label:

Indicator (id = pc_i4): Well-developed illness scripts allow essential and accurate information to be gathered and precise diagnoses to be reached with ease and efficiency when presented with most pediatric problems, but still relies on analytic reasoning through basic pathophysiology to gather information when presented with complex or uncommon problems.


Label:

Indicator (id = pc_i5): Robust illness scripts and instance scripts (where the specific features of individual patients are remembered and used in future clinical reasoning) lead to unconscious gathering of essential and accurate information in a targeted and efficient manner when presented with all but the most complex or rare clinical problems. These illness and instance scripts are robust enough to enable discrimination among diagnoses with subtle distinguishing features.

Pediatrics Component

• ID: 12345• Title: Prescribe and perform all medical

procedures • Competency:

Description: http://www.example.org/peds_milestones/PC8.xmlType: http://ns.medbiq.org/competencyobject/v1/

• Competency:Description: http://www.example.org/peds_milestones.xml Type: http://ns.medbiq.org/competencyframework/v1/

• Author: Patricia Hicks, MD





Additional Information (label = background)

• All of the competencies are involved in prescribing and performing medical procedures. In an integrated …

Additional Information ContinuedThe component KSA of each procedure are numerous and complex. They include: • Anatomy and Physiology • Indications and Benefits • Contra-indications and Risks • Informed Consent • Pain Management, Patient Psychological Preparation • Specimen Handling • Interpretation of Results or Outcomes • Procedural Technique (multiple elements unique to procedure; common elements to all [e.g., sterile

technique, situational awareness, course correction]) • Post-procedure Management

This approach to assessment makes some assumptions: • Performance level is specific to each procedure based on the relevant components and level of

responsibility of the physician. • Given the variability of required components, measures of competence are based on all of the relevant

components for that procedure. • Performance level for a given procedure, therefore, requires reaching the desired performance level for

each of the individual components.

Additional Information (label = reference, position = 1): Wigton R, Nicolas J, Blank L. Procedural skills of the general internist: a survey of 2500 physicians. Annals of Internal Medicine. 1989;111:1023-1034.

Additional Information (label = reference, position = 2): Wigton R, Blank L, Nicolas J, Tape T. Procedural skills training in internal medicine residencies. Annals of Internal Medicine. 1989;111:932-938.

Additional Information (label = reference, position = 3): Wigton R. Training internists in procedural skills. Annals of Internal Medicine. 1992;116:1091-1093.

Additional Information (label = reference, position = 4): Hicks C, Gonzales R, Morton M, et al. Procedural experience and comfort level in internal medicine trainees. General Internal Medicine. 2000;15:716-722.

Additional Information (label = reference, position = 5): Kirkpatrick DL. Evaluating Training Programs: The Four Levels. San Francisco, CA: Berrett-Koehler Publishers; 1998.

Additional Information (label = reference, position = 6): Kirkpatrick L, Kirkpatrick JD. The four levels: an overview. In: Kirkpatrick DL, ed. Evaluating Training Programs: The Four Levels. San Francisco, CA: Berrett-Koehler Publishers; 2006:21-26.

Additional Information (label = reference, position = 7): Davis D. Accuracy of physician self-assessment compared with observed measures of competence. Journal of the American Medical Association. 2006:296: 1094-1102.

Additional Information (label = reference, position = 8): Carbine D, Finer N, Knodel E, Rich W. Video recording as a means of evaluating neonatal resuscitation performance. Pediatrics. 2000;106:654-658.

Additional Information (label = reference, position = 9): Adams K, Scott R, Perkin R, Langga L. Comparison of intubation skills between interfacility transport team members. Pediatric Emergency Care. 2000;16:5-8.

Additional Information (label = reference, position = 10): Falck A, Escobedo M, Baillargeon J, et al. Proficiency of pediatric residents in performing neonatal endotracheal intubation. Pediatrics. 2003;112:1242-1247.

Etc.

