AMIA Board White Paper: AMIA 2017 core competencies for applied health informatics education at the master’s degree level

Annette L Valenta; Eta S Berner; Suzanne A Boren; Gloria J Deckard; Christina Eldredge; Douglas B Fridsma; Cynthia Gadd; Yang Gong; Todd Johnson; Josette Jones; E LaVerne Manos; Kirk T Phillips; Nancy K Roderer; Douglas Rosendale; Anne M Turner; Guenter Tusch; Jeffrey J Williamson; Stephen B Johnson

doi:10.1093/jamia/ocy132

. 2018 Oct 26;25(12):1657–1668. doi: 10.1093/jamia/ocy132

AMIA Board White Paper: AMIA 2017 core competencies for applied health informatics education at the master’s degree level

Annette L Valenta ^1,², Eta S Berner ³, Suzanne A Boren ⁴, Gloria J Deckard ⁵, Christina Eldredge ⁶, Douglas B Fridsma ⁷, Cynthia Gadd ⁸, Yang Gong ⁹, Todd Johnson ⁹, Josette Jones ¹¹, E LaVerne Manos ¹², Kirk T Phillips ¹³, Nancy K Roderer ^14,¹⁵, Douglas Rosendale ¹⁶, Anne M Turner ^17,¹⁸, Guenter Tusch ¹⁹, Jeffrey J Williamson ^20,^✉, Stephen B Johnson ²¹

¹Department of Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago, Illinois, USA

²Department of Medical Education, University of Illinois at Chicago, Chicago, Illinois, USA

³Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, Alabama, USA

⁴Department of Health Management and Informatics, University of Missouri, Columbia, Missouri, USA

⁵Department of Information Systems and Business Analytics, Florida International University, Miami, Florida, USA

⁶School of Information, University of South Florida, Tampa, Florida, USA

⁷Executive Office, AMIA, Bethesda, Maryland, USA

⁸Department of Biomedical Informatics, Vanderbilt University, Nashville, Tennessee, USA

⁹School of Biomedical Informatics, University of Texas Health Science Center, Houston, Texas, USA

¹¹Department of BioHealth Informatics, Indiana University-Purdue University, Indianapolis, Indiana, USA

¹²University of Kansas Center for Health Informatics, University of Kansas Medical Center, Kansas City, Kansas, USA

¹³Department of Health Management and Policy, University of Iowa, Iowa City, Iowa, USA

¹⁴Division of Health Sciences Informatics, Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA

¹⁵ISchool, University of Maryland, College Park, Maryland, USA

¹⁶Deloitte Consulting for Federal Healthcare, Washington, District of Columbia, USA

¹⁷Department of Health Services, University of Washington, Seattle, Washington, USA

¹⁸Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, USA

¹⁹Department of Computer Science and Information Systems, Grand Valley State University, Allendale, Michigan, USA

²⁰Education, AMIA, Bethesda, Maryland, USA

²¹Division of Health Informatics, Healthcare Policy and Research, Weill Cornell Medicine, New York, New York, USA

This paper was formally approved by the AMIA Board on May 7, 2018.

^✉

Corresponding Author: Jeffrey J. Williamson, AMIA, 4720 Montgomery Lane, Suite 500, Bethesda, MD 20814, USA (jeff@amia.org)

PMCID: PMC7647152 PMID: 30371862

Abstract

This White Paper presents the foundational domains with examples of key aspects of competencies (knowledge, skills, and attitudes) that are intended for curriculum development and accreditation quality assessment for graduate (master’s level) education in applied health informatics. Through a deliberative process, the AMIA Accreditation Committee refined the work of a task force of the Health Informatics Accreditation Council, establishing 10 foundational domains with accompanying example statements of knowledge, skills, and attitudes that are components of competencies by which graduates from applied health informatics programs can be assessed for competence at the time of graduation. The AMIA Accreditation Committee developed the domains for application across all the subdisciplines represented by AMIA, ranging from translational bioinformatics to clinical and public health informatics, spanning the spectrum from molecular to population levels of health and biomedicine. This document will be periodically updated, as part of the responsibility of the AMIA Accreditation Committee, through continued study, education, and surveys of market trends.

