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Focusing on the Performance of Individuals Misses the Bigger (team) Picture

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teamworkI was fortunate to attend two conferences this month. First up was the MedBiquitous 2013 conference in Baltimore where the key theme of the conference was “big data”. From Baltimore, I headed to the NEGEA 2013 conference in New York City, hosted by Weill Cornell Medical College, where the theme was aligning values and competencies.

What struck me as I reflected on my experience at the conferences on the long flight back to Vancouver was how another theme – measuring the effectiveness of interprofessional teams, tied the two conferences together.

The importance of interprofessional activities and teams came up right away at the Medbiquitous conference. In his opening remarks, Peter Greene, Medbiquitous’ Executive Director spoke about the shift to interprofessional and interdiscilinary educational experiences and how cross-functional teams are common-place.

The topic came up again in David Nichols‘ presentation on “Longitudinal Outcomes Assessment of Clinicians.” The key takeaway I got from his presentation was that assessing physicians on an individual level is inadequate. There is a real need to think about and measure team performance and outcomes.

This was plenty of food for thought on the train ride from Baltimore to New York – “how can one45 support interprofessional and team-based evaluation and performance assessment?” (As an aside, If you have any thoughts or ways that you are already doing this, I’d love to hear from you!)

With thoughts of team-based evaluations on my mind, my ears perked up when Deborah Simpson brought up the topic during her keynote at the NEGEA meeting. Dr. Simpson noted that while the import of interprofessional training and teamwork is a hot topic, no one really knows how to evaluate the effectiveness of teams, particularly cross-functional ones.

To underscore how important it will be in the coming months to figure this out, I learned about a new LCME standard, ED 19A during a presentation on LCME Hot Topics by Suzi Rose and Latha Candran. The new standard says that:

The core curriculum of a medical education program must prepare medical students to function collaboratively on health care teams that include other health professionals. Members of the health care teams from other health professions may be either students or practitioners.

My takeaway from these conferences was that there is a seismic shift happening around how medical students, practitioners, and schools are evaluated. The shift toward competency-based training and evaluation and the development of new standards and methods of assessing competency is well underway. We see this in the emerging standards for competency frameworks, performance frameworks, entrustable professional activities and in the common standards and formats for sharing that information.

What is now emerging is a new way of thinking about evaluating the entire enterprise. When we think of medical education activities in the context of the Triple Aim framework, where population health, patient experience, and per capita cost outcomes are the key indicators of success, it’s clear that individual performance evaluation is only one piece of the puzzle.

I’m excited by the challenges ahead and feel privileged to have had an opportunity to attend these conferences and learn from so many experts and practitioners. I look forward to speaking and working with all of you to solve these new challenges together.


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