Nested Component

• ID: 98765• Competency:

Description: http://www.example.org/peds_milestones/anatomy_physiology.xmlType: http://ns.medbiq.org/competencyobject/v1/


• Title: Anatomy and Physiology

http://www.example.org/peds_milestones/anatomy_physiology.xml




Performance levels• Performance Scale Reference: 1 to 4


Label: Beginning of Spectrum

Indicator (id = pcap_i1): 2 SD below mean on knowledge test


Label:

Indicator (id = pcap_i2): 1 SD below mean on knowledge test


Label:

Indicator (id = pcap_i3): 1 SD above mean on knowledge test


Label:

Indicator (id = pcap_i4): 2 SD above mean on knowledge test

Pediatrics Component from http://www.acgme-nas.org/assets/pdf/Milestones/PediatricsMilestones.pdf

• ID: 90876• Title: Identify strengths, deficiencies, and

limits in one’s knowledge and expertise• Competency:

Description: http://www.example.org/peds_milestones/PBLI1.xmlType: http://ns.medbiq.org/competencyobject/v1/


http://www.acgme-nas.org/assets/pdf/Milestones/PediatricsMilestones.pdf

http://www.example.org/peds_milestones/PBLI1.xml




Performance Levels

• Performance Scale Reference: 1 to 4Position: 1 Score:

Single Value: 1Label: Level 1

Indicator (id = pbli_i1): The learner acknowledges external assessments, but understanding of his performance is superficial and limited to the overall grade or bottom line; has little understanding of how the performance measure relates in a meaningful way to his specific level of Knowledge, Skills and Attitudes (KSA)Additional Information (label=example):

During a semiannual review, a learner is unable to describe in any specific terms how he has performed when asked to do so by his mentor. In response, the mentor reviews and interprets the learner’s evaluations and then asks the learner to reflect on the discussion. The learner repeats the language used and recites the overall score/grade without interpretation of further meaning or inference regarding the reported performance assessment.

Nursing (DNP Eval) Example

• Title: University of San Diego Hahn School of Nursing and Health Science DNPC 630 Residency DNP NP Student Evaluation

• Identifier: – Catalog: URI– Entry:

http://www.sandiego.edu/nursing/DNPC_630_Eval

• Performance Scale– 1 to 3 (1 least competent, 3 most competent)



DNP Component

• Competency: Description: http://www.example.org/dnp630_3.xml Type: http://ns.medbiq.org/competencyobject/v1/

• Competency: Description: http://www.example.org/dnp630.xmlType: http://ns.medbiq.org/competencyframework/v1/

• ID: 5678• Title: Prepared to practice independently

managing previously diagnosed and undiagnosed patients.

http://www.example.org/dnp630_3.xml



Performance Levels• Performance Scale Reference: 1 to 3


Label:

Indicator (id = pi_i1): Met


Label:

Indicator (id = pi_i2): In progress


Label:

Indicator (id = pi_i3): Not Met

National University of Singapore Example

• Title: Standards of Achievement• Identifier:

– Catalog: URI– Entry: http://www.nus.edu.sg/standards2013


http://www.nus.edu.sg/standards2013

NUS Component

• ID: 2013_1• Title: Standards of Achievement

Performance Levels• Performance Scale Reference: 1 to 5


Label:

Indicator (id = i1): Unable to achieve outcome.


Label:

Indicator (id = i2): Requires a lot of guidance to achieve outcome.


Label:

Indicator (id = i3): Requires moderate amount of guidance to achieve outcome.

Performance Levels


Label:

Indicator (id = i4): Able to achieve outcome with little or no guidance (entrustment)


Label:

Indicator (id = i5): Has the ability to guide/teach others.

Diagnostic Radiology Example(see http://www.acgme-nas.org/assets/pdf/Milestones/DiagnosticRadiologyMilestones.pdf)

• Title: The Diagnostic Radiology Milestone Project • Identifier:

– Catalogue: URI– Entry: http://www.acgme-nas.org/assets/DiagnosticRadiologyMilestones


• Contributions:– Role: Author– Entity: Kay Vydareny, MD– Role: Author– Entity: E. Stephen Amis Jr., MD


http://www.acgme-nas.org/assets/pdf/Milestones/DiagnosticRadiologyMilestones.pdf

Diagnostic Radiology Continued


programs to use…• Performance Scale


Diagnostic Radiology Component• ID: 546756• Competency:

Description: http://www.example.org/dr_milestones/PROF1.xmlType: http://ns.medbiq.org/competencyobject/v1/

• Competency: Description: http://www.example.org/dr_milestones.xmlType: http://ns.medbiq.org/competencyframework/v1/

• Title: Professional Values and Ethics• Additional Information (label = Assessment method): End-of-Rotation Global

Assessment• Additional Information (label = Assessment method): 360 Evaluation/Multi-rater/Peer• Additional Information (label = Assessment method): Simulation/OSCE• Additional Information (label = Assessment method): Direct observation and feedback• Additional Information (label = Assessment method): Conference attendance logs• Additional Information (label = Assessment method): Timeliness in completing

institutional and program requirements

http://www.example.org/dr_milestones/PROF1.xml



Diagnostic Radiology Component continued

• Additional Information (label = resource): Teaching and Assessing Professionalism: A Program Director’s Guide by the ABP and APPD . See Chapter 8: Measuring Professionalism, Critical incidents, Peer assessments, Multi-source assessments, Professionalism Mini-Evaluation Exercise (P-MEX)

• Additional Information (label = resource): The Professionalism Mini-Evaluation Exercise: A Preliminary Investigation. Richard Cruess, Jodi Herold McIlroy, Sylvia Cruess, Shiphra Ginsburg, and Yvonne Steinert Acad Med. 2006 Oct;81(10 Suppl):S74-8

These are suggested educational tools.