Keywords: professional competence, professional practice, education, graduate, accreditation, curriculum

INTRODUCTION AND BACKGROUND

In 2012, a committee of the AMIA Academic Forum published as an AMIA Board White Paper the definition of biomedical informatics and specification of core competencies for graduate education in the discipline.¹ The White Paper drew on a series of task force meetings with stakeholders and sought to provide broad competency statements that programs could use in curriculum and course development.

Recognizing the importance of supporting the emerging profession of health informatics, in January 2015, AMIA joined the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM) as an Organizational Member to work on one aspect of a maturing profession: accreditation.² CAHIIM is an independent accrediting organization whose mission is to serve the public interest by establishing and enforcing quality accreditation standards for health informatics (HI) and health information management (HIM) educational programs.

AMIA and CAHIIM began working together on an update of accreditation standards for professionals in applied health informatics at the master’s degree level. The collaboration sought to move from an accreditation model of standards driven by curriculum content to a model driven by attainment of competence. AMIA and CAHIIM agreed that the foundation for the new model should be based on the 2012 White Paper. To accomplish this goal, two separate committees were created. AMIA worked with CAHIIM to establish the Health Informatics Accreditation Council (HIAC) and AMIA established the AMIA Accreditation Committee (AAC).

Health Informatics Accreditation Council

The HIAC was initially charged with updating the existing CAHIIM Curriculum Requirements document and the CAHIIM 2010 Standards and Interpretations for Accreditation of Master’s Degree Programs in Health Informatics (http://www.cahiim.org/documents/2012_HI_Masters_Stndrds.pdf). The Curriculum Requirements were to be reframed as new graduate outcome “Health Informatics Competencies” and were to be formally referenced within the curriculum section of the CAHIIM accreditation standards so as to reflect the emergent knowledge, skills, and attitudes associated with the foundational domains for health informatics. It is the role of HIAC within CAHIIM to:

Review and revise accreditation standards in conjunction with the CAHIIM board of directors;
Establish decisions for accreditation action, based on review of the documentation provided by programs and site visits;
Report accreditation decisions to the CAHIIM board;
Review outcome reports and dashboard data from CAHIIM staff; and
Oversee peer reviewers who serve the council.

AMIA Accreditation Committee

The AMIA AAC (a subcommittee of the AMIA Education Committee) is to serve as the primary interface between AMIA and CAHIIM to achieve the goals of participation by AMIA in CAHIIM and the HIAC. The AAC was charged with establishing a set of foundational domains that reflected the intent of the 2012 White Paper and an outline of competencies to guide graduate programs seeking accreditation. It is the role of AAC within AMIA to:

Provide validation examples and guidelines to assist programs in interpreting domains and competencies;
Collaborate in monitoring and refining domains and competencies to keep them current;
Provide guidelines to assist programs in interpreting domains for competency-driven curricula;
Collaborate for the purpose of coordination and communication across health informatics education-focused groups;
Help identify educational activities that can assist academic programs through shared ideas for curriculum evaluation and student assessment as it relates to the foundational domains; and
Maintain/update the foundational domains and core competencies.

ESTABLISHING THE FOUNDATIONAL DOMAINS FOR HEALTH INFORMATICS EDUCATION

In reviewing the CAHIIM 2010 Standards and Interpretations for Accreditation of Master’s Degree Programs in Health Informatics to begin its update, HIAC found the curriculum requirements aligned with the 2012 White Paper, yet the requirements had become somewhat dated, were difficult to interpret, lacked specifics on the depth of instruction, and focused on content of the curriculum rather than the expected competence to be demonstrated by a graduate with a master’s degree in Health Informatics. While the White Paper described a core set of competencies that were shared by many informatics subdisciplines, the broadly stated competencies were not sufficiently succinct for use in a formal accreditation process.

