View in EDS HTML Full Text PDF Full Text

A realist synthesis of prospective entrustment decision making by entrustment or clinical competency committees.

Saved in:
Bibliographic Details
Title: A realist synthesis of prospective entrustment decision making by entrustment or clinical competency committees.
Authors: Schumacher, Daniel J., Michelson, Catherine, Winn, Ariel S., Turner, David A., Martini, Abigail, Kinnear, Benjamin
Source: Medical Education. Jul2024, Vol. 58 Issue 7, p812-824. 13p.
Subjects: Medical education, CINAHL database, Decision making, Descriptive statistics, Systematic reviews, MEDLINE, Professions, Clinical competence, Trust, Outcome-based education, Online information services, Committees, Psychology information storage & retrieval systems, ERIC (Information retrieval system)
Geographic Terms: United States
Abstract: Introduction: The real‐world mechanisms underlying prospective entrustment decision making (PEDM) by entrustment or clinical competency committees (E/CCCs) are poorly understood. To advance understanding in this area, the authors conducted a realist synthesis of the published literature to address the following research question: In E/CCC efforts to make defensible prospective entrustment decisions (PEDs), what works, for whom, under what circumstances and why? Methods: Realist work seeks to understand the contexts (C), mechanisms (M) and outcomes (O) that explain how and why things work (or do not). In the authors' study, contexts included individual E/CCC members, E/CCC structures and processes, and training programmes. The outcome (i.e. desired outcome) was a PED. Mechanisms were a substantial focus of the analysis and informed the core findings. To define a final corpus of 52 included papers, the authors searched four databases, screened all results from those searches and performed a full‐text review of a subset of screened papers. Data extraction focused on developing context–mechanism–outcome configurations from the papers, which were used to create a theory for how PEDM leads to PEDs. Results: PEDM is often driven by default (non‐deliberate) decision making rather than a deliberate process of deciding whether a trainee should be entrusted or not. When defaulting, some E/CCCs find red flags that sometimes lead to being more deliberate with decision making. E/CCCs that seek to be deliberate describe PEDM that can be effortful (when data are insufficient or incongruent) or effortless (when data are robust and tell a congruent story about a trainee). Both information about trainee trustworthiness and the sufficiency of data about trainee performance influence PEDM. Several moderators influence what is considered to be sufficient data, how trustworthiness data are viewed and how PEDM is carried out. These include perceived consequences and associated risks, E/CCC member trust propensity, E/CCC member personal knowledge of and experience with trainees and E/CCC structures and processes. Discussion: PEDM is rarely deliberate but should be. Data about trainee trustworthiness are foundational to making PEDs. Bias, equity and fairness are nearly absent from the papers in this synthesis, and future efforts must seek to advance understanding and practice regarding the roles of bias, equity and fairness in PEDM. Entrustment decisions made by committees are rarely deliberate, but should be. These authors provide practical advice, based in the literature, for improvement. [ABSTRACT FROM AUTHOR]
Copyright of Medical Education is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
Full text is not displayed to guests.
FullText Links:
  – Type: pdflink
Text:
  Availability: 1
Header DbId: pbh
DbLabel: Psychology and Behavioral Sciences Collection
An: 177626281
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: A realist synthesis of prospective entrustment decision making by entrustment or clinical competency committees.
