{"id":17,"date":"2007-03-30T07:20:15","date_gmt":"2007-03-30T15:20:15","guid":{"rendered":"http:\/\/www.ramblemuse.com\/rmtp\/2007\/03\/30\/guidelines-learning-objects-competence-descriptions\/"},"modified":"2007-04-14T12:56:12","modified_gmt":"2007-04-14T20:56:12","slug":"guidelines-learning-objects-competence-descriptions","status":"publish","type":"post","link":"https:\/\/www.ramblemuse.com\/rmtp\/2007\/03\/30\/guidelines-learning-objects-competence-descriptions\/","title":{"rendered":"Guidelines, Learning Objects, &#038; Competency Definitions"},"content":{"rendered":"<p>Over the last 15 months, I&#8217;ve been working as part of the <a target=\"_blank\" href=\"http:\/\/www.massagetherapyfoundation.org\/\">Massage Therapy Foundation&#8217;s<\/a> Best Practices Committee on defining a protocol for creating evidence-based guidelines for massage therapy. Fairly early on in the process I did a <a target=\"_blank\" href=\"http:\/\/www.ramblemuse.com\/mmap\/documents\/rev_guidelines.html\">draft literature review of existing criteria<\/a> for guideline creation. Recently, I&#8217;ve been thinking of how to define outcomes from training. These are what the trainee should be able to do\/demonstrate after the training, not the process of the training. It gets away from the pervasive idea in the massage world that the results of training are defined by hours. Several weeks ago, I put together <a target=\"_blank\" href=\"http:\/\/www.ramblemuse.com\/mmap\/documents\/training_outcomes.html\">a few notes<\/a> and an example of some very rough XML.<\/p>\n<p>With a bit more searching around, I&#8217;ve come up with some more pieces of what the informatics people are doing in similar directions. The first addition is the work on <a target=\"_blank\" href=\"http:\/\/en.wikipedia.org\/wiki\/Learning_object_metadata\">Learning Object Metadata<\/a> (LOM). The second piece is with <a target=\"_blank\" href=\"http:\/\/www.ostyn.com\/rescompetency.htm\">Reusable Competency Definitions<\/a> (RCDs). In particular, look at Claude Ostyn&#8217;s white paper on <a target=\"_blank\" href=\"http:\/\/www.ostyn.com\/standardswork\/competency\/DistillingCompetencyInformation.pdf\">Distilling Competency Information<\/a>.<\/p>\n<p>The interaction between these information elements would be useful, for example, to a rural health care facility willing to hire practitioners not fully meeting desired knowledge and skills, and then bring them up to speed. Thus identifying and remedying skill gaps would be important. The flexibility to do this, provides the rural facility more leverage in recruiting \u00e2\u20ac\u201d i.e. lets them be more competitive in recruiting practitioners for what might be seen as less desirable locations. The facility could use guidelines to help determine what prior knowledge is essential and what can be added &#8220;in place&#8221;. The interaction of context specific guidelines [<a target=\"_blank\" href=\"http:\/\/gem.med.yale.edu\/default.htm\">Guideline Element Model<\/a> (GEM)], learning object metadata (LOM), and reusable competence descriptions (RCDs) facilitate this.<\/p>\n<p>The guidelines can include fields both for suggested protocols and considerations for suggested competencies. The suggested competencies can point directly to a database of RCDs. The RCDs can in turn point to the collection of learning objects for the competencies. The comparison of the individual&#8217;s knowledge, skills, and abilities (based on multiple streams of input) with the LOMs in the RCDs results in the training plan. In searching around, I found sample use cases for implementation of these concepts in <a target=\"_blank\" href=\"http:\/\/www.ostyn.com\/standardswork\/competency\/RecruitingUseCase1.pdf\">recruiting<\/a> and <a target=\"_blank\" href=\"http:\/\/www.ostyn.com\/standardswork\/competency\/ProjMgmtUseCase1.pdf\">filling team learning gaps<\/a>. I also came across a <a target=\"_blank\" href=\"http:\/\/medir.ohsu.edu\/~hersh\/amia-06-medbiq.pdf\">paper<\/a> and <a target=\"_blank\" href=\"http:\/\/medir.ohsu.edu\/~hersh\/amia-medbiq.pdf\">presentation<\/a> specific to health care.