Accepted Type
Oral
Code
OA2-1-2
Acceptance Declaration
Accept
Additional Information
I declare I have no actual or potential conflict of interest in relation to this program.
Was this work accepted for CCME 2020?
no
Category
General Call (Workshop, Oral Presentation, Poster Presentation)
Type
Oral
Sub Type
Education Research
Will the presenter be a:
Fellow
Affiliation
Considered for Poster
yes
Title
Variable meanings of entrustment - variable decision-making? How supervisors make procedural entrustment decisions in simulation- and workplace-based settings
Length of Presentation
Background/Purpose
Entrustment, a central construct in competency-based medical education (CBME), is operationalized in the assessment of entrustable professional activities (EPAs). While EPA assessment is foundational in many CBME systems, research has yet to clarify how supervisors form judgments when assessing EPAs in both workplace- and simulation-based settings. We aimed to explore the features supervisors report as influencing their entrustment decisions across these assessment settings.
Methods
We designed an interview-based, constructivist grounded theory-informed study involving gastroenterology supervisors and trainees. Supervisors completed separate EPA assessments of each trainee's endoscopic polypectomy (a relevant EPA) performance in both workplace- and simulation-based settings. Supervisors were interviewed after each to explore how they made their entrustment decision within and across settings. Transcribed interview data were coded iteratively using constant comparison to generate themes.
Results
Based on 14 interviews with 7 supervisors, we found that participants: 1) held multiple meanings of entrustment, both within and across participants, (2) expressed variability in how they justified their decisions, the related narrative, and numerical scoring, (3) held unique personal criteria for making decisions 'comfortably', and (4) perceived a relative freedom when using simulation to make entrustment decisions.
Conclusion
We found that participants spoke about and defined entrustment in a variety of ways, leading to variability in how they judged entrustment within and across participants and assessment settings. The observed rater idiosyncrasies suggest residency programs cannot assume equivalence of EPA data from different assessment settings.
Keyword 1
Entrustment
Keyword 2
Assessment
Keyword 3
Simulation
Level of Training
Post Graduate
Abstract Themes
Assessment
Assessment
- Work-place based
- Competency-based assessment
- Raters
- Entrustable Professional Activities
- Programmatic Assessment
Additional Theme (First choice)
Postgraduate
Additional Theme (Second Choice)
Additional Theme (Third Choice)
Authors
Presenter
Thurarshen Jeyalingam
Term 1
Yes
Term 2
Yes
Term 3
Yes
Term 4
Yes
Term 5
Yes