The updated accreditation standards related to curriculum sought to provide a framework to define HI competencies broadly enough to be applicable to a wide variety of established programs. Additionally, the scope of the discipline, and, therefore, the curriculum standards, needed to span the spectrum from translational bioinformatics to public health, including clinical informatics, consumer health informatics, and clinical research informatics. As a general guideline, AMIA and CAHIIM agreed that the new framework should define roughly 10 areas of competence.

In 2015, a task force that was a subgroup of HIAC (Johnson, Boren, and Tusch) created an initial vision for HI competencies. The HIAC task force analyzed the 5 broad areas defined in the AMIA White Paper: 1) professional skills; 2) scope and breadth of discipline; 3) theory and methodology; 4) technologic approach; and 5) human and social context. The task force began by reorganizing the content in areas 2 to 5, drawing on related publications.^3–6 The outcome of this work was a Venn diagram with 3 intersecting circles corresponding to the broad “parent” disciplines that inform health informatics: health science, information science, and social science. The regions of intersection among the circles produced 7 distinct combinations: health science, information science, social science, health information science, social health science, social information science, and social health information science.

In analyzing the remaining area from the AMIA White Paper (professional skills), the HIAC task force was influenced by the Health Leadership Competency Model™ of the National Center for Healthcare Leadership, which is also represented by a Venn diagram of 3 intersecting circles.⁷^,⁸ The team adapted this model to produce a second Venn diagram with 7 regions, which were labeled analyze, execute, communicate, manage, conduct, collaborate, and lead, drawing on related literature.⁹^,¹⁰ The skill for lead was defined broadly to include many forms of leadership that students could exhibit through methods, projects, innovation, and studies, and was placed at the center to align with the AMIA motto: informatics professionals leading the way.

The final model produced by the HIAC task force defined 14 focal areas for HI: 7 describing knowledge areas, and 7 describing areas of skills. The model was presented at multiple venues in 2015 (Table 1).

Table 1.

Timelines for establishing AMIA foundational domains

Time Period	Committee/Organization	Deliverable/Activity
2015	HIAC Task Force	1. Venn diagram describing 7 foundational domains
2015	HIAC Task Force	2. Venn diagram describing 7 professional skills
April 2015	HIAC - CAHIIM	Model of Venn diagrams presented at AMIA Academic Forum
October 2015	HIAC – CAHIIM	Model of Venn diagrams presented during an AMIA webinar
November 2015	HIAC – CAHIIM	Model of Venn diagrams and accreditation process overview presented at AMIA Annual Symposium
March 18, 2016	HIAC—AAC—AMIA Leadership	Committee charters discussed; transition of work effort from HIAC to AAC
April 2016	AAC	AAC model, reducing HIAC model to 10 foundational domains
June 2016	AAC	First draft of AMIA domains presented at AMIA InSpire Conference
September 14 – October 14, 2016	AAC and members of AMIA leadership	AMIA foundational domains and examples of key aspects of competencies disseminated for public comment to Academic Forum and AMIA community
November 2016	AAC and members of AMIA leadership	AMIA foundational domains and examples of key aspects of competencies incorporate both stakeholder and public comments
December 2016	AMIA Board of Directors	Final version of AMIA foundational domains and examples of key aspects of competencies submitted and approved by email vote
January 12, 2017	AMIA Board of Directors	AMIA 2017 Core Competencies for Health Informatics Education at the Master’s Degree Level formally accepted by vote of the Board
January 2017	HIAC	Newly approved AMIA 2017 Core Competencies… embedded in CAHIIM revised 2017 Standards for Accreditation of Master’s Degree Programs in Health Informatics
March 2017	CAHIIM	2017 Standards for Accreditation… disseminated for public comment
June 2017	CAHIIM	2017 Standards for Accreditation… approved by CAHIIM Board

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Subsequent to the work of the HIAC task force, the AAC launched its work effort with an inaugural meeting among members of HIAC, AAC, and AMIA leadership on March 18, 2016. The AAC understood that the foundational domains and accompanying example statements of knowledge, skills, and attitudes had to be written in a manner that provided a common core for competency building that could apply across the subdisciplines represented by all AMIA constituents (translational bioinformatics, clinical informatics, public health informatics, consumer health informatics, and clinical research informatics) as well as within the focus of individual programs.