<\/p>\n<p>Back in December 2003, I attended a lecture by <a target=\"_blank\" href=\"http:\/\/en.wikipedia.org\/wiki\/William_Wulf\">William A. Wulf<\/a>, president of the National Academy of Engineering. One of his comments that struck me was on the difference between small improvements in technology that make something already being done easier and on the continuing and often unexpected  social changes stemming from huge quantitative changes in technology. He  noted that he had a computer in his briefcase 100 times faster than the  <a target=\"_blank\" href=\"http:\/\/en.wikipedia.org\/wiki\/ENIAC\">ENIAC<\/a> (circa 1946) which weighed 100 tons and was the size of a squash  court. The computer in his briefcase? A greeting card with a general 4-bit  microprocessor to generate music. Wulf quoted a statement by Danny Hillis.<\/p>\n<blockquote><p>&#8220;I went to my first computer conference at the New York Hilton about 20  years ago. When somebody there predicted the market for microprocessors  would eventually be in the millions, someone else said, &#8216;Where are they all going to go? It&#8217;s not like you need a computer in every doorknob!'&#8221;<\/p>\n<p>&#8220;Years later, I went back to the same hotel. I noticed the room keys had  been replaced by electronic cards you slide into slots in the doors.&#8221;<\/p>\n<p>&#8220;There was a computer in every doorknob.&#8221;<\/p><\/blockquote>\n<p>I expect the changes in the informatics of guidelines, learning objects, and competence descriptions to create a similar impact. We can expect the health care system (and other systems) to adopt both the mechanisms and the benefits of more specific granularity in managing knowledge, skills, and abilities (KSAs) that technology is making possible. It&#8217;s more efficient use of people. One way or the other, legislation will evolve to accommodate such practices. We might as well look to the future and start defining competence in terms of KSAs and training outcomes.<\/p>\n<p>All of this combines well with the studies of how people transition to new careers (e.g. Herminia Ibarra, <a target=\"_blank\" href=\"http:\/\/www.amazon.com\/Working-Identity-Unconventional-Strategies-Reinventing\/dp\/1591394139\/\">Working Identity<\/a>). Technology will change how we view learning and careers. It allows us to be more precise on what needs to be learned and when, and to allow the &#8220;try it on&#8221; approach that Ibarra discusses without the costs of &#8220;front-loading&#8221; education in the &#8220;linear model&#8221; of learning.<\/p>\n<p>It also ties in with a quote in a <a target=\"_blank\" href=\"http:\/\/www.ffne.org\/PDF%20files\/transition0905%20David%20Leach.pdf\">presentation by David Leach<\/a>, executive director of the Accreditation Council for Graduate Medical Education. &#8220;You Improve what you measure&#8221;.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Over the last 15 months, I&#8217;ve been working as part of the Massage Therapy Foundation&#8217;s Best Practices Committee on defining a protocol for creating evidence-based guidelines for massage therapy. Fairly early on in the process I did a draft literature review of existing criteria for guideline creation. Recently, I&#8217;ve been thinking of how to define [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5,4],"tags":[],"class_list":["post-17","post","type-post","status-publish","format-standard","hentry","category-health","category-technology"],"_links":{"self":[{"href":"https:\/\/www.ramblemuse.com\/rmtp\/wp-json\/wp\/v2\/posts\/17","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ramblemuse.com\/rmtp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.ramblemuse.com\/rmtp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.ramblemuse.com\/rmtp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ramblemuse.com\/rmtp\/wp-json\/wp\/v2\/comments?post=17"}],"version-history":[{"count":0,"href":"https:\/\/www.ramblemuse.com\/rmtp\/wp-json\/wp\/v2\/posts\/17\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.ramblemuse.com\/rmtp\/wp-json\/wp\/v2\/media?parent=17"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.ramblemuse.com\/rmtp\/wp-json\/wp\/v2\/categories?post=17"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.ramblemuse.com\/rmtp\/wp-json\/wp\/v2\/tags?post=17"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}