When to trust our learners? Clinical teachers’ perceptions of decision variables in the entrustment process

Chantal C. M.A. Duijn
HaroldG. J. Bok
Lisanne S. Welink
Olle T. J. ten Cate
Soort article
Original Research
Clinical teachers,
Decision variables,
Entrustable professional activities,
Focus group,
Supervision level,
Workplace-based assessment,
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Introduction Clinical training programs increasingly use entrustable professional activities (EPAs) as focus of assessment. However, questions remain about which information should ground decisions to trust learners. This qualitative study aimed to identify decision variables in the workplace that clinical teachers find relevant in the elaboration of the entrustment decision processes. The findings can substantiate entrustment decision-making in the clinical workplace.

Methods Focus groups were conducted with medical and veterinary clinical teachers, using the structured consensus method of the Nominal Group Technique to generate decision variables. A ranking was made based on a relevance score assigned by the clinical teachers to the different decision variables. Field notes, audio recordings and flip chart lists were analyzed and subsequently translated and, as a form of axial coding, merged into one list, combining the decision variables that were similar in their meaning.

Results A list of 11 and 17 decision variables were acknowledged as relevant by the medical and veterinary teacher groups, respectively. The focus groups yielded 21 unique decision variables that were considered relevant to inform readiness to perform a clinical task on a designated level of supervision. The decision variables consisted of skills, generic qualities, characteristics, previous performance or other information. We were able to group the decision variables into five categories: ability, humility, integrity, reliability and adequate exposure.

Discussion To entrust a learner to perform a task at a specific level of supervision, a supervisor needs information to support such a judgement.


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