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Developing the Expected Entrustment Score: Accounting for Variation in Resident Assessment.

Daniel P Schauer1, Benjamin Kinnear2, Matthew Kelleher2

  • 1Department of Internal Medicine, University of Cincinnati, PO Box 670535, Cincinnati, OH, 45267-0535, USA. Daniel.Schauer@uc.edu.

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Developing an expected entrustment score aids clinical competency committees in interpreting workplace-based assessment (WBA) ratings for residents. This score helps standardize performance evaluation by accounting for contextual factors and potential bias in WBA data.

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Area of Science:

  • Medical Education
  • Healthcare Quality Improvement

Background:

  • Clinical competency committees (CCCs) face challenges interpreting workplace-based assessment (WBA) ratings due to contextual factors and bias.
  • Standardizing performance evaluation in residency programs is crucial for accurate assessment.

Purpose of the Study:

  • To develop an expected entrustment score for resident performance.
  • To provide a guidepost for interpreting workplace-based assessment (WBA) ratings within an Observable Practice Activity (OPA) system.

Main Methods:

  • Utilized regression modeling on historical WBA data.
  • Developed an expected entrustment score to serve as a performance benchmark.
  • Conducted an observational study with internal medicine residents.

Main Results:

  • Each resident demonstrated a unique relationship between observed and expected entrustment scores.
  • Many residents' observed scores closely aligned with expected scores.
  • Distinct resident performance patterns were identified through this analysis.

Conclusions:

  • The developed expected entrustment score facilitates more objective interpretation of WBA ratings.
  • This approach can help mitigate the impact of bias and contextual factors in resident assessment.
  • The system provides a valuable tool for residency program leaders and CCCs.