There’s a lot of ways to make these measurements that I’m talking about. There’s a whole world of psychometrics where wonderfully crafted multiple choice questions, large numbers of them written well, can measure what people’s competence is – what strategies they have for care. You can use standardized patients to measure what people’s competence is, what strategies they would use if given a certain clinical situation. You can use them before and after. You can look directly at patients' practices using performance measures at a very high level.
Most accredited providers have always used a measurement tool. They’ve given people questions up on the audience response system, on a piece of paper, on the Web after. And they’ve said: Are you happy with this educational activity? Well, that’s behind us. You can ask people whether they’re happy, whether they liked lunch, whether they liked the room, but that’s not a measure of competence or performance or patient outcome.
Some providers want to say: Are you going to do something different? and you get a yes or a no. That’s not what the ACCME is asking. There’s one more step; it’s not to say: Are you going to change? but [instead] you ask: What are you going to do differently now than you did before? Describe for us what you’re going to do differently now than you did before. When the accredited provider reads that information – when you analyze and synthesize the information that you get from this report – you will have determined that these people have changed and that they’ve changed to something that you’ve designed the educational activity to try and accomplish or meet. So that in evaluating the activity what you want to know is what competence, what performance or what patient outcome has occurred or changed as a result of your educational intervention. You can craft your evaluation or your measure any way you want. It can be self-reported by the physicians, it can be by outside observers looking at the physician — that’s not the issue. It’s whether or not it is a measure where people are actually planning or doing what’s different than what they had before.
