Journal of General Internal Medicine

, Volume 25, Supplement 4, pp 586–592

Developing Measures of Educational Change for Academic Health Care Teams Implementing the Chronic Care Model in Teaching Practices

  • Judith L. Bowen
  • David P. Stevens
  • Connie S. Sixta
  • Lloyd Provost
  • Julie K. Johnson
  • Donna M. Woods
  • Edward H. Wagner
Original Research



The Chronic Care Model (CCM) is a multidimensional framework designed to improve care for patients with chronic health conditions. The model strives for productive interactions between informed, activated patients and proactive practice teams, resulting in better clinical outcomes and greater satisfaction. While measures for improving care may be clear, measures of residents’ competency to provide chronic care do not exist. This report describes the process used to develop educational measures and results from CCM settings that used them to monitor curricular innovations.


Twenty-six academic health care teams participating in the national and California Academic Chronic Care Collaboratives.


Using successive discussion groups and surveys, participants engaged in an iterative process to identify desirable and feasible educational measures for curricula that addressed educational objectives linked to the CCM. The measures were designed to facilitate residency programs’ abilities to address new accreditation requirements and tested with teams actively engaged in redesigning educational programs.


Field notes from each discussion and lists from work groups were synthesized using the CCM framework. Descriptive statistics were used to report survey results and measurement performance.


Work groups generated educational objectives and 17 associated measurements. Seventeen (65%) teams provided feasibility and desirability ratings for the 17 measures. Two process measures were selected for use by all teams. Teams reported variable success using the measures. Several teams reported use of additional measures, suggesting more extensive curricular change.


Using an iterative process in collaboration with program participants, we successfully defined a set of feasible and desirable education measures for academic health care teams using the CCM. These were used variably to measure the results of curricular changes, while simultaneously addressing requirements for residency accreditation.


Chronic Care Model quality improvement graduate medical education ambulatory care practice-based learning and improvement systems-based practice 

Supplementary material

11606_2010_1358_MOESM1_ESM.doc (32 kb)
ESM 1(DOC 32 kb)

Copyright information

© Society of General Internal Medicine 2010

Authors and Affiliations

  • Judith L. Bowen
    • 1
  • David P. Stevens
    • 2
  • Connie S. Sixta
    • 3
  • Lloyd Provost
    • 4
  • Julie K. Johnson
    • 5
  • Donna M. Woods
    • 6
  • Edward H. Wagner
    • 7
  1. 1.Oregon Health & Science UniversityPortlandUSA
  2. 2.The Dartmouth Institute for Health Policy and Clinical PracticeHanoverUSA
  3. 3.UTHSC School of NursingHoustonUSA
  4. 4.Process ImprovementAustinUSA
  5. 5.Centre for Clinical Governance ResearchUniversity of New South WalesSydneyAustralia
  6. 6.Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  7. 7.MacColl Institute for Healthcare Innovation, Group Health Center for Health StudiesSeattleUSA

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