Developing measures of educational change for academic health care teams implementing the chronic care model in teaching practices.
BACKGROUND
The Chronic Care Model (CCM) is a multidimensional framework designed to improve care for patients with chronic health conditions. The model strives for productive interactions between informed, activated patients and proactive practice teams, resulting in better clinical outcomes and greater satisfaction. While measures for improving care may be clear, measures of residents' competency to provide chronic care do not exist. This report describes the process used to develop educational measures and results from CCM settings that used them to monitor curricular innovations.


METHODS
Twenty-six academic health care teams participating in the national and California Academic Chronic Care Collaboratives.


METHODS
Using successive discussion groups and surveys, participants engaged in an iterative process to identify desirable and feasible educational measures for curricula that addressed educational objectives linked to the CCM. The measures were designed to facilitate residency programs' abilities to address new accreditation requirements and tested with teams actively engaged in redesigning educational programs.


METHODS
Field notes from each discussion and lists from work groups were synthesized using the CCM framework. Descriptive statistics were used to report survey results and measurement performance.


RESULTS
Work groups generated educational objectives and 17 associated measurements. Seventeen (65%) teams provided feasibility and desirability ratings for the 17 measures. Two process measures were selected for use by all teams. Teams reported variable success using the measures. Several teams reported use of additional measures, suggesting more extensive curricular change.


CONCLUSIONS
Using an iterative process in collaboration with program participants, we successfully defined a set of feasible and desirable education measures for academic health care teams using the CCM. These were used variably to measure the results of curricular changes, while simultaneously addressing requirements for residency accreditation.
Bowen
Judith L
JL
Oregon Health & Science University Portland, OR 97239-3098, USA. bowenj@ohsu.edu
Stevens
David P
DP
Sixta
Connie S
CS
Provost
Lloyd
L
Johnson
Julie K
JK
Woods
Donna M
DM
Wagner
Edward H
EH
D000553:Ambulatory Care; D002140:California; D002908:Chronic Disease; D002983:Clinical Competence; D003299:Cooperative Behavior; D003479:Curriculum; D004059:Diffusion of Innovation; D004493:Education; D004521:Educational Measurement / Q000379:methods*; D004522:Educational Status; D005240:Feasibility Studies; D017144:Focus Groups; D019538:Health Care Surveys; D006784:Hospitals, Teaching; D006801:Humans; D008962:Models, Theoretical; D010348:Patient Care Team; D018794:Problem-Based Learning; D016730:Program Development; D015397:Program Evaluation; D013597:Systems Analysis; D013663:Teaching; D013997:Time Factors