In the process of establishing the foundational domains, the AAC examined the output of the HIAC task force and reviewed the 2012 White Paper, the literature published on the skills and practices related to the field of health informatics, as well as the literature on the general concepts of competency and the mastery of learning. The committee incorporated scholarship written for the three domains of learning, ie, cognitive, affective, and psychomotor by Bloom, Krathwohl, Dave, and others, in its deliberations.^11–13 Embracing the Dreyfus Model of Skill Acquisition (later adapted by Patricia Benner in her seminal nursing theory on stages of clinical competence), the committee adopted a “competent/proficient level of skills acquisition at the time of graduation” to frame its discussions.^14–16

As a standard point of reference for its work, AAC adopted the following definitions for the terms competence and competency (Table 2).

Table 2.

Definitions (KSA acronym for Knowledge, Skills, and Attitudes)

Competency – “An observable ability of a health professional, integrating multiple components such as knowledge, skills, values, and attitudes. Since competencies are observable, they can be measured and assessed to ensure their acquisition. Competencies can be assembled like building blocks to facilitate progressive development.”¹⁷

Competence – “The array of abilities across multiple domains or aspects of performance in a certain context. Statements about competence require descriptive qualifiers to define the relevant abilities, context, and stage of training. Competence is multi-dimensional and dynamic. It changes with time, experience, and setting.”¹⁷

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In updating curriculum standards and requirements, particularly the framework, content, and processes represented in the HIAC task force Venn diagrams, the AAC employed a deliberative process of review and revision to refine each of the HIAC domains as well as to explore additional domains that may have been needed, given the evolution of the profession since the 2012 White Paper.¹⁸ The process for establishing the foundational domains for accreditation required completing 3 tasks: 1) identifying and naming the domains needed in the present health informatics field, 2) describing each domain clearly and succinctly, and 3) describing examples of key aspects of competencies (knowledge, skills, and attitudes) associated with each domain—capabilities to be demonstrated by a student at the time of graduation from an applied master of science in health informatics program. Following the March inaugural meeting, the members of AAC deliberated and through an iterative process, at the next meeting in April, reduced the 14 areas originally proposed by HIAC to 10 foundational domains, in concept. The committee then drafted and/or edited the domain name, wrote a description for each domain, and proposed example statements of knowledge, skills, and attitudes—the components of a competency—expected of new graduates. Seeking input during the process of deliberation, committee members presented the first draft of the domains to attendees of the InSpire conference in Columbus, Ohio, in June 2016, as part of the session by CAHIIM on accreditation standards for programs.

Public comment and board approval

By September 2016, the AAC had refined the work of the HIAC taskforce and established a set of foundational domains and descriptions with accompanying examples of knowledge, skills, and attitudes necessary to succeed as health informatics professionals or health informaticians. AAC and members of AMIA Leadership prepared the document for dissemination for public comment. Table 1 summarizes the timelines for developing and vetting the AMIA foundational domains document and its insertion into the CAHIIM 2017 accreditation standards. Under the 2017 standards, new programs seeking accreditation must comply with the officially termed AMIA 2017 Core Competencies for Health Informatics Education at the Master’s Degree Level that are part of the 2017 Standards for Accreditation of Master’s Degree Programs in Health Informatics.¹⁹ All programs either currently accredited by CAHIIM or in the initial accreditation process must be in compliance by January 1, 2020.

