The Healthcare Matrix is currently a Word document, but will soon have a web-based interface attached to a database. The 36-cell Matrix has one cell to represent each intersection of an IOM Aim for Improvement (identified in the IOM report, crossing the Quality Chasm) with an ACGME Core Competency. This tool provides learners with a structured framework to analyze complex episodes of patient care in terms of the Aims and Competencies. The individual cells of the Matrix allow the care analysis to be segmented into more manageable parts. By associating the Aims for Improvement with the Core Competencies, The Matrix encourages learners to reflect on the care they provide and determine the improvements needed, while helping them learn and apply the Aims and Competencies. If learners cannot identify issues in the bottom line of the Matrix-practice-based learning and improvement--then they have not sufficiently analyzed the care. Learners may then use this information to develop action plans that improve care from an individual -- and systems-perspective so that they experience first-hand the 'Practice-Based Learning & Improvement' Core competency.