Establishing an AHRQ Learning Collaborative, A White Paper
Intersection of the AHRQ Learning Collaborative and the Health Services Research Community
As part of assessing the need for an AHRQ Learning Collaborative, we also explored current collaborations in the field of health services research to better understand the landscape and avoid unnecessary duplication. Central to that process were discussions with key leaders at AcademyHealth, a predominant convener of health services researchers, and a review of the previous work done on doctoral core competencies in health services research. It is important to keep in mind that the goals of these institutions and efforts, while all focused on health services research, may be distinct. Thus, consideration of how cross-institution efforts in the health services research community can be enhanced through collaboration should take into account the respective goals and interests of the distinct partners.
One example of existing efforts by AcademyHealth is the Health Services Research (HSR) Consortium.
The HSR Consortium is a forum for educators, employers, and students to address training needs for the field of health services research (HSR). A key goal of the HSR Consortium is to improve communication between stakeholders in the field and encourage partnerships to ensure that HSR training is appropriately meeting the needs of employers in the public and private sector, as well as academia.31
The first meeting of the HSR Consortium was held on June 30, 2009, during AcademyHealth's Annual Research Meeting. Since that time, the HSR Consortium has met annually to engage in conversations about updates in the field and how to support and advance training in health services research. Meeting materials are shared with members of the Consortium to promote enhanced collaboration and communication across the Consortium.
In addition to the HSR Consortium, there are several online resources available on the AcademyHealth Web site that are particularly focused on training, professional development, and career resources.32,33 These Web resources include listings of pre- and postdoctoral health services research training programs, information about online and in-person methods workshops, resources to support professional skill-building, resources for enhancing research skills and staying on top of the latest health services research literature, and a variety of opportunities, including employment, scholarships, fellowships, and funding. AcademyHealth is also developing a member profile, a social networking platform to be called "My AcademyHealth," where members can communicate in a manner similar to Facebook. This offers a way for members to communicate outside of the formal channels (Personal communication, Lisa Simpson, April 29, 2011).
To further promote participation in the broader health services research community, AcademyHealth has started Student Chapters. The main goal of a Student Chapter is "to enhance the learning and professional development experience for students of health services research and health policy" (Personal communication, Eric Kokuma, May 12, 2011). Currently, there are 26 Student Chapters, up from 13 last year (Personal communication, Lisa Simpson, April 29, 2011). Student Chapters participate in monthly journal clubs, host archived webinars at their respective universities, and invite speakers. AcademyHealth works with these chapters to support activities that could enrich the training experience. In addition, chapter leaders are invited to participate in the HSR Consortium meetings (Personal communication, Eric Kokuma, May 12, 2011). Encouraging all AHRQ T32 predoctoral training sites to establish a Student Chapter is of great interest to AcademyHealth at this time (Personal communication, Erin Holve, April 27, 2011). Furthermore, AcademyHealth is working to develop ways that Student Chapters can work together in the future to organize regional events (Personal communication, Eric Kokuma, May 12, 2011).
Ongoing conversations will be needed to fully understand how the AHRQ Learning Collaborative can interact with these efforts at AcademyHealth to prevent duplication of efforts and promote a value-added component for members of the AHRQ Learning Collaborative. Leaders at AcademyHealth are interested in staying involved in the continuing efforts of the AHRQ Learning Collaborative, as they develop.
Health Services Research Doctoral Core Competencies
There has been a concerted effort to establish a common set of knowledge and skills-based core competencies needed for health services researchers trained at the doctoral level. In 2005, several stakeholders participated in this conference, including training directors and students from T32 training programs, directors of the Council on Education for Public Health (CEPH)-accredited doctoral programs, and representatives from AcademyHealth, AHRQ, CEPH, and employers of health services researchers in both the public and private sector.34 The conference attendees reviewed a draft set of core competencies developed through an assessment of current literature, training grants funded by AHRQ, and accreditation materials from academic institutions that were submitted to CEPH. Drawing on Lohr and Steinwachs,35 health services research was defined as:
The multidisciplinary field of scientific investigation that studies how social factors, financing systems, organizational structures and processes, health technologies, and personal behaviors affect access to health care, the quality and cost of health care, and ultimately our health and well-being. Its research domains are individuals, families, organizations, institutions, communications, and populations.
The report recognizes that several disciplines, including "psychology, economics, anthropology, biomedicine, mathematics, political science, sociology, and management sciences" contribute to the health services research community, and this is reflected in the diversity of the training programs sponsored by AHRQ.34 Maintaining a balance between establishing a core set of standards across these training programs while continuing to support and enable innovation in training practices was a common concern of this effort. Those who receive doctoral degrees in health services research pursue careers in diverse settings including academic institutions, health care delivery systems, policy analysis organizations, and research institutes. However, as students enter these fields, they often lack a common identity about what it means to be a health services researcher and what skills and knowledge they are expected to demonstrate.34 Thus, the three primary goals of this effort are to:
- Assist program directors with developing and identifying the most important learning objectives for training students in health services research.
- Clarify for employers of graduates of health services research training programs what the skills and abilities are for individuals in health services research.
- Give health services research trainees a unique professional identity.
As a result of the conference, 14 health services research doctoral core competencies were established, based on a consensus of conference participants, and later published for dissemination purposes.36 The 14 core competencies as defined through this conference are included in Appendix E. The core competencies that resulted from this first effort were termed Version 1.34 To continue this effort, another conference was held to revisit the doctoral level core competencies, assess the extent to which programs used the competencies, and develop a revised set of core competencies.37 The result was a revised set of 11 HSR doctoral competencies (Version 2) as outlined in Table 1.
An important aspect of this initiative was to work to standardize the core knowledge and skills, yet at the same time encourage flexibility and innovation across the diverse training programs in health services research. Perhaps this could be one way that an AHRQ Learning Collaborative could support this effort, facilitating more sharing of innovative practices across programs, while at the same time valuing the diversity of training experiences that this field has to offer. In addition, a task of the AHRQ Learning Collaborative could be encouraging training programs to build on these core competencies across programs by refining the core competencies and establishing new ones for clinical and research postdoctoral trainees. Furthermore, core competencies could be developed in specific areas of health services research, such as comparative effectiveness research. These efforts could be one example of smaller collaborative efforts that take place within the larger AHRQ Learning Collaborative community. The result of these and similar initiatives could be increased awareness of health services research as a profession and a better defined identity for the health services research community.