Diagnostic Radiology Component continued

• Additional Information (label = resource): Text: ABRF Online Modules on Ethics and ProfessionalismDcterms: references: Description: https://www.abronline.org/asp/abrf/

https://www.abronline.org/asp/abrf/



Label: Level 1

Indicator (id = p1_1): recognizes the importance and priority of patient care and advocates for patient interestsIndicator (id = p1_2): fulfills work-related responsibilities

Indicator (id = p1_3): is truthful

Indicator (id = p1_4): recognizes personal limitations and seeks help when appropriateIndicator (id = i1_5): recognizes personal impairment and seeks help when neededEtc…


Label: Level 2

Indicator (id = p2_1): Is an effective health care team member

Indicator (id = p2_2): Demonstrates professional behaviors listed in the second column


Label: Level 3

Indicator (id = p3_1): Is an effective health care team leader, promoting primacy of patient welfare, patient autonomy, and social justiceIndicator (id = p3_2): Demonstrates professional behaviors listed in the second column


Label: Level 4

Indicator (id = p4_1): Serves as a role model for professional behavior

Indicator (id = p4_2): Demonstrates professional behaviors listed in the second column


Label: Level 5

Indicator (id = p5_1): Participates in local and national organizations to advance professionalism in radiologyIndicator (id = p5_2): Mentors others regarding professionalism and ethics

Psychiatry Example(see http://www.acgme-nas.org/assets/pdf/Milestones/PsychiatryMilestones.pdf)

• Title: The Psychiatry Milestone Project • Identifier:

– Catalogue: URI– Entry: http://www.acgme-nas.org/assets/PsychiatryMilestones


• Contributions:– Role: Author– Entity: Sheldon Benjamin, M.D.– Role: Author– Entity: Adrienne L. Bentman, M.D


http://www.acgme-nas.org/assets/pdf/Milestones/PsychiatryMilestones.pdf

Psychiatry Continued


programs to use…• Performance Scale


Psychiatry Component• ID: 546756• Competency:

Description: http://www.example.org/psy_milestones/pc4.xmlType: http://ns.medbiq.org/competencyobject/v1/

• Competency: Description: http://www.example.org/psy_milestones.xml Type: http://ns.medbiq.org/competencyframework/v1/

• Title: Psychotherapy Refers to 1) the practice and delivery of psychotherapies, including but not limited to psychodynamic (1), cognitive-behavioral (2), and supportive therapies (3); 2) exposure to couples, family, and group therapies; and 3) integrating psychotherapy with psychopharmacology

• Additional Information (label = note, position = 1): Includes the capacity to generate a case formulation, to demonstrate techniques of intervention, and to understand the concepts of resistance/defenses, transference/countertransference

http://www.example.org/psy_milestones/pc4.xml


http://www.example.org/psy_milestones.xml


Psychiatry Component (continued)

• Additional Information (label = note, position = 2): Includes the capacity to generate a case formulation, to demonstrate techniques of intervention, including behavior change, skills acquisition, and addressing cognitive distortions

• Additional Information (label = note, position = 3): Includes the capacity to generate a case formulation, to demonstrate techniques of intervention, and to strengthen the patient’s adaptive defenses, resilience, and social supports



Label: Level 1

Indicator (id = pc4_1_1): 1.1 Accurately identifies patient emotions, particularly sadness, anger, and fear (4)

Additional Infomration (label =note): This thread, consisting of the first item at each level, regarding the development of empathy across residency is adapted from the AADPRT Psychotherapy Workgroup’s document “Benchmarks for Psychotherapy Training.”

Indicator (id = pc4_1_2): 1.2 Demonstrates interest and curiosity in patient’s story


Label: Level 2

Indicator (id = pc4_2_1): 1.1 Accurately identifies patient emotions, particularly sadness, anger, and fear (4)Indicator (id = pc4_2_2): 1.2 Demonstrates interest and curiosity in patient’s storyEtc.

