Mission

To develop and promote technology standards for the health professions that advance lifelong learning, continuous improvement, and better patient outcomes.

Not-for-profit, member-driven, standards development organization

Technology Blueprint Based on Extensible Markup Language

(XML)• An open industry standard developed by WWW Consortium to facilitate exchange of structured data

• Markup language is a set of annotations to text that describe how it is to be structured, laid out, or formatted.

• XML as an extensible language allows user to define mark-up elements

Standards Development• XML becomes more powerful when an industry

agrees on a common syntax• MedBiquitous provides a consensus-building

process for defining an XML vocabulary specific to medicine

• Standards allow linking of disparate information silos to facilitate access to resources, competency assessment activities, and organizations that support the ongoing education, performance, and assessment of healthcare professionals.

Building the Foundation:The MedBiquitous Architecture

* Official standards

VA and MedBiquitous• VA joined MedBiquitous in 2004• Early participation in Education Working and

Learning Objects Working Groups• Helped develop the Healthcare Learning Object

Metadata standard, ANSI/MEDBIQ LO.10.1-2008 – Allows for enhanced search and discovery based on

healthcare specific terminologies – Uses LOM as part of its cross agency collaborations

saving $/time in eliminating duplication of effort

ADL Partnering with MedBiquitous• The Advanced Distributed Learning (ADL) Initiative

was established by President Clinton• Ensure that DoD and other federal employees take

full advantage of technological advances in skill acquisition and learning

• Intent was to determine how to better support lifelong learning through the use of technology

• Establish guidelines on use of standards and assist DoD and other Federal agencies in the large-scale development, implementation, and assessment of interoperable and reusable learning

Proposed Accelerated Standard for Simulation-Based Education

• ADL leadership interested in partnering with VA and MedBiquitous to develop methodology for capturing simulation education data

• Standard would integrate MedBiquitous Competency and Performance Standards with ADL Experience API (xAPI) aka Tin Can API

• xAPI allows very different systems to communicate securely by capturing and sharing stream of learner activities using a simple vocabulary.

ACLS Tachycardia Scenario

A competency object . . .

Relates to other competency objects . . .

Which can relate to external resources . . .

Learning Object

EducationalAchievement

Performance Framework

Competency Framework

A Strategy for Return on Educational Investment

ACLS Competency Framework

MaintainAirway

MaintainCirculation

SelectMed & Dose

• Remove…• Perform…• Ventilate

…

• Perform…• Identify…• Assess…

• Select…• Dose…

ACLS Performance Framework

Perform Chest Compressions

Novice Intermediate Mastery

Depth off by > 1 SDTiming off by > 1SD

Depth off by 1 SD - .5 SDTiming off by 1 SD - .5 SD

Depth correctTiming correct

XAPI Message

Rosalyn Scott completed CPR simulation

Rosalyn Scott demonstrated competency “perform chest compressions” to level 3, mastery.

Integrating MedBiquitous and ADL Standards to Track Simulation

Activities

Compile Learner Data from Multiple Sources for Analysis

SimulationChecklist

Assessed airway? Assessed circulation?

Learner Record Store

Rosalyn Scott completed CPR simulation

Rosalyn Scott demonstrated competency “perform chest compressions” to level 3, mastery.

Rosalyn Scott completed CPR simulation checklist.

Rosalyn Scott demonstrated competency “assessed circulation” to level 3, mastery.

Rosalyn Scott completed CPR virtual patient.

Rosalyn Scott demonstrated competency “Select appropriate medication” to level 3, mastery.

XAPI

XAPI

XAPI

Assess circulation

Perfom chest compressions

Identify arrythmias

Use defibrillator 0

1

2

3

Look at Learner Data Across VA

According toindividual, profession, experience, trainee status, shift, unit, facility, VISN, enterprise

maintain airway maintain circulation select medication and dose

0

0.5

1

1.5

2

2.5

3

• Based on today's simulation training, how comfortable are you with diagnosing abdominal pain in a female patient?

• How many female patients have you seen in the last month? Average: 9 Range: 0-40

• How comfortable are you with diagnosing lower abdominal pain in a female patient?

Women’s Health RotationHybrid Simulation of Ovarian Torsion using DecisionSim VP and Mannequin

Pre-Assessment (n=55) Post-Assessment (n=53)