Trust, entrustment decisions and a&amp;nbsp;few things we shouldn’t forget

Govaerts, Marjan

doi:10.1007/s40037-017-0337-1

Cited by 10 publications

(10 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Trust was a central theme when discussing DO in our focus groups. We know from the literature how mutual trust relates to the quality of the training relationship and how this quality may be affected by its duration . We add the importance of a solid start to the training relationship, and the role of DO in this.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Patterns of direct observation and their impact during residency: general practice supervisors’ views

et al. 2018

View full text Add to dashboard Cite

ContextDirect observation (DO) of residents’ performance, despite the importance that is ascribed to it, does not readily fit in with the practice of postgraduate medical education (PGME); it is infrequent and the quality of observation may be poor in spite of ongoing efforts towards improvement. In recent literature, DO is mostly portrayed as a means to gather information on the performance of residents for purposes of feedback and assessment. The role of DO in PGME is likely to be more complex and poorly understood in the era of outcome‐based education. By exploring the possible complexity of DO in workplace learning, our research aims to contribute to a better use of DO in the practice of PGME.MethodsConstructivist grounded theory informed our data collection and analysis. Data collection involved focus group sessions with supervisors in Dutch general practice who were invited to discuss the manifestations, meanings and effects of DO of technical skills. Theoretical sufficiency was achieved after four focus groups, with a total of 28 participants being included.ResultsWe found four patterns of DO of technical skills: initial planned DO sessions; resident‐initiated ad hoc DO; supervisor‐initiated ad hoc DO, and continued planned DO sessions. Different patterns of DO related to varying meanings, such as checking or trusting, and effects, such as learning a new skill or experiencing emotional discomfort, all of them concerning the training relationship, patient safety or residents’ learning.ConclusionsDirect observation, to supervisors, means much more than gathering information for purposes of feedback and assessment. Planned DO sessions are an important routine during the initiation phase of a training relationship. Continued planned bidirectional DO sessions, although infrequently practised, potentially combine most benefits with least side‐effects of DO. Ad hoc DO, although much relied upon, is often hampered by internal tensions in supervisors, residents or both.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Another shared recommendation from the literature is that the supervisor and resident openly discuss how DO can best help serve their mutual needs. In preparation for this dialogue, our results may inspire supervisors and residents to identify advantages and risks of the various patterns of DO.…”

Section: Discussionmentioning

confidence: 99%

Patterns of direct observation and their impact during residency: general practice supervisors’ views

et al. 2018

View full text Add to dashboard Cite

show abstract

“…as summarised by ten Cate et al . and Govaerts . The suggestion that emotions add ‘noise’ to the assessment system results in a similar solution to that mentioned above: an increase in the number of ratings of performance for a given candidate.…”

Section: Emotions In Rater‐based Assessmentmentioning

confidence: 87%

“…as summarised by ten Cate et al 17 and Govaerts. 47 The suggestion that emotions add 'noise' to the assessment system results in a similar solution to that mentioned above: an increase in the number of ratings of performance for a given candidate. Particularly in view of the littleunderstood area of EPAs, we feel there are few potential detrimental effects to considering an increased number of observations and ratings of performance.…”

Section: Emotions That Add Random Noise To Assessment Measurementmentioning

confidence: 95%

Emotions and assessment: considerations for rater-based judgements of entrustment

Gómez-Garibello

Young

2017

Med Educ

View full text Add to dashboard Cite

We identify and discuss three different interpretations of the influence of raters' emotions during assessments: (i) emotions lead to biased decision making; (ii) emotions contribute random noise to assessment, and (iii) emotions constitute legitimate sources of information that contribute to assessment decisions. We discuss these three interpretations in terms of areas for future research and implications for assessment.

show abstract

“…Formal entrustment, without clear instructions on how to use it, may create differences in how faculty members work with entrustment decisions, and can lead to situations in which residents have different independence levels depending on their supervisors. Therefore, supervisors need to discuss and work on a shared professional judgment, 24 otherwise it limits generalizability of entrustment decisions to other contexts. Attention focused on the implementation of formal entrustment instruments like EPAs, including faculty development to ensure a common mental model and communication among faculty members, is key in making formal entrustment work.…”

Section: Discussionmentioning

confidence: 99%

Formal Versus Informal Judgments: Faculty Experiences With Entrustment in Graduate Medical Education

Loon

Teunissen

Driessen

et al. 2018

Journal of Graduate Medical Education

View full text Add to dashboard Cite

Background Entrustment of residents has been formalized in many competency-based graduate medical education programs, but its relationship with informal decisions to entrust residents with clinical tasks is unclear. In addition, the effects of formal entrustment on training practice are still unknown.Objective Our objective was to learn from faculty members in training programs with extensive experience in formal entrustment how formal entrustment relates to informal entrustment decisions.Methods A questionnaire was e-mailed to all Dutch obstetrics and gynecology program directors to gather information on how faculty entrusts residents with clinical independence. We also interviewed faculty members to explore the relationship between formal entrustment and informal entrustment. Interviews were analyzed with conventional content analysis. ResultsOf 92 programs, 54 program directors completed the questionnaire (59% response rate). Results showed that formal entrustment was seen as valuable for generating formative feedback and giving insight into residents' progress in technical competencies. Interviewed faculty members (n ¼ 12) used both formal and informal entrustment to determine the level of resident independence. Faculty reported they tended to favor informal entrustment because it can be reconsidered. In contrast, formal entrustment was reported to feel like a fixed state.Conclusions In a graduate medical education program where formal entrustment has been used for more than a decade, faculty used a combination of formal and informal entrustment. Informal entrustment is key in deciding if a resident can work independently. Faculty members reported being unsure how to optimally use formal entrustment in practice next to their informal decisions.

show abstract

Trust, entrustment decisions and a few things we shouldn’t forget

Abstract: None

Cited by 10 publications

References 15 publications

Patterns of direct observation and their impact during residency: general practice supervisors’ views

Patterns of direct observation and their impact during residency: general practice supervisors’ views

Emotions and assessment: considerations for rater-based judgements of entrustment

Formal Versus Informal Judgments: Faculty Experiences With Entrustment in Graduate Medical Education

Contact Info

Product

Resources

About