AMIA 2017 CORE COMPETENCIES FOR APPLIED HEALTH INFORMATICS EDUCATION AT THE MASTER’S DEGREE LEVEL

The newly refined foundational domains with example statements of knowledge, skills, and attitudes (key components of competencies) are intended for curriculum development and accreditation quality assessment for graduate (master’s level) education in applied health informatics. The application areas of health informatics, ranging from translational bioinformatics to clinical and public health informatics, span the spectrum from molecular to population levels of health and biomedicine. An in-depth discussion of each of the application areas can be found under The Science of Informatics at the AMIA website https://www.amia.org/about-amia/science-informatics

For the purposes of the foundational domains, the AAC used the following definitions:

Clinical informatics is the application of informatics and information technology to deliver healthcare services, including medical, nursing, pharmacy, and dental informatics.
Public health informatics is the application of informatics in areas of public health, including population health, surveillance, prevention, preparedness, and health promotion.
Consumer health informatics is the field devoted to informatics from multiple consumer or patient views.
Translational bioinformatics includes the development of storage, analytic, and interpretive methods to optimize the transformation of increasingly voluminous biomedical data and genomic data, into proactive, predictive, preventive, and participatory health.
Clinical research informatics (CRI) includes the use of informatics in the discovery and management of new knowledge relating to health and disease. CRI and translational bioinformatics are the primary informatics domains supporting translational research.

The discipline of health informatics exists at the confluence of 3 major domains: Health, Information Science and Technology, and Social and Behavioral Science (represented by F1, F2, and F3 in Figure 1). Graduate students in this discipline are expected to have working knowledge of these 3 domains, as these domains define and affect the practice of health informatics. Where 2 foundational domains intermingle, each affects the other, and the graduate student is expected to demonstrate the knowledge, skills, and attitudes that exist in these co-mingled domains: Health Information Science and Technology, Human Factors and Socio-technical Systems, and Social and Behavioral Aspects of Health (F4, F5, and F6). Where all 3 domains intermingle, the graduate student is expected to demonstrate the knowledge, skills, and attitudes that exist in this most complex domain: Social, Behavioral, and Information Science and Technology Applied to Health (F7). As with all other health professions, the work of health informaticians affects the health, safety, and effectiveness of those working and being cared for within the system of health care delivery. Graduate students are also expected to demonstrate the knowledge, skills, and attitudes reflecting the domains of Professionalism, Interprofessional Collaborative Practice, and Leadership (Figure 1).

Figure 1. — Foundational domains of applied health informatics. Graphic: Christina Lorenzo, MS in Biomedical Visualization, 2017, Department of Biomedical and Health Information Sciences, University of Illinois at Chicago.

Table 3 summarizes the 10 foundational domains. Please see the Appendix for full descriptions of the domains along with their accompanying example statements of knowledge, skills, and attitudes, which can be used to develop program-specific competencies to reflect the program’s focus within an AMIA Application Area.

Table 3.

Foundational domain titles and short descriptions

Domain	Name	Brief Description
F1	Health	The background knowledge of the history, goals, methods, and current challenges of the major health sciences, including human biology, genomics, clinical and translational science, healthcare delivery, personal health, and public health.
F2	Information Science and Technology	The background knowledge of the concepts, terminology, methods, and tools of information science and technology for managing and analyzing data, information, and knowledge.
F3	Social and Behavioral Science	The background knowledge of the effects of social, behavioral, legal, psychological, management, cognitive, and economic theories, methods, and models applicable to health informatics from multiple levels including individual, social group, and society.
F4	Health Information Science and Technology	The knowledge, skills, and attitudes to use concepts and tools for managing and analyzing biomedical and health data, information, and knowledge. Key foci include systems design and development, standards, integration, interoperability, and protection of biomedical and health information.
F5	Human Factors and Socio-technical Systems	The knowledge, skills, and attitudes to apply social behavioral theories and human factors engineering to better understand the interaction between users and information technologies within the organizational, social, and physical contexts of their lives, and apply this understanding in information system design.
F6	Social and Behavioral Aspects of Health	The knowledge, skills, and attitudes to use social determinants of health and patient-generated data to analyze problems arising from health or disease, to recognize the implications of these problems on daily activities, and to recognize and/or develop practical solutions to managing these problems.
F7	Social, Behavioral, and Information Science and Technology Applied to Health	The knowledge, skills, and attitudes to apply the diverse foundational concepts and facets in order to develop integrative approaches to the design, implementation, and evaluation of health informatics solutions.
F8	Professionalism	The conduct that reflects the aims or qualities that characterize a professional person, encompassing especially a defined body of knowledge and skills and their lifelong maintenance as well as adherence to an ethical code.
F9	Interprofessional Collaborative Practice	Behavior that reflects the foundations of values/ethics, roles/responsibilities, interprofessional communication practices, and interprofessional teamwork for team-based practice.
F10	Leadership	Behavior that demonstrates the following characteristics: credibility, honesty, competence, ability to inspire, and ability to formulate and communicate a vision.

