Skip to main content
Journal cover image

Making prospective entrustment decisions: Knowing limits, seeking help and defaulting.

Publication ,  Journal Article
Schumacher, DJ; Michelson, C; Winn, AS; Turner, DA; Elshoff, E; Kinnear, B
Published in: Med Educ
September 2022

INTRODUCTION: Many studies focused on entrustment have not considered prospective entrustment decisions, where clinical competency and entrustment committees determine how much supervision trainees will require in the future for tasks occurring in not completely known contexts. The authors sought to explore factors that influence and determine prospective entrustment decisions made by members of such committees in graduate medical education (GME) and undergraduate medical education (UME). METHODS: The authors conducted a constructivist grounded theory study with 23 faculty participants from GME and UME clinical competency and entrustment committees in the United States between October 2020 and March 2021. Interviews sought to explore factors and considerations participants weigh in making prospective entrustment decisions about trainees. Data collection and analysis occurred in an iterative fashion, ensuring constant comparison. Theoretical sampling was used to confirm, disconfirm and elaborate on the evolving results. RESULTS: Trainees' ability to know limits and seek help is the foundation of participants' prospective entrustment decision making. Most participants, however, describe a presumption of trainee readiness to progress and describe commonly making default prospective entrustment decisions unless 'red flags' in performance are present. Although participants desire sufficient and trusted data about trainee performance to inform decisions, they often lack it. Finally, the perceived permanence and consequences of prospective entrustment decisions influence how participants weigh other factors contributing to prospective entrustment decisions. CONCLUSION: Trainees' ability to know limits and seek help appears to be the foundation of prospective entrustment decision making. Training programmes should strive to collect and employ robust data supporting and questioning the presence of these attributes.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Med Educ

DOI

EISSN

1365-2923

Publication Date

September 2022

Volume

56

Issue

9

Start / End Page

892 / 900

Location

England

Related Subject Headings

  • United States
  • Prospective Studies
  • Medical Informatics
  • Internship and Residency
  • Humans
  • Education, Medical, Graduate
  • Decision Making
  • Competency-Based Education
  • Clinical Competence
  • 3904 Specialist studies in education
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Schumacher, D. J., Michelson, C., Winn, A. S., Turner, D. A., Elshoff, E., & Kinnear, B. (2022). Making prospective entrustment decisions: Knowing limits, seeking help and defaulting. Med Educ, 56(9), 892–900. https://doi.org/10.1111/medu.14797
Schumacher, Daniel J., Catherine Michelson, Ariel S. Winn, David A. Turner, Ethan Elshoff, and Benjamin Kinnear. “Making prospective entrustment decisions: Knowing limits, seeking help and defaulting.Med Educ 56, no. 9 (September 2022): 892–900. https://doi.org/10.1111/medu.14797.
Schumacher DJ, Michelson C, Winn AS, Turner DA, Elshoff E, Kinnear B. Making prospective entrustment decisions: Knowing limits, seeking help and defaulting. Med Educ. 2022 Sep;56(9):892–900.
Schumacher, Daniel J., et al. “Making prospective entrustment decisions: Knowing limits, seeking help and defaulting.Med Educ, vol. 56, no. 9, Sept. 2022, pp. 892–900. Pubmed, doi:10.1111/medu.14797.
Schumacher DJ, Michelson C, Winn AS, Turner DA, Elshoff E, Kinnear B. Making prospective entrustment decisions: Knowing limits, seeking help and defaulting. Med Educ. 2022 Sep;56(9):892–900.
Journal cover image

Published In

Med Educ

DOI

EISSN

1365-2923

Publication Date

September 2022

Volume

56

Issue

9

Start / End Page

892 / 900

Location

England

Related Subject Headings

  • United States
  • Prospective Studies
  • Medical Informatics
  • Internship and Residency
  • Humans
  • Education, Medical, Graduate
  • Decision Making
  • Competency-Based Education
  • Clinical Competence
  • 3904 Specialist studies in education