Table 3.  Health Services Research (HSR) Doctoral Training Knowledge-based and Skills-based Educational Domains

Domain #

Domain Description

1.0

Health:

  • Essential.
  • Distribution of health and disease in populations.
  • Models of how health is produced with special emphasis on how health services influence health.
  • Health disparities.

2.0

Financing of Health Care:

  • Essential.
  • Costs of care and cost containment.
  • Healthcare markets.
  • Links between financing and organization of health services.
  • Coverage policy.
  • Provider payment.

3.0

Organization of Health Care:

  • Essential.
  • Organizational theory (which may merit a separate category).
  • Models for understanding behavior of organizations.
  • Measurement of health organizational characteristics.
  • Health workforce.
  • Models for understanding human behavior within health organizations.

4.0

Health Policy:

  • Essential: Understanding the impact of health policy.
  • Optional: Health policy analysis.
  • Health policy formation and implementation.
  • Role of advocacy.

5.0

Health Care Law:

  • Optional.
  • Effects of legal environment on organization and financing of health care.
  • Using the legal system to improve health.
  • Links between regulation and health system performance and outcomes.

6.0

Ethics and Health Care:

  • Optional.
  • Models for the just allocation of resources.
  • Equity.
  • Resource allocation.
  • Ethical principles that help explain health system effects on the patient-provider relationship.

7.0

Health Care Seeking, Access, and Use:

  • Essential.
  • Models of access, use, and health care seeking behavior.
  • Health beliefs and preferences.
  • Healthcare disparities.

8.0

Quality of Care:

  • Esssential: Knowledge about quality of care.
  • Optional:: Quality improvement applications.
  • Quality of care frameworks.
  • System-oriented approach to understanding quality and improving quality.
  • Effectiveness and outcomes research.
  • Patient safety.
  • Quality improvement.

9.0

Health Care Decisionmaking:

  • Optional.
  • Category could be embedded within health care organization.
  • Models of individual and health professional decisionmaking.
  • Ways to improve shared decisionmaking between patients and professionals.

10.0

Health Informatics:

  • Essential.
  • Computer-assisted decisionmaking.
  • Use of electronic media as data collection devices.
  • Knowledge of common health care classification systems.

11.0

Scientific Method and Theory:

  • Essential.
  • Scientific method: theory and application.
  • Philosophy of science.
  • Hypothesis development.
  • Causality.

12.0

Literature Review:

  • Essential.
  • Literature review methods.
  • Meta-analysis.
  • Putting a research study into the context of prior work.

13.0

Study Design:

  • Essential.
  • Intervention study design: experimental and quasi-experimental.
  • Threats to validity and bias associated with alternative study designs.
  • Longitudinal study designs.
  • Unit of analysis.
  • Cohort and case-control study design.
  • Risk adjustment methods.

14.0

Survey Research:

  • Essential.
  • Data collection protocols.
  • Questionnaire development.
  • Sampling methods.
  • Subject recruitment.

15.0

Qualitative Research:

  • Essential.
  • Focus groups, key informant interviews, semi-structured interviews.
  • Ethnographic analysis and case study methods.

16.0

HSR Data Sources:

  • Essential.
  • Database development.
  • Matching secondary data to specific HSR questions.

17.0

Measurement and Variables:

  • Essential.
  • Psychometrics of items, indexes, and scales.
  • Reliability and validity.
  • Classical and modern measurement theory and applications.

18.0

Data Acquisition and Quality Control:

  • Essential.
  • Research protocols that standardize procedures in a reproducible way.
  • Data entry and data quality control methods.
  • Interviewer training manuals.

19.0

Research Ethics:

  • Essential.
  • Identify human subjects research.
  • HIPAA.
  • Informed consent and assent.
  • Conflicts of interest.
  • Responsible conduct of research.

20.0

Teamwork:

  • Essential.
  • Multi-disciplinary approach to HSR design and implementation.
  • Staff supervision.
  • Team communication.

21.0

Project Management:

  • Optional.
  • Project timelines.
  • Manage team meetings.
  • Personnel management.
  • Accounting methods.

22.0

Advanced HSR Analytic Methods:

  • Essential.
  • Commonly used econometric methods.
  • Causal modeling.
  • Multivariable linear and logistic regression.
  • Generalized linear models.
  • Longitudinal and multi-level modeling.
  • Non-parametric measures of association.

23.0

Economic Evaluation and Decision Sciences:

  • Essential.
  • Cost-effectiveness.
  • Cost-benefit.
  • Cost-utility analyses.

24.0

Proposal Development:

  • Essential.
  • Write a research project proposal.
  • Sponsors of HSR.
  • Grant peer review process.

25.0

Dissemination:

  • Essential.
  • Oral presentation skills.
  • Manuscript preparation.
  • Manuscript peer review process.
  • Translating research into policy and practice.

26.0

Professional Development:

  • Optional.
  • Develop a plan for lifelong learning in HSR.
  • Successfully transitioning from life as a student to a career in HSR.

27.0

Pedagogy:

  • Optional.
  • Course design.
  • Prepare and delivery instructional material.
  • Course evaluation.
  • Teaching philosophies.

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