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DISCUSSION

These foundational domains and example statements of knowledge, skills, and attitudes provide a step forward in defining the core competencies for applied health informatics education and practice, reflecting the expansion of the field as it has evolved since 2012. The embedding of these domains into the accreditation standards provides a basis for curriculum development and quality assurance across a wide variety of health informatics programs by applying the competency framework to a program’s specific application area of expertise.

Why change from content to competencies?

Knox and colleagues proposed in 2014 that we can no longer continue to emphasize only rote performance based on content. Rather, we should cultivate performance that demonstrates an understanding and application of principles and processes that will prepare graduates for continuous learning of new skills and techniques as their futures evolve.²⁰ The endpoint of all curricula—clinical informatics, public health informatics, consumer health informatics, translational bioinformatics, clinical research informatics—must integrate all 10 domains illustrated in Figure 1; however, the relative weight of any particular competency will differ depending on the program focus or purpose, and may be adjusted to reflect the job market demands.

Transforming curriculum

The AAC envisions the best way to integrate programmatic competencies reflecting the foundational domains is through competency-driven curricula. Health informatics education, as proposed, is more open to interdisciplinary learning and focuses more on problem solving and critical thinking than on traditional “sit and get” learning. Moving to a competency-driven educational approach will require an intensive educational process and multiple assessments involving all educational and professional stakeholders (Figure 2). The approach asks programs to rethink outcomes and course expectations, moving away from rote memory to the incorporation of essential knowledge, skills, and attitudes and assessed performance of defined competencies.

Figure 2. — Path from content- to competency-driven curriculum.

Where do program directors start?

The introduction of the foundational domains within a program starts with mapping the current curriculum. Program directors should start at the endpoint of their program and identify those competencies students are expected to demonstrate at graduation that align with the foundational domains. Essentially, program directors should define the program outcomes as competencies that offer a meaningful reflection of what a graduate “knows” and what he/she can “do with that knowledge.” Competencies are observable and can be measured and assessed. The content as taught in the current curriculum can be reused and reorganized to address the competencies defined in the program outcomes, resulting in a more comprehensive curriculum that integrates the domains and culminates in the acquisition of the higher level, more complex competencies.

The content of each course in a curriculum should be a stepping stone to the next one, adhering to the principles of instructional scaffolding.²¹ Instructional scaffolding encompasses iterative and interconnected assessment of the intended learning objectives of each course and the instructional support and didactic approaches needed to attain the intended levels of competence. Reflecting its theoretical frameworks of Activity Theory and Knowledge Integration, instructional scaffolding facilitates the development of cohesive mental models—in this case, the scientific foundations of the health informatics.²² Ultimately, the placement and sequence of courses leading to the program outcome competencies are determined by each individual program.

How do programs assess (measure) performance?

For decades, whether formative or summative, regardless of the format or type of assessment, all health professions educational programs have assessed students’ attainment of knowledge. Graduate programs in health informatics, however, have far less experience in assessing attainment of technical skills and desired attitudes. Fortunately, the discipline can draw on the experiences of other health professions that have sought to build conceptual frameworks for such assessment. Conceptual frameworks for assessment of competence, such as the work of Miller and Cruess et al. in medical education, and the work of Lenburg for nursing competence, among others, can inform the assessment efforts of the discipline as it moves to a new paradigm of graduate education.^23–29

CONCLUSION

Ultimately, the value of the competencies that programs develop will be demonstrated as graduates of health informatics programs gain employment in this field. They may become teachers or practitioners in any number of industries, based upon their and their employers’ ability to articulate and apply these skills. AMIA has surveyed and analyzed industries’ view of health informatics, and fosters strong relationships with public and private employers. As a past Chair of the AMIA Board of Directors stated, “I hope the move will lend some clarity to employers who seek skills, competencies, and talent that informatics graduates possess, in the nation’s effort to proliferate clinical information systems using informatics tools and techniques.”

