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Key Factors in Clinical Competency Committee Members’ Decisions Regarding Residents’ Readiness to Serve as Supervisors

A National Study

Schumacher, Daniel J., MD, MEd; Martini, Abigail; Bartlett, Kathleen W., MD; King, Beth, MPP; Calaman, Sharon, MD; Garfunkel, Lynn C., MD; Elliott, Sean P., MD; Frohna, John G., MD, MPH; Schwartz, Alan, PhD; Michelson, Catherine D., MD, MMSc and the Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network Clinical Competency Committee Study Group

doi: 10.1097/ACM.0000000000002469
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Purpose Entrustment has become a popular assessment framework in recent years. Most research in this area has focused on how frontline assessors determine when a learner can be entrusted. However, less work has focused on how these entrustment decisions are made. The authors sought to understand the key factors that pediatric residency program clinical competency committee (CCC) members consider when recommending residents to a supervisory role.

Method CCC members at 14 pediatric residency programs recommended residents to one of five progressive supervisory roles (from not serving as a supervisory resident to serving as a supervisory resident in all settings). They then responded to a free-text prompt, describing the key factors that led them to that decision. The authors analyzed these responses, by role recommendation, using a thematic analysis.

Results Of the 155 CCC members at the participating programs, 84 completed 769 supervisory role recommendations during the 2015–2016 academic year. Four themes emerged from the thematic analysis: (1) Determining supervisory ability follows from demonstrated trustworthiness; (2) demonstrated performance matters, but so does experience; (3) ability to lead a team is considered; and (4) contextual considerations external to the resident are at play.

Conclusions CCC members considered resident and environmental factors in their summative entrustment decision making. The interplay between these factors should be considered as CCC processes are optimized and studied further.

D.J. Schumacher is associate professor, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio.

A. Martini is clinical research coordinator, Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio.

K.W. Bartlett is associate professor and associate program director, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina.

B. King is research project manager, Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network, McLean, Virginia.

S. Calaman is associate professor and pediatric program director, Department of Pediatrics, Drexel University College of Medicine and St. Christopher’s Hospital for Children, Philadelphia, Pennsylvania.

L.C. Garfunkel is professor and associate program director, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York.

S.P. Elliott is professor, associate chair, and program director, Department of Pediatrics, and interim associate dean, University of Arizona College of Medicine, Tucson, Arizona.

J.G. Frohna is professor, Departments of Pediatrics and Internal Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.

A. Schwartz is Michael Reese Endowed Professor of Medical Education and associate head, Department of Medical Education, and research professor, Department of Pediatrics, University of Illinois College of Medicine, Chicago, Illinois, and director, Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network, McLean, Virginia.

C.D. Michelson is assistant professor and pediatric program director, Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts.

Funding/Support: The Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network provided in-kind support for this study.

Other disclosures: None reported.

Ethical approval: The institutional review board (IRB) at Cincinnati Children’s Hospital Medical Center (lead site) granted exempt status to this study. The IRB at each participating program also reviewed and approved this study.

Disclaimer: The views expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of the Department of the Navy, the Department of Defense, or the U.S. Government.

Previous presentations: Data from this study were presented in oral form at the 2017 International Conference on Residency Education in Quebec, Canada on October 20, 2017.

Supplemental digital content for this article is available at http://links.lww.com/ACADMED/A602.

Correspondence should be addressed to Daniel J. Schumacher, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave., MLC 2008, Cincinnati, OH 45229; telephone: (513) 803-2639; e-mail: daniel.schumacher@cchmc.org.

Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a "work of the United States Government" for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government

© 2019 by the Association of American Medical Colleges