Moore’s Level 5, Performance


The fifth level in one established outcomes framework, Moore’s Level 5 emphasizes the need to measure the change in performance that are associated with an educational intervention. Performance is defined as actions taken when an HCP returns to practice.



A comparison of pre/post behaviors made in practices by HCPs, including improved performance measure(s) and clinical habits, to examine the association between education and performance. Provider performance level data may be retrieved from patient charts, EHR system, claims-based data, registry database, or other appropriate data source.

Secondary method: Self-reported performance change.



Moore et al. JCEHP, 29(1):1–15, 2009.



[PENDING: We are continuing to collect examples…if you have examples that you’d like us to leverage, please share them!]


Additional Contextual Information:

  • Measures of Performance should be aligned with a predefined learning objective.
  • Since Level 5 is defined by the change in Performance, data should be collected before and after the educational intervention. If statistical approaches are being applied, one must understand the limitations of such approaches.
  • It is recognized that the while the secondary method of self-reported performance change is considered by Moore’s framework to be a Performance measure, the accuracy of these data are broadly questioned within the profession. As such, it is the recommendation to refer to self-reported performance change as a “Surrogate Performance” measurement.