Relationship of Preceptor Ad-hoc Entrustment Decisions to Students’ Clinical Skills Performance

Abstract

Using a workplace evaluation instrument that included clinical skills evaluation and supervisory EPA scale, this study provided empirical evidence of the relationship between preceptor evaluation of student clinical ability and their entrustment decisions at the medical student level, and advanced the understanding of general conditions that ad-hoc entrustment decision are based upon. A total of 4217 evaluations from 353 third-year medical students were included in the study. The analyses focused on entrustment decisions for seven EPAs (EPA1, 2, 3, 5, 6, 7, and 9) and the relationship with related clinical skill (e.g. history taking) performance. Pearson's correlations showed statistically significant and positive correlations within clerkships (r= 0.43-0.75) and across clerkships (r= 0.70-0.77). Analyses of individual entrustment level and skill rating also revealed that the lowest level of entrustment was predominantly associated with the rating of developing on corresponding skills, whereas the highest level of entrustment with the rating of approaching advanced/advanced; the link between the three middle entrustment levels and particular skill ratings were less salient. Overall, these patterns of association between individual entrustment level and skill rating varied by EPAs as well as level of entrustment. Limitations of the current study were also discussed.