The Influence of Prior Performance Information on Ratings of Current Performance and Implications for Learner Handover: A Scoping Review

Humphrey‐Murto, Susan; LeBlanc, Aaron R. H.; Touchie, Claire; Pugh, Debra; Wood, Timothy; Cowley, Lindsay; Shaw, Tammy

doi:10.1097/acm.0000000000002731

Cited by 25 publications

(25 citation statements)

References 46 publications

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“…Learner handover is a controversial topic in medical education [5,7,8,14]. Studies about stakeholder views towards learner handover have primarily focused on educational leaders [6,9,10,12,13], with only one recently published study including the perspectives of medical students and residents [10].…”

Section: Discussionmentioning

confidence: 99%

“…While understanding supervisor perspectives is critical to successful implementation, discussions regarding learner handover would benefit from robust evidence regarding the observed benefits and harms of learner handover as well as factors influencing their likelihood and extent. The majority of available experimental studies can be found within the educational, social, and organizational psychology literature [ 5 , 35 – 38 ], with a small, but growing, literature in health professions education with mixed results [ 17 , 39 ]. Further studies are needed to understand the potential positive and negative impacts of learner handover in medical education settings.…”

Section: Discussionmentioning

confidence: 99%

“…While learner handover is well-aligned with the goals of CBME, we know little regarding the potential risks, benefits, or strategies for its successful implementation within CBME [5]. Current views regarding learner handover in medical education vary substantially [6][7][8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

“…These models are characterized by their consideration for learner development and progress towards competency through the repeated assessment and monitoring of learners’ progress [ 1 – 3 ]. The developmental lens of CBME models and the accompanying assessment approaches have led to an increased focus on learner handover, or ‘forward-feeding’, where information about learners is shared across educational phases, supervisors, and/or clinical placements [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Learner handover: Perspectives and recommendations from the front-line

Gumuchian¹,

Pal²,

Young³

et al. 2020

Perspect Med Educ

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Introduction Current medical education models increasingly rely on longitudinal assessments to document learner progress over time. This longitudinal focus has re-kindled discussion regarding learner handover—where assessments are shared across supervisors, rotations, and educational phases, to support learner growth and ease transitions. The authors explored the opinions of, experiences with, and recommendations for successful implementation of learner handover among clinical supervisors. Methods Clinical supervisors from five postgraduate medical education programs at one institution completed an online questionnaire exploring their views regarding learner handover, specifically: potential benefits, risks, and suggestions for implementation. Survey items included open-ended and numerical responses. The authors used an inductive content analysis approach to analyze the open-ended questionnaire responses, and descriptive and correlational analyses for numerical data. Results Seventy-two participants completed the questionnaire. Their perspectives varied widely. Suggested benefits of learner handover included tailored learning, improved assessments, and enhanced patient safety. The main reported risk was the potential for learner handover to bias supervisors’ perceptions of learners, thereby affecting the validity of future assessments and influencing the learner’s educational opportunities and well-being. Participants’ suggestions for implementation focused on who should be involved, when and for whom it should occur, and the content that should be shared. Discussion The diverse opinions of, and recommendations for, learner handover highlight the necessity for handover to maximize learning potential while minimizing potential harms. Supervisors’ suggestions for handover implementation reveal tensions between assessment-of and for-learning.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Learner handover: Perspectives and recommendations from the front-line

Gumuchian¹,

Pal²,

Young³

et al. 2020

Perspect Med Educ

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“…Increasing the duration of rotations 4 has been used to target the failure to fail phenomenon and may help to accommodate the disbelief phase. Other failure to fail solutions that may also target this phase include encouraging discussion between supervisors, such as strategic learner handover 43 and mentorship training sessions, 44 to help supervisors process their experiences and understand unexpected trainee performance. Disbelief might also be addressed in faculty development materials by acknowledging that not all trainees should graduate 3 and demystifying underperformance by clearly describing trajectories and outcomes for underperforming trainees 45 …”

Section: Discussionmentioning

confidence: 99%

Seeing but not believing: Insights into the intractability of failure to fail

et al. 2020

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Context: Inadequate documentation of observed trainee incompetence persists despite research-informed solutions targeting this failure to fail phenomenon. Documentation could be impeded if assessment language is misaligned with how supervisors conceptualise incompetence. Because frameworks tend to itemise competence as well as being vague about incompetence, assessment design may be improved by better understanding and describing of how supervisors experience being confronted with a potentially incompetent trainee. Methods: Following constructivist grounded theory methodology, analysis using a constant comparison approach was iterative and informed data collection. We interviewed 22 physicians about their experiences supervising trainees who demonstrate incompetence; we quickly found that they bristled at the term 'incompetence,' so we began to use 'underperformance' in its place. Results: Physicians began with a belief and an expectation: all trainees should be capable of learning and progressing by applying what they learn to subsequent clinical experiences. Underperformance was therefore unexpected and evoked disbelief in supervisors, who sought alternate explanations for the surprising evidence. Supervisors conceptualised underperformance as: an inability to engage with learning due to illness, a life event or learning disorders, so that progression was stalled, or an unwillingness to engage with learning due to lack of interest, insight or humility. Conclusion: Physicians conceptualise underperformance as problematic progression due to insufficient engagement with learning that is unresponsive to intensified supervision. Although failure to fail tends to be framed as a reluctance to document underperformance, the prior phase of disbelief prevents confident documentation of performance and delays identification of underperformance. The findings offer further insight and possible new solutions to address under-documentation of underperformance. | 1149 GINGERICH Et al.

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