How do supervising physicians decide to entrust residents with unsupervised tasks? A qualitative analysis

Choo, Kevin J.; Arora, Vineet M.; Barach, Paul; Johnson, Julie K.; Farnan, Jeanne M.

doi:10.1002/jhm.2150

Cited by 86 publications

(98 citation statements)

References 18 publications

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“…Trusting a consulting colleague involves expertise, interaction style with the patient and collegial interaction (Choudhry et al 2014). The 10 most important trainee features for entrustment identified from the literature are summarised in Table 7 (Kennedy et al 2008;Choo et al 2014;Sterkenburg et al 2010;Wijnen-Meijer et al 2013a,b;Hauer et al 2014;ten Cate et al in press).…”

Section: Trainee Features That Allow Supervisors To Entrust Them Withmentioning

confidence: 99%

Curriculum development for the workplace using Entrustable Professional Activities (EPAs): AMEE Guide No. 99

et al. 2015

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This Guide was written to support educators interested in building a competency-based workplace curriculum. It aims to provide an up-to-date overview of the literature on Entrustable Professional Activities (EPAs), supplemented with suggestions for practical application to curriculum construction, assessment and educational technology. The Guide first introduces concepts and definitions related to EPAs and then guidance for their identification, elaboration and validation, while clarifying common misunderstandings about EPAs. A matrix-mapping approach of combining EPAs with competencies is discussed, and related to existing concepts such as competency milestones. A specific section is devoted to entrustment decision-making as an inextricable part of working with EPAs. In using EPAs, assessment in the workplace is translated to entrustment decision-making for designated levels of permitted autonomy, ranging from acting under full supervision to providing supervision to a junior learner. A final section is devoted to the use of technology, including mobile devices and electronic portfolios to support feedback to trainees about their progress and to support entrustment decision-making by programme directors or clinical teams.

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Section: Trainee Features That Allow Supervisors To Entrust Them Withmentioning

confidence: 99%

Curriculum development for the workplace using Entrustable Professional Activities (EPAs): AMEE Guide No. 99

et al. 2015

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“…Supervising faculty must balance nurturing trainee independence with appropriate care provision, efficiency, and patient expectations. [1][2][3] Recent studies have suggested that provision of autonomy is an area of concern for faculty and residents. 4,5 Trainees express that they are not given enough opportunities to participate in clinical decision making, while faculty identify the challenges of supporting autonomy for residents in settings of high acuity, high patient census, and limited trainee experience.…”

Section: Introductionmentioning

confidence: 99%

Promoting Resident Autonomy During Family-Centered Rounds: A Qualitative Study of Resident, Hospitalist, and Subspecialty Physicians

Beck

Kind

Meyer

et al. 2016

Journal of Graduate Medical Education

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“…In a survey‐based study of supervisors and trainees, four main domains of ‘entrusting factors’ were identified: trainee factors (e.g. confidence), supervisor factors, task factors and systems factors . Furthermore in a qualitative study, Dijksterhuis et al .…”

Section: What Does ‘Entrustable’ Mean?mentioning

confidence: 99%

The ABCs of entrustable professional activities: an overview of ‘entrustable professional activities’ in medical education

El-Haddad

Damodaran

McNeil

et al. 2016

Internal Medicine Journal

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Consultants regularly need to decide whether a trainee can be entrusted to perform a clinical activity independently. 'Entrustable professional activities' (EPA) provide a framework for justifying and better utilising supervisor entrustment decisions for trainee feedback and assessment in the workplace. Since being proposed by Olle ten Cate in 2005, EPA are emerging as an integral part of many international medical curricula, and are being considered by the Royal Australasian College of Physicians in the current review of physician training. EPA are defined as tasks or responsibilities that can be entrusted to a trainee once sufficient competence is reached to allow for unsupervised practice. An example might be to entrust a trainee to 'Initiate and co-ordinate care of the palliative patient' with only off-site or indirect supervision. Rather than attempting to measure directly each of the many separate competencies required to undertake such a complex task, EPA direct the trainee and supervisor's attention to the trainee's performance in a limited number of selected, representative, important day-to-day activities. EPA-based assessment is gaining momentum, amongst significant concerns regarding feasibility of implementation. While the optimal process for designing and implementing EPA remains to be determined, it is an assessment strategy where the over-arching goal of optimal patient care remains in clear sight. This review explores the central role of trust in medical training, the case for EPA and potential barriers to implementing EPA-based assessment.

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How do supervising physicians decide to entrust residents with unsupervised tasks? A qualitative analysis

Cited by 86 publications

References 18 publications

Curriculum development for the workplace using Entrustable Professional Activities (EPAs): AMEE Guide No. 99

Curriculum development for the workplace using Entrustable Professional Activities (EPAs): AMEE Guide No. 99

Promoting Resident Autonomy During Family-Centered Rounds: A Qualitative Study of Resident, Hospitalist, and Subspecialty Physicians

The ABCs of entrustable professional activities: an overview of ‘entrustable professional activities’ in medical education

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