We have a beginning toolbox (Entry #2), but nothing to brag
about. How can we improve the toolbox? Let me lay out some OFIs.
1.
We need more and better questions, assignments, and realistic
team projects. Colleague Begun says he wants cases. I’m not opposed, but we
need to start beginners at the beginning. I’m not sure cases are the best tool
for that. You can think of the “assignments” as mini-cases.
2.
We need ways to conduct year over year assessment of
student learning. I want to find OFIs
and do better in ’17.
3.
We need to test the overall structure, basically are we
producing good professionals? I want to score my 2016 grads, look at their post
grad performance, and find more OFIs.
“Good” is teaching that will help our students implement
best practice on the job and be fully satisfied with their professional life. Our
most pressing need is to measure how good our tools are, so we can make them
better. All the usual questions of reliability and validity are important. We
have a limited grasp right now; we need to improve our understanding.
Our LMS and our initial learning tools give us a start. With
the automated multiple choice (AMCQ), peer grading, and review rubrics, we have
quantitative scores to evaluate both individual and class performance. The text
annotating system should give us evidence of student concerns. Reliability is
uncertain. Within a single program, it’s probably safe to use these measures to
identify OFIs and assess year over year improvement. It’s also reasonable to
use individual scores to identify students needing assistance, subjectively
verifying improvable behavior. As samples accumulate, we can do statistical
analysis.
Validity is the more challenging question. How do we know we
are on the right track? What constitutes “implement best practice?” I have
postulated that the AMCQ and QFD are (1) realistic, and (2) properly answered
in the accompanying commentary. What if I’m wrong? That’s an interesting
philosophic question that must be addressed by every profession in its
education and certification activities. The answer used throughout clinical
medicine is expert panels, including researchers, teachers, and practitioners,
convened to discuss a specific subject and to publish a report summarizing
their consensus and areas of disagreement.
The collaborative tools won’t be finished until we have similar
panels vetting 3 core questions:
·
What is excellence in managing HCOs, and what
processes achieve it?
·
Are the questions asked of students consistent
with excellence, and comprehensive enough to support beginning practice?
·
Are the recommended answers correct and
complete?
This sounds completely unrealistic until you recognize that:
1.
Engineering and medicine have addressed analogous
problems with substantial success.
2.
A growing list of HCOs have actually published detailed
documentation of high performance. They have systematically copied earlier
success, extending it to a varied array of American communities. Their work has
been carefully audited. The documentation implements evidence-based management.
While improvements are not only possible but likely, the processes they
describe constitute best practice. (http://patapsco.nist.gov/Award_Recipients/index.cfm
)
3.
An additional bibliography is not hard to accumulate,
with help from sources like IOM’s Best
Care at Lower Cost, AHA’s Hospital Research and Education Trust, and the
Institute for Healthcare Improvement.
#CreatingHealthcareManagers