The Learning Health System Competency Appraisal Inventory (LHS‐CAI): A novel tool for assessing LHS‐focused education needs

Abstract

There is increasing interest in health care organizations functioning as learning health systems (LHSs) to improve the quality and efficiency of health care delivery while generating new knowledge. Individuals must be trained in associated concepts and competencies and subsequently positioned (or embedded) within the delivery system for maximum effect as they perform their scholarship. Potential researchers within LHSs come from many different training backgrounds; therefore, each LHS scholar requires a goal-directed plan tailored to his or her needs. There are few tools available to guide development, training, or evaluation of individuals interested in becoming leaders of research in LHSs. In this paper, we present a newly developed tool for guiding the training of such researchers, the Learning Health Systems Competency Appraisal Inventory (LHS-CAI). The LHS-CAI is modeled after the Clinical Research Appraisal Index (CRAI) used within Clinical and Translational Science Award sites across the United States. The LHS-CAI is a tool for trainees at all levels to use with their mentors in an interactive manner. The tool can then identify areas in which more training is needed and at what level to ensure success as a researcher within LHSs. We further modified the CRAI format to better leverage the LHS-CAI as a key part of an LHS scholar's individual development plan. To implement the LHS-CAI, we have identified key points within the Minnesota Learning Health System Mentored Career Development Program (MN-LHS) at which assessment of expertise for each competency would be useful to LHS scholars, mentors, and program leaders. Scholars in this program come from various clinical and academic backgrounds but are all targeting their career trajectories toward leading embedded LHS research. They will reevaluate their expertise upon completion of the program, with comparison to baseline serving as a key program evaluation tool. The LHS-CAI is currently being implemented with the first cohort of scholars in the MN-LHS program.

Identifying requisite learning health system competencies: a scoping review

“… 7 Greenberg-Worisek et al subsequently identified the domains from this work as competencies required of healthcare providers working in LHS. 15 However, this author did not consider the alignment between the competencies identified by Forrest et al and the skills and knowledge required by practitioners beyond identification of the domains. 7 Further research should explore which of the specific competencies as identified by Forrest et al should be developed for practitioners working in LHS and should also focus on the competencies of patients in the LHS.…”

“…Ten articles addressed practitionerrelated competencies, with early work done in the field of nursing. [14][15][16][17][18][19][20][21][22][23] Early work emphasised skills in evidence-based practice. 14 21 These skills included the ability to use guidelines and quality improvement programmes for evidence-based practice, the ability to use electronic health record (EHR) data to assess quality and provide quality care and the ability to use practice guidelines and clinical decision support (CDS) for evidence-based practice.…”

Training the next generation of learning health system scientists

“…2 , 3 The Agency for Healthcare Research and Quality (AHRQ) and the Patient‐Centered Outcomes Research Institute (PCORI) have seen the development of the LHS as a key strategy to help healthcare organizations make transformational changes to improve healthcare quality and value, and have invested in efforts to promote the development, synthesis, and rapid movement of new evidence into practice. 4 A brief but representative list of publications 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 from our institutions is included in the references. This selection contributes, if fractionally, to a rapidly growing body of impactful literature on the LHS.…”

Development of a rehabilitation researcher survey of knowledge and interest in learning health systems research

“…Our survey is distinctly different from prior work that developed an appraisal inventory to help direct LHS scholar's individual development plans and which utilized the core competency statements verbatim 12 . We revised some language in the original core competencies and wrote separate survey items for those core competencies that contained multiple components.…”

“…The ease of understanding the wording of the item (ie, the meaning of the item is clear and is free of overly vague language or unnecessary jargon) Our survey is distinctly different from prior work that developed an appraisal inventory to help direct LHS scholar's individual development plans and which utilized the core competency statements verbatim. 12 We revised some language in the original core competencies and wrote separate survey items for those core competencies that contained multiple components. Feedback from a multidisciplinary expert panel in rehabilitation was used to enhance clarity of language, and relevance for the rehabilitation research community.…”