Proposal of a linear rather than hierarchical evaluation of educational initiatives: the 7Is framework

Extensive resources are expended attempting to change clinical practice; however, determining the effects of these interventions can be challenging. Traditionally, frameworks to examine the impact of educational interventions have been hierarchical in their approach. In this article, existing frameworks to examine medical education initiatives are reviewed and a novel '7Is framework' discussed. This framework contains seven linearly sequenced domains: interaction, interface, instruction, ideation, integration, implementation, and improvement. The 7Is framework enables the conceptualization of the various effects of an intervention, promoting the development of a set of valid and specific outcome measures, ultimately leading to more robust evaluation.