Trust, power and learning in workplace‐based assessment: The trainee perspective

Abstract

For trainees to participate meaningfully in workplace‐based assessment (WBA), they must have trust in their assessor. However, the trainee's dependent position complicates such trust. Understanding how power and trust influence WBAs may help us make them more effective learning opportunities. We conducted semi‐structured interviews with 17 postgraduate anaesthesia trainees across Australia and New Zealand. Sensitised by notions of power, we used constructivist grounded theory methodology to examine trainees' experiences with trusting their supervisors in WBAs. In our trainee accounts, we found that supervisors held significant power to mediate access to learning opportunities and influence trainee progress in training. All episodes where supervisors could observe trainees, from simply working together to formal WBAs, were seen to generate assessment information with potential consequences. In response, trainees actively acquiesced to a deferential role, which helped them access desirable expertise and minimise the risk of reputational harm. Trainees granted trust based on how they anticipated a supervisor would use the power inherent in their role. Trainees learned to ration exposure of their authentic practice to supervisors in proportion to their trust in them. Trainees were more trusting and open to learning when supervisors used their power for the trainee's benefit and avoided WBAs with supervisors they perceived as less trustworthy. If assessment for learning is to flourish, then the trainee–supervisor power dynamic must evolve. Enhancing supervisor behaviour through reflection and professional development to better reward trainee trust would invite more trainee participation in assessment for learning. Modifying the assessment system design to nudge the power balance towards the trainee may also help. Modifications could include designated formative and summative assessments or empowering trainees to select which assessments count towards progress decisions. Attending to power and trust in WBA may stimulate progress towards the previously aspirational goal of assessment for learning in the workplace.

Flattening Hierarchical Structures: Case Studies from Advocacy-Focused, Social Media Teams

“…For example, it is associated with adverse clinical and training outcomes, such as hesitancy to speak out against harassment or when witnessing medical errors. [1][2][3] It also disenfranchises trainees, underutilized of their skill sets, 1,4,5 and jeopardizes the development of their autonomy. 6 Strategic trainee empowerment can transform this traditional hierarchy into a more equitable and flattened model.…”

How progress evaluations are used in postgraduate education with longitudinal supervisor-trainee relationships: a mixed method study

“…This power imbalance was described by supervisors as affecting the supervisortrainee relationship negatively. Clarity of the power differential, transparency in the hierarchy, and trust between supervisor and trainee are key (Castanelli et al, 2022;Falender & Shafranske, 2017;Mohtady et al, 2019). The power imbalance requires further attention in the community pharmacy specialization program and also in other programs with a similar structure.…”

Empowering or validity threat? Trainee control over workplace‐based assessments

“…However, the notion of empowering trainees to make decisions about their WBAs has multiple benefits that are worth considering. Indeed, Castanelli et al 1 use their model to argue that trainees who can choose assessors whom they trust may feel more comfortable being vulnerable and honest in the assessment. These are crucial ingredients for maximising engagement with the assessment process, allowing the full potential of the assessment to be realised 2 .…”

“…Castanelli et al 1 note that the tension between trainee empowerment and assessment validity relates to another: that between trainees' desires to both learn and appear competent. Both tensions sit within a broader one: formative versus summative assessment.…”

“…In their recent study, Castanelli et al 1 closely examined how the trainee–assessor relationship can affect workplace‐based assessments (WBAs), focusing specifically on the reciprocal effects of trust and power. From their interviews with trainees, they produced a model for understanding the relationships between supervisors exercising their ‘power over’, trainee trust in supervisors, and trainees exercising their ‘power to’.…”