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Published on: March 29, 2019
Conceptualising and assessing interdependent clinical performances: Early insights from emergency medicine and
Lorelei Lingard1,2, Kristen Ng3, Michael Panza2
1Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
Purpose:
Patient care is inherently collaborative, yet traditional assessment methods often emphasise individual performance. This study explores how the concept of interdependence can be used for assessment within clinical settings by examining how faculty in Emergency Medicine (EM) and Paediatrics identify interdependence and distinguish between the different types when assessing residents.
Methods:
We employed a mixed-methods survey design, recruiting board-certified faculty from EM and Paediatrics across Canada and the United States. Participants watched three different videos, each ranging from 3 to 7 minutes that depicted interdependent performances. After watching the videos, participants completed relevant Entrustable Professional Activity (EPA) assessments. Then, each video was broken down into smaller clips for participants to watch again. After watching each of the individual video clips, participants answered questions regarding their observations of interdependence, which included the type and appropriateness. After watching all the videos and their associated clips, participants provided Milestone ratings.
Results:
A total of 126 faculty members participated, evenly split between EM and Paediatrics. Descriptive statistics revealed that participants were able to precisely identify interdependence, but notable differences in distinguishing between supportive and collaborative interdependence existed based on specialty. Open-ended responses support the notion that faculty conceptually understand the interdependence they observed in clinical scenarios. Correlation analyses indicated various relationships between interdependence assessments, EPAs and Milestone ratings.
Conclusion:
This study highlights the complexities of assessing interdependence. Although faculty demonstrated an understanding of interdependence and were able to identify it, challenges remain with classification during real-time assessments. These findings underscore the need for faculty development and reflection on how to best use assessments of interdependence to measure residents' performance and contributions to collaborative patient care.
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