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Learning organizations seamlessly share knowledge, evaluate the impact of their actions, and continuously learn to improve outcomes (Senge 1990; Garvin 2000). Although this model of innovation and transformation has been [...], Objective. To develop core competencies for learning health system (LHS) researchers to guide the development of training programs. Data Sources/Study Setting. Data were obtained from literature review, expert interviews, a modified Delphi process, and consensus development meetings. Study Design. The competencies were developed from August to December 2016 using qualitative methods. Data Collection/Extraction Methods. The literature review formed the basis for the initial draft of a competency domain framework. Key informant semi-structured interviews, a modified Delphi survey, and three expert panel (n = 19 members) consensus development meetings produced the final set of competencies. Principal Findings. The iterative development process yielded seven competency domains: (1) systems science; (2) research questions and standards of scientific evidence; (3) research methods; (4) informatics; (5) ethics of research and implementation in health systems; (6) improvement and implementation science; and (7) engagement, leadership, and research management. A total of 33 core competencies were prioritized across these seven domains. The real-world milieu of LHS research, the embeddedness of the researcher within the health system, and engagement of stakeholders are distinguishing characteristics of this emerging field. Conclusions. The LHS researcher core competencies can be used to guide the development of learning objectives, evaluation methods, and curricula for training programs. Key Words. Learning health system, health services research, stakeholder engagement, graduate education, professional competence

Race and ethnicity occupy a prominent place in the medical literature. Recognizing unquestionable genetic and cultural differences among racial and ethnic populations, researchers have tried to correlate race and ethnicity [...], For decades data have been collected comparing health care in racial and ethnic groups. The use of such groups in health services research assumes that standard, reliable, and valid definitions of race and ethnicity exist and that these definitions are used consistently. In fact, race is a term often used, but ill defined. It can incorporate biological, social, and cultural characteristics of patients and can refer to both genetic and behavioral traits. Various investigators have reported differences between racial and ethnic groups in health status, disease manifestation and outcome, resource utilization, and health care access, often specifying neither a definition of race nor the measurement they used to classify their study populations. The role of race as an explanatory variable in health services research requires greater scrutiny than many researchers currently provide. Many studies use race as a proxy for other socioeconomic factors not collected in the research effort. This article explores the ambiguities about race as an explanatory variable that render such research difficult to interpret. We suggest that health services researchers focus on nonracial socioeconomic characteristics that might be both more informative and more useful in guiding policy formation. Key Words. Race, health services research, access, outcomes

In previous HSR Updates this year, we discussed the Agency for Healthcare Research and Quality's (AHRQ) research agenda: priority health care research issues; developing the tools and talent for using [...]