2017-2018 – Kimberly Luu

Background:

Clinical supervisors need to form judgments of trainees’ readiness to practice. The Entrustable Professional Activities (EPA) framework offers promise of a novel assessment strategy that aligns with decisions made in an everyday clinical environment. Adopting this framework requires a clear sense of what factors influence the judgments of trust that form the foundation on which EPAs are built. The literature exploring how entrustment has been reliant on retrospective interpretation of past decisions, which may lead to inaccurate information about how decisions of trust are formed. Capturing in the moment information about supervisors’ decision making about entrustment could provide a better understanding of trust formation in the clinical environment.

Purpose:

The purpose of the study is to explore assessors’ real time judgments related to entrustability during a clinical encounter in order to understand when and how supervisors make entrustment decisions.

Methods:

Otolaryngology – Head & Neck supervisors at a tertiary care institution will be invited to participate. The methodology draws from developed polling methods used in other areas to capture shifts in individuals’ perceptions in real time. Participants will be asked to observe videos of clinical vignettes used to trigger judgments of trust and asked to adjust a sliding scale, presented below the video, to capture real time changes in the level of trust. Interviews will be conducted to review the results of the sliding scale and solicit opinions on how decisions of trust were formed.

Implications:

A better understanding of how real–‐time judgments are used to form an entrustment decisions, has the potential to enhance interpretation of these decisions, the development of assessment instruments, and the nature of feedback provided to the learner.