Accepted Type
Oral
Code
OA2-1-4
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
How clinical supervisors conceptualize entrustment in procedural training: A qualitative study of entrustment decision-making in endoscopic training
Length of Presentation
Background/Purpose
While entrustment is a central assessment construct in competency-based medical education (CBME), the factors clinical supervisors consider in entrusting procedural skills and how they report synthesizing these factors into their final decision has not been clearly elucidated. We aimed to characterize this process using gastrointestinal endoscopy as a model procedure.
Methods
Using methods from constructivist grounded theory, we interviewed 29 endoscopic supervisors from across North America in pediatric and adult gastroenterology, general surgery, and family medicine. Interviews focused on how supervisors make endoscopic entrustment decisions and which factors they consider in this process. Transcripts were analyzed using constant comparison to generate themes and an explanatory framework.
Results
Twenty-nine supervisors were interviewed. Participants conceptualized entrustment as a continuum (vs. a binary decision) and perceived their decision could fluctuate over time. That is, they reported their judgements were influenced by both dynamic factors, which change day-to-day, and by static factors, which persist over time. In their final entrustment decision, participants perceived synthesizing various dynamic factors (patient acuity, procedural risk, time constraints, etc.) against their personal baseline informed by static factors (institutional culture, legal considerations, etc.).
Conclusion
Procedural entrustment appears to be a complex cognitive process involving multiple dynamic factors synthesized against a baseline of static factors. CBME programs will benefit from understanding how this synthesis of factors influences faculty judgments, trainee learning, and program decision-making.
Keyword 1
Entrustment
Keyword 2
Procedures
Keyword 3
CBME
Level of Training
Post Graduate
Abstract Themes
Assessment
Assessment
- General
- Work-place based
- Competency-based assessment
- Raters
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
