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Entrustment Unpacked: Aligning Purposes, Stakes, and Processes to Enhance Learner Assessment
Benjamin Kinnear1, Eric J Warm2, Holly Caretta-Weyer3
1B. Kinnear is associate professor of internal medicine and pediatrics, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; ORCID: https://orcid.org/0000-0003-0052-4130 .
Summary
Educators use entrustment decisions in competency-based medical education assessment. Understanding the spectrums of purpose, stakes, and process optimizes entrustment integration for better programmatic assessment.
Area of Science:
- Medical Education
- Competency-Based Medical Education
- Programmatic Assessment
Background:
- Entrustment is a framework used in medical education for assessment, feedback, and decision-making.
- Entrustment decisions vary in purpose (formative/summative), stakes (low/high), and process (ad hoc/structured).
- These characteristics exist on a spectrum, not as distinct poles.
Purpose of the Study:
- To describe the continua of purpose, stakes, and process in entrustment decisions.
- To illustrate how aligning these continua optimizes entrustment in programmatic assessment.
- To provide practical applications of entrustment continua in clinical learning environments.
Main Methods:
- Conceptual analysis of entrustment decision characteristics (purpose, stakes, process).
- Description of entrustment continua and their potential interactions.
- Use of case studies to demonstrate practical application in medical education.
Main Results:
- Entrustment decisions exist on spectrums of purpose, stakes, and process.
- Strategic alignment between these continua can enhance the value of entrustment in assessment.
- Understanding these spectrums aids in optimizing programmatic assessment within competency-based medical education.
Conclusions:
- Entrustment continua offer a framework for refining assessment practices.
- Optimizing the alignment of purpose, stakes, and process enhances entrustment utility.
- This approach supports effective programmatic assessment in competency-based medical education.
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