In Criterion 36, change in performance refers to measured changes in a learner’s or learners' behavior (e.g., higher patient communication ratings, fewer coding errors, greater participation in team meetings, more appropriate prescribing, etc.). Providers can set their own specific goals and targets for the performance improvement objective. The provider can also choose the most appropriate mechanisms to measure performance change, and how much change in learners is acceptable. The standard, target, and performance improvement that is measured or reported should be consequential in relation to the objectives. The improvement data may emerge from self-reported changes, from practice-level data, or other sources. Improvements in knowledge and plans to change performance would not meet the expectation of this criterion.