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Making prospective entrustment decisions: Knowing limits, seeking help and defaulting.

Daniel J Schumacher1, Catherine Michelson2, Ariel S Winn3

  • 1Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.

Medical Education
|March 9, 2022
PubMed
Summary
This summary is machine-generated.

Prospective entrustment decisions in medical education rely on trainees knowing their limits and seeking help. Committees often assume trainee readiness, making decisions based on

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Area of Science:

  • Medical Education Research
  • Graduate Medical Education (GME)
  • Undergraduate Medical Education (UME)

Background:

  • Prospective entrustment decisions in medical education are crucial for determining future trainee supervision.
  • Existing research often overlooks the factors influencing these forward-looking decisions by committees.

Purpose of the Study:

  • To explore factors influencing prospective entrustment decisions made by clinical competency and entrustment committees.
  • To understand the considerations of committee members in graduate medical education (GME) and undergraduate medical education (UME).

Main Methods:

  • Constructivist grounded theory study involving 23 faculty participants from GME and UME committees in the US.
  • Semi-structured interviews were conducted between October 2020 and March 2021.
  • Iterative data collection and analysis with theoretical sampling ensured robust findings.

Main Results:

  • Trainee self-awareness of limitations and help-seeking behavior form the basis of entrustment decisions.
  • A presumption of trainee readiness is common, with decisions defaulting unless performance 'red flags' appear.
  • Committee members often lack sufficient performance data, and the perceived consequences of decisions influence the process.

Conclusions:

  • Trainee ability to recognize limits and seek help is fundamental to prospective entrustment.
  • Medical training programs must prioritize collecting data that supports or challenges these critical trainee attributes.