Practice Gap analysis is mentioned multiple times in the ACCME Criteria. The Academy reviews how you collect the gap information (through review of your Instructional Design), the outcomes of that process (by reviewing the gaps themselves), and how you address the gaps in the content. This Gap Analysis leads to the creation of Learning Objectives, and will dictate the Activity Evaluation.
ACCME Criteria 2: The provider [the Academy and its joint sponsors] incorporates into CME activities the educational needs (knowledge, competence, or performance) that underlie the professional practice gaps of their own learners.
ACCME Criteria 11: The provider analyzes changes in learners (competence, performance, or patient outcomes) achieved as a result of the overall program's activities/educational interventions.
ACCME Criteria 16: The provider operates in a manner that ingrates CME into the process for improving professional practice.
Definitions Related to Practice Gaps
- Gaps / Practice gap: The difference between a current state and desired state. Gaps are typically expressed in terms of normative data.
- Gap analysis (GA): The methods used to collect a Gap and an interpretation of the information.
- Needs: 1) contributing factors to the formation of a Gap. 2) The knowledge or skills that must be remedied to help close a practice gap.
- Target Audience: The intended recipients of an educational activity.
- Wants: Possible solutions proposed to close a gap by targeting a need.
Tips and Tools for Developing Practice Gaps
- Link the subject to the environment where a learner will encounter the gap
- Avoid generalities
- Quantify the information being presented
- Provide backup for claims and statements
Examples of Approved Practice Gaps
- Compliance with screening for diabetic retinopathy was 42.8% for type 1 and 24% for type II diabetic patients (sample size encompassing both group, n=100) [Performance gap]
- 36 patients were enrolled in this study. Average age was 12.08 years (range 7months-75 years). Mean time between consent and surgery was 38 days (range 6-96 days). 34 patients (94%) felt they had adequate understanding of the surgery. However; of the 504 answers in the 14 questions presented, 322 (64%) were either incorrect or not sure. [Performance gap]
- [For an activity in March, 2011] In findings from April 30, 2010: Mechanical modeling suggests that greater inferior than superior Lateral Rectus (LR) zone contraction in orbit tilt up contributes to ocular extorsion, while greater inferior zone relaxation contributes to intorsion in orbit tilt down. This differential zonal LR behavior is absent in Superior Oblique (SO) palsy, compounding the deficiency in Ocular Counter-rolling (OCR) due to SO weakness. [Knowledge gap]
- In a study, concluded in 2009 at St. Jude Children's Research Hospital, 46.5% of the 101 children who both underwent bone marrow transplantation (BMT) and met inclusion criteria, 46.5% developed ophthalmic complications. Complications included cataracts in 42 (41.6%), dry eye disease in fourteen (13.9%), and infectious retinitis in 2 (2%). [Knowledge gap]
- Diagnose This Review: Summer, 2011. Gaps uncovered via online diagnosis simulation, reviewed for validity and contributing needs.
- Evidence in:
- Contact lens fitting and management of related complications.
- Diagnostic evaluation of white retinal lesions.
- Management of orbital lymphangioma.
- Differentiation of abnormal and normal gonioscopic findings.
- Differentiation of microbiologic studies.