Entrustment Unpacked: Aligning Purposes, Stakes, and Processes to Enhance Learner Assessment.

Journal Article (Journal Article)

Educators use entrustment, a common framework in competency-based medical education, in multiple ways, including frontline assessment instruments, learner feedback tools, and group decision making within promotions or competence committees. Within these multiple contexts, entrustment decisions can vary in purpose (i.e., intended use), stakes (i.e., perceived risk or consequences), and process (i.e., how entrustment is rendered). Each of these characteristics can be conceptualized as having 2 distinct poles: (1) purpose has formative and summative, (2) stakes has low and high, and (3) process has ad hoc and structured. For each characteristic, entrustment decisions often do not fall squarely at one pole or the other, but rather lie somewhere along a spectrum. While distinct, these continua can, and sometimes should, influence one another, and can be manipulated to optimally integrate entrustment within a program of assessment. In this article, the authors describe each of these continua and depict how key alignments between them can help optimize value when using entrustment in programmatic assessment within competency-based medical education. As they think through these continua, the authors will begin and end with a case study to demonstrate the practical application as it might occur in the clinical learning environment.

Full Text

Duke Authors

Cited Authors

  • Kinnear, B; Warm, EJ; Caretta-Weyer, H; Holmboe, ES; Turner, DA; van der Vleuten, C; Schumacher, DJ

Published Date

  • July 1, 2021

Published In

Volume / Issue

  • 96 / 7S

Start / End Page

  • S56 - S63

PubMed ID

  • 34183603

Electronic International Standard Serial Number (EISSN)

  • 1938-808X

Digital Object Identifier (DOI)

  • 10.1097/ACM.0000000000004108


  • eng

Conference Location

  • United States