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Schumacher%2C+Daniel+J%2E%22">Schumacher, Daniel J.</searchLink><br /><searchLink fieldCode="AR" term="%22Michelson%2C+Catherine%22">Michelson, Catherine</searchLink><br /><searchLink fieldCode="AR" term="%22Winn%2C+Ariel+S%2E%22">Winn, Ariel S.</searchLink><br /><searchLink fieldCode="AR" term="%22Turner%2C+David+A%2E%22">Turner, David A.</searchLink><br /><searchLink fieldCode="AR" term="%22Martini%2C+Abigail%22">Martini, Abigail</searchLink><br /><searchLink fieldCode="AR" term="%22Kinnear%2C+Benjamin%22">Kinnear, Benjamin</searchLink>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="JN" term="%22Medical+Education%22">Medical Education</searchLink>. Jul2024, Vol. 58 Issue 7, p812-824. 13p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Medical+education%22">Medical education</searchLink><br /><searchLink fieldCode="DE" term="%22CINAHL+database%22">CINAHL database</searchLink><br /><searchLink fieldCode="DE" term="%22Decision+making%22">Decision making</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Systematic+reviews%22">Systematic reviews</searchLink><br /><searchLink fieldCode="DE" term="%22MEDLINE%22">MEDLINE</searchLink><br /><searchLink fieldCode="DE" term="%22Professions%22">Professions</searchLink><br /><searchLink fieldCode="DE" term="%22Clinical+competence%22">Clinical competence</searchLink><br /><searchLink fieldCode="DE" term="%22Trust%22">Trust</searchLink><br /><searchLink fieldCode="DE" term="%22Outcome-based+education%22">Outcome-based education</searchLink><br /><searchLink fieldCode="DE" term="%22Online+information+services%22">Online information services</searchLink><br /><searchLink fieldCode="DE" term="%22Committees%22">Committees</searchLink><br /><searchLink fieldCode="DE" term="%22Psychology+information+storage+%26+retrieval+systems%22">Psychology information storage & retrieval systems</searchLink><br /><searchLink fieldCode="DE" term="%22ERIC+%28Information+retrieval+system%29%22">ERIC (Information retrieval system)</searchLink>
– Name: SubjectGeographic
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22United+States%22">United States</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Introduction: The real‐world mechanisms underlying prospective entrustment decision making (PEDM) by entrustment or clinical competency committees (E/CCCs) are poorly understood. To advance understanding in this area, the authors conducted a realist synthesis of the published literature to address the following research question: In E/CCC efforts to make defensible prospective entrustment decisions (PEDs), what works, for whom, under what circumstances and why? Methods: Realist work seeks to understand the contexts (C), mechanisms (M) and outcomes (O) that explain how and why things work (or do not). In the authors' study, contexts included individual E/CCC members, E/CCC structures and processes, and training programmes. The outcome (i.e. desired outcome) was a PED. Mechanisms were a substantial focus of the analysis and informed the core findings. To define a final corpus of 52 included papers, the authors searched four databases, screened all results from those searches and performed a full‐text review of a subset of screened papers. Data extraction focused on developing context–mechanism–outcome configurations from the papers, which were used to create a theory for how PEDM leads to PEDs. Results: PEDM is often driven by default (non‐deliberate) decision making rather than a deliberate process of deciding whether a trainee should be entrusted or not. When defaulting, some E/CCCs find red flags that sometimes lead to being more deliberate with decision making. E/CCCs that seek to be deliberate describe PEDM that can be effortful (when data are insufficient or incongruent) or effortless (when data are robust and tell a congruent story about a trainee). Both information about trainee trustworthiness and the sufficiency of data about trainee performance influence PEDM. Several moderators influence what is considered to be sufficient data, how trustworthiness data are viewed and how PEDM is carried out. These include perceived consequences and associated risks, E/CCC member trust propensity, E/CCC member personal knowledge of and experience with trainees and E/CCC structures and processes. Discussion: PEDM is rarely deliberate but should be. Data about trainee trustworthiness are foundational to making PEDs. Bias, equity and fairness are nearly absent from the papers in this synthesis, and future efforts must seek to advance understanding and practice regarding the roles of bias, equity and fairness in PEDM. Entrustment decisions made by committees are rarely deliberate, but should be. These authors provide practical advice, based in the literature, for improvement. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Medical Education is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=177626281
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1111/medu.15296
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 13
        StartPage: 812
    Subjects:
      – SubjectFull: Medical education
        Type: general
      – SubjectFull: CINAHL database
        Type: general
      – SubjectFull: Decision making
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Systematic reviews
        Type: general
      – SubjectFull: MEDLINE
        Type: general
      – SubjectFull: Professions
        Type: general
      – SubjectFull: Clinical competence
        Type: general
      – SubjectFull: Trust
        Type: general
      – SubjectFull: Outcome-based education
        Type: general
      – SubjectFull: Online information services
        Type: general
      – SubjectFull: Committees
        Type: general
      – SubjectFull: Psychology information storage & retrieval systems
        Type: general
      – SubjectFull: ERIC (Information retrieval system)
        Type: general
      – SubjectFull: United States
        Type: general
    Titles:
      – TitleFull: A realist synthesis of prospective entrustment decision making by entrustment or clinical competency committees.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Schumacher, Daniel J.
      – PersonEntity:
          Name:
            NameFull: Michelson, Catherine
      – PersonEntity:
          Name:
            NameFull: Winn, Ariel S.
      – PersonEntity:
          Name:
            NameFull: Turner, David A.
      – PersonEntity:
          Name:
            NameFull: Martini, Abigail
      – PersonEntity:
          Name:
            NameFull: Kinnear, Benjamin
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 07
              Text: Jul2024
              Type: published
              Y: 2024
          Identifiers:
            – Type: issn-print
              Value: 03080110
          Numbering:
            – Type: volume
              Value: 58
            – Type: issue
              Value: 7
          Titles:
            – TitleFull: Medical Education
              Type: main
ResultId 1