Linear rather than vertical analysis of educational initiatives: proposal of the 7Is framework.

A large amount of resource is 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 contains seven domains sequenced in a linear fashion: Interaction, Interface, Instruction, Ideation, Integration, Implementation, and Improvement. The 7Is framework allows the various effects of an intervention to be conceptualized, promoting the development of a set of valid and specific outcome measures, ultimately leading to more robust evaluation.