Development of a learning health system science competency assessment to guide training and proficiency assessment.
Development of a learning health system science competency assessment to guide training and proficiency assessment.
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DOI：
10.1002/lrh2.10343
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发表时间：
2022-10
影响因子：
3.1
通讯作者：
Cella, David
中科院分区：
文献类型：
--
作者：
Franklin, Patricia D;Drane, Denise;Wakschlag, Lauren;Ackerman, Ronald;Kho, Abel;Cella, David
学习卫生系统（LHS）科学基本上是一个跨学科领域。为了了解LHS科学家的能力范围，AHRQ和国家专家定义了一系列支持成功的七个领域的42项能力。临床医生，研究人员和领导者谁是新的LHS领域可以识别和优先考虑这些领域之间的熟练发展。此外，现有的领导者和研究人员将组建代表LHS科学领域的专家团队。为了服务于LHS劳动力发展和能力评估，AHRQ资助的ACCELERAT K12培训计划招募了领域专家和学员，以定义和操作项目，包括在LHS能力评估中，以支持新兴和现有的LHS科学家优先考虑和监控能力发展。与18位专家进行的连续访谈迭代地定义了技能和任务，以说明LHS七个专业领域中的42种能力的熟练程度及其进展：系统科学;研究问题和科学证据标准;研究方法;信息学;卫生系统研究和实施的伦理学;改进和实施科学;参与，领导和研究管理。一位教育评估专家和LHS科学家在每个阶段改进了评估标准，以便在各个领域使用并行语言。最后，目前的受训人员审查和试点测试的评估和LHS能力评估进一步完善使用他们的反馈。评估框架是由布卢姆修订的教育目标分类法提供信息的（安德森和克拉思沃尔，学习、教学和评估的分类法：布卢姆的教育目标分类法的修订，2001年），其中学习的进展，从回忆，定义，理解和意识在较低水平的分类，应用和采用，最后创造，设计，并在分类学的上层进行批评。我们还制定了评估标准，可用于直接绩效的长期评估。货车der Vleuten等人（最佳临床妇产科实践研究）二○一○年; 24（6）：703 - 719）将长期直接评估方法定义为在数周至甚至数年的时间内进行的评估，涉及多种评估方法，并在较长时间内接触学习者的工作。本经验报告描述了LHS能力评估的内容。对于每个领域和能力，评估列出了支持每个熟练程度的专业知识的证据示例：没有接触;基础（意识/理解）;新兴（早期应用）;熟练（高技能水平的应用）。受训者开始使用基线标准评估表，在表中他们可以指出没有接触或标记他们有能力的基础和新兴技能。对于已经获得基础技能和新兴技能的领域，用户可以继续查看列出熟练程度证据的评估表。LHS能力评估在七个LHS领域提供一致的分级标准，以指导学员和导师评估从没有经验到基础知识，新兴能力和熟练程度的进展。该评估还可用于为那些新接触LHS科学的人和那些希望扩大LHS专业知识的关键专业知识的人设计培训和指导。
Learning health systems (LHS) science is fundamentally a transdisciplinary field. To capture the breadth of the competencies of an LHS scientist, AHRQ and national experts defined a series of 42 competencies across seven domains that support success. Clinicians, researchers, and leaders who are new to the LHS field can identify and prioritize proficiency development among these domains. In addition, existing leaders and researchers will assemble teams of experts who together represent the LHS science domains. To serve LHS workforce development and proficiency assessment, the AHRQ‐funded ACCELERAT K12 training program recruited domain experts and trainees to define and operationalize items to include in an LHS Competency Assessment to support emerging and existing LHS scientists in prioritizing and monitoring proficiency development. Sequential interviews with 18 experts iteratively defined skills and tasks to illustrate stage in proficiency, and its progression, for each of 42 competencies in the seven LHS expertise domains: systems science; research questions and standards of scientific evidence; research methods; informatics; ethics of research and implementation in health systems; improvement and implementation science; and engagement, leadership, and research management. An educational assessment expert and LHS scientist refined the assessment criteria at each stage to use parallel language across domains. Last, current trainees reviewed and pilot tested the assessment and the LHS Competency Assessment was further refined using their feedback. The assessment framework was informed by Bloom's revised taxonomy of educational objectives (Anderson and Krathwohl, A taxonomy for learning, teaching, and assessing: A revision of Bloom's taxonomy of educational objectives, 2001) where learning progresses from recalling, defining, understanding, and awareness at the lower levels of the taxonomy, to applying and adopting and finally to creating, designing, and critiquing at the upper levels of the taxonomy. We also developed assessment criteria that could be used for longer term assessment of direct performance. Van der Vleuten et al. (Best Pract Res Clin Obstetr Gynaecol. 2010;24(6):703‐719) define longer term direct assessment methods as assessment that occurs over a period ranging from weeks to even years and involves multiple assessment methods and exposure to the learner's work over an extended period. This experience report describes the content of the LHS Competency Assessment. For each domain and competency, the assessment lists examples of evidence to support expertise at each level of proficiency: no exposure; foundational (awareness/understanding); emerging (early application); and proficient (application with a high level of skill). Trainees begin with baseline standard assessment tables, where they can indicate no exposure or mark the foundational and emerging skills with which they have competence. For domains where foundational and emerging skills have been achieved, users can move on to assessment tables that list evidence of proficiency. The LHS Competency Assessment offers consistent, graded criteria across the seven LHS domains to guide trainees and mentors to evaluate progress from no experience to foundational knowledge, emerging proficiency, and proficiency. The assessment can also be used to design training and mentoring for those newly exposed to LHS science and for those with key expertise who wish to expand LHS expertise.