Building standards across programs and the change from content-driven to competency-driven curricula is an evolutionary process. The definition of core competence is part of any accreditation standard; accreditation is one step in the journey toward professionalism of a discipline. Professional societies and their contribution to professional education (as opposed to formal graduate education) is an essential component of a profession.³⁰ This document will be periodically updated, as part of the responsibility of the AMIA Accreditation Committee, through continued study, education, and surveys of market trends. The active participation of AMIA within CAHIIM provides a pathway for the member programs of AMIA to speak in a more unified voice, while respecting the unique differences and diversity that make informatics such a dynamic field.

Finally, the 10 foundational domains emerged from the comprehensive review of the field in the 2012 article authored by Kulikowski and colleagues.¹ These domains define the field. Competencies are created and anchored to the level of skills acquisition appropriate for the population under consideration. Competencies can be adapted for different stages of education, including that of the baccalaureate or, potentially, doctoral program, by modifying the level of knowledge, skills, and attitudes to be expected at the time of graduation of the baccalaureate (or doctoral) student; other competencies may be required for those stages. Over time, through the iterative process of building competency-driven curricula, through national conversations at the AMIA Academic Forum and its annual Informatics Educators Forum, and through the work of the AMIA Education Committee and its subcommittee, the AMIA Accreditation Committee, insight on the foundational domains and the knowledge, skills, and attitudes required of informaticians will grow. This has been the path to the professionalization of every other health profession and will be the path taken for those in the discipline of health informatics.

APPENDIX

AMIA 2017 core competencies for applied health informatics education at the master’s degree level

INTRODUCTION

Competencies describe what a student will be able to do at a point in time. For the purpose of this document, the point in time is set at graduation from an applied master of science in health informatics program. A given competency is built upon an integrated set of knowledge, skills, and attitudes needed to perform an activity. For each of the 10 foundational domains presented here, every program must develop competency statements that reflect the individual AMIA Application Area that is the focus of the program. For each domain described below, examples are provided of knowledge, skills, and attitudes that could be reflected in competencies for those domains.

As an example, in looking at Foundational Domain F9, Interprofessional Collaborative Practice, a competency reflecting that domain from a program focusing on preparing students for an applied clinical informatics role might be “Collaborate with clinicians and administrative and technical personnel to implement a communication plan for a new EHR system.” A competency for a program in translational bioinformatics from the same domain might be “Participate with clinical researchers on a team science project.” Both of these competencies reflect the integration of a knowledge component that includes the knowledge about different professions, stakeholders, and team dynamics; a skill component related to relationship-building and interprofessional communication; and an attitude component related to mutual respect and shared values. The example statements of knowledge, skills, and attitudes listed within each of the domains below can be used to develop the program-specific competencies that reflect an individual program’s focus within an AMIA Application Area. Programs may also define competencies within a given foundational domain that are an integration of other knowledge, skills, and attitudes that are not listed here.

As a final note, the discipline of health informatics exists at the confluence of 3 major domains: Health, Information Science and Technology, and Social and Behavioral Science (represented by F1, F2, and F3), which define and affect the practice of health informatics. During its deliberations, members of the AAC concluded that graduate students in this discipline should have working knowledge of these 3 domains as they enter their graduate work. As a result, only a statement of knowledge was developed for each of these 3 major domains.

F1. HEALTH

Health refers to the biomedical and health sciences underlying AMIA’s 5 major informatics areas: translational bioinformatics, clinical research informatics, clinical informatics, consumer health informatics, and public health informatics. The biomedical and health sciences aim to understand and improve human health. To identify and develop solutions to biomedical informatics problems, students must understand the history, goals, methods (including data and information used and produced), and current challenges of the major health sciences, including human biology, genomics, clinical and translational science, healthcare delivery, personal health, and public health.