Score ranges


Position: 1 Score: RangeMinScore: 1 MaxScore: 3

Label: Below Minimum

Indicator (id = i1_1): Performs inaccurate or grossly incomplete PE

Indicator (id = i1_2): Misses major or obvious findings in most cases


Label: Marginal Performance

Indicator (id = i2_1): Frequent significant omissions or inaccuracies


Label: Expected Performance

Indicator (id = i3_1): Occasional omissions or inaccuracies

Position: 4 Score: Single value: 10

Label: Exceeds Expectations

Indicator (id = i4_1): Complete, accurate PE; rare omissions or inaccuracies

TIME Example• Title: Transformation in Medical Education• Identifier:

– Catalogue: URI– Entry: http://www.utsystem.edu/initiatives/time/

• Description: This document elaborates the initial vision for competency-based education (CBE) in the University of Texas System's Transformation in Medical Education (TIME) initiative. CBE is one of the four principal elements of the TIME model of predoctoral physician education…

• Contributions:– Role: Author– Entity: Pedro Reyes, Ph.D.– Role: Author– Entity: Steve Lieberman, M.D.


http://www.utsystem.edu/initiatives/time/

TIME Continued


TIME Component

• ID: 56789• Title: Demonstrate compassion and respect

for patient• Competency:

Description: http://www.example.org/time_milestones/PC1_1_3.xmlType: http://ns.medbiq.org/competencyobject/v1/

• Competency:Description: http://www.example.org/time_framework.xml Type: http://ns.medbiq.org/competencyframework/v1/

http://www.example.org/time_milestones/PC1_1_3.xml

http://www.example.org/time_milestones/PC1_1_3.xml





TIME Component (continued)

• Threshold– Title: Milestone for transition to medical campus –

compassion and respect– Description: At the time of transition from the

undergraduate to the medical campus, the student will have demonstrated the ability to demonstrate compassion and respect for a patient in a stressful encounter when faced with a purpose designed ‐standardized patient based simulation challenge at the following level.

– MinimumAcceptableScore: 4



Label: I

Indicator (id = pc1_1_3_1): Demonstrates decontextualized skills, knowledge, behaviors


Label: II

Indicator (id = pc1_1_3_2): Demonstrates application of knowledge, skills, behavior to relevant health care problems


Label: II+

Indicator (id = pc1_1_3_3): Competency demonstration is required in non clinical ‐settings as a transition milestone. The skill/behavior is expected whenever the student is in clinical settings, but its demonstration is not required as a transition milestone.


Label: III

Indicator (id = pc1_1_3_4): Demonstrates competency in simulated environments.


Label: IV

Indicator (id = pc1_1_3_5): Consistently demonstrates competency in a clinical setting under direct supervision.


Label: V

Indicator (id = pc1_1_3_6): Consistently demonstrates competency in a clinical setting with supervision immediately available.


Label: VI

Indicator (id = pc1_1_3_7): Consistently demonstrates competency in a clinical setting without supervision (“entrustable”).

How are use cases addressed?• Map performance frameworks to competencies, including Entrustable Professional

Activities– YES (Competency Reference)

• Publish a performance framework for use in curriculum planning and assessment– YES (Requires IDs for Components so that assessments may be tied to performance levels)

• Import descriptions of performance levels for use in assessment– YES

• Reference a Performance Framework for use in assessment– YES (Requires IDs for Components so that assessments may be tied to performance levels)

• Describe an individual’s current level of performance for purposes of formative or summative assessment

– YES (a score and a reference to a Component should do the trick)• Describe an individual’s level of performance over a longitudinal period for purposes of

formative or summative assessment– YES (provided the framework is authored to support that)

• Associate assessment evidence with a particular level of performance in a portfolio– Change: assessment evidence to have a score that is interpreted using a particular group of

performance levels defined for the relevant competency.

How are use cases addressed?• Define where in a curriculum students are expected to achieve certain levels of

performance– YES (will require updates to curriculum inventory, may require id on performance level)

• Define what level of performance is required to progress to the next phase or block within a curriculum

– YES (will require updates to curriculum inventory, may require id on performance level)• Use in a system that is capable of showing a learner changes in performance over time

– YES• View data regarding the performance levels of learners in a program for purposes of

program evaluation (external)– YES (would require a spec that allows for the exchange of aggregate data)

• View data regarding the performance levels of learners in a program for purposes of program evaluation (internal)

– YES• Publish program data for public viewing

– YES (would require a spec that allows for the exchange of aggregate data)

Applying the Performance Framework Data Model August 15, 2013.

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