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On the validity of summative entrustment decisions.

Claire Touchie1,2, Benjamin Kinnear3, Daniel Schumacher4

  • 1Medical Council of Canada, Ottawa, Canada.

Medical Teacher
|May 22, 2021
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Summary

Physician entrustment decisions require rigorous validity arguments. Applying frameworks by Kane and Messick ensures trainees are prepared for safe patient care.

Keywords:
Assessment: generallearning outcomes: decision-makingteaching and learning: work-based

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Area of Science:

  • Medical Education
  • Healthcare Professional Development
  • Patient Safety

Background:

  • Healthcare relies on patient trust, necessitating trustworthy physicians.
  • Medical education programs must ensure trainees are competent for unsupervised practice.
  • Summative entrustment decisions are critical for patient safety and physician readiness.

Purpose of the Study:

  • To scrutinize the validity of end-of-training entrustment decisions for physicians.
  • To apply established frameworks for evaluating the defensibility of these critical decisions.
  • To provide a foundation for high-quality, safe patient care through robust assessment.

Main Methods:

  • Utilizing Kane's framework for building validity arguments.
  • Incorporating Messick's framework to identify potential sources of invalidity.
  • Analyzing components supporting summative entrustment decisions in medical training.

Main Results:

  • Validity arguments require defensible components supporting entrustment decisions.
  • Inadequate evidence in content, process, structure, or consequences can lead to invalidity.
  • Kane and Messick's frameworks offer robust methods for evaluating entrustment decisions.

Conclusions:

  • Defensible entrustment decisions are essential for ensuring physician competence.
  • Applying validity frameworks enhances the rigor of evaluating trainees for practice.
  • Strengthening entrustment decision-making processes directly contributes to safer patient care.