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Mapping cognitive overlaps between practice-based learning and improvement and evidence-based medicine: an operational definition for assessing resident physician competence.

ABSTRACT: PURPOSE: The complex competency labeled practice-based learning and improvement (PBLI) by the Accreditation Council for Graduate Medical Education (ACGME) incorporates core knowledge in evidence-based medicine (EBM). The purpose of this study was to operationally define a "PBLI-EBM" domain for assessing resident physician competence. METHOD: The authors used an iterative design process to first content analyze and map correspondences between ACGME and EBM literature sources. The project team, including content and measurement experts and residents/fellows, parsed, classified, and hierarchically organized embedded learning outcomes using a literature-supported cognitive taxonomy. A pool of 141 items was produced from the domain and assessment specifications. The PBLI-EBM domain and resulting items were content validated through formal reviews by a national panel of experts. RESULTS: The final domain represents overlapping PBLI and EBM cognitive dimensions measurable through written, multiple-choice assessments. It is organized as 4 subdomains of clinical action: Therapy, Prognosis, Diagnosis, and Harm. Four broad cognitive skill branches (Ask, Acquire, Appraise, and Apply) are subsumed under each subdomain. Each skill branch is defined by enabling skills that specify the cognitive processes, content, and conditions pertinent to demonstrable competence. Most items passed content validity screening criteria and were prepared for test form assembly and administration. CONCLUSIONS: The operational definition of PBLI-EBM competence is based on a rigorously developed and validated domain and item pool, and substantially expands conventional understandings of EBM. The domain, assessment specifications, and procedures outlined may be used to design written assessments to tap important cognitive dimensions of the overall PBLI competency, as given by ACGME. For more comprehensive coverage of the PBLI competency, such instruments need to be complemented with performance assessments.

SUBMITTER: Chatterji M

PROVIDER: S-EPMC2931258 | biostudies-other | 2009 Dec

REPOSITORIES: biostudies-other

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Project description:BackgroundDetermining which therapies fall under the umbrella of complementary, alternative, and/or integrative medicine (CAIM) is difficult for several reasons. An operational definition is dynamic, and changes depending on both historical time period and geographical location, with many countries integrating or considering their traditional system(s) of medicine as conventional care. We have previously reported the first operational definition of CAIM informed by a systematic search. In the present study, we have developed a comprehensive search string informed by an operational definition of CAIM for systematic bibliographic database search strategies.MethodsWe developed a single search string for the most common bibliographic databases, including those searchable on the OVID platform (e.g., MEDLINE, EMBASE, PsycINFO, AMED), the EBSCO platform (e.g., ERIC, CINAHL), Scopus, and Web of Science, using the finalised operational definition of CAIM's 604 therapies. We searched the Therapeutic Research Center's "Natural Medicines" database for all 604 therapies, and each item's scientific name and/or synonym was included as a keyword or phrase in the search string.ResultsThis developed search string provides a standardised list of CAIM terms (i.e., keywords and phrases) that may be searched on bibliographic databases including those found on the OVID platform (e.g., MEDLINE, EMBASE, PsycINFO, AMED), the EBSCO platform (e.g., ERIC, CINAHL), Scopus, and Web of Science.ConclusionResearchers can select relevant terms for their CAIM study and insert the keywords/phrases into these databases to receive all accessible data. This search technique can simply be copied and pasted into the search bar of each database to identify research by keywords, which is the most inclusive, or by words in the article title, which is more selective. Given its versatility across multiple commonly used academic platforms/databases, it is expected that this search string will be of great value to those conducting research on CAIM topics involving systematic search strategies.

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Mapping cognitive overlaps between practice-based learning and improvement and evidence-based medicine: an operational definition for assessing resident physician competence.

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