Clinical laboratory tests have no value if clinicians cannot quickly order and obtain the results they need. We found that efforts to obtain even the most commonly ordered tests are often derailed by excessively complex nomenclature. Ordering the right laboratory tests is critical to diagnosis and treatment, but existing mechanisms for entering lab orders actively interfere with physicians' efforts to provide good clinical care. Rather than simplifying lab orders, the advent of computerized physician order entry (CPOE) systems-generally programmed by non-clinicians-has introduced new and vexing practical problems. Medical laboratories have filled their test menus, whether paper or electronic, with bewildering nomenclature and abbreviations, and have failed to appreciate the dangers of assigning perilously similar names to different tests. The efficient and efficacious patient care demanded by the quality care initiative requires progress beyond traditional solutions, such as convening naming conventions, to the development of innovative software with intelligent, real-time, clinically driven search functions that will allow these programs to help rather than hinder physicians.

Problem In the competency-based medical education literature, investigators have typically discussed notions of trust in the context of entrustment decision-making rather than as attitudes within competency frameworks. Complementarity between concepts of entrustable professional activities and of competencies created an opportunity to infuse the latter with notions of trust. Bedside cardiac assessment (BCA) exemplified one such competency. Traditional approaches to teaching and learning BCA addressed relevant knowledge and skills but not attitudes. We conceptualized entrustability as part of an attitudinal approach to teaching and learning BCA more holistically and effectively. The purpose of this thematic analysis was to explore students′ experience, in a medicine clerkship at one U.S. medical school, of participating in a newly developed BCA curriculum that aimed to foster attitudinal growth and a holistic approach to clinical learning. Approach Building upon Teaching for Understanding and conceptual change frameworks, the authors developed a flipped class curriculum utilizing pre-class short online videos and practice exercises followed by in-class activities and reflective discussions. Using a combination of content analysis and thematic analysis methodology of open-ended questionnaires administered from November 2017 to June 2018, the authors analyzed the experiences of medical students at one of the schools at which the curriculum was implemented. Outcomes Thematic analysis suggested learning strategies were effective and that peer encounters, skills practice, and encounters with educators were meaningful. The analysis also revealed opportunities to improve the original instructional design. Next Steps The authors will incorporate feedback into future iterations of the curriculum and make it widely available to better study its impact on learners′ abilities; entrustability as a construct; and transfer of learning from the classroom to the workplace. Further work is needed to clarify the value of incorporating notions of trust into competency frameworks. The authors intend this exploratory work to stimulate conversations around expanded roles of trustworthiness and entrustability in medical education.