Trust Me – I’m a Doctor

MedEdPearls November 2019: Competency based medical education (CBME) is an outcomes-based time-independent concept that is informing curricular innovation across the country and beyond.

Competency based medical education (CBME) is an outcomes-based time-independent concept that is informing curricular innovation across the country and beyond. The roll out of Entrustable Professional Activities (EPAs) has incited discussion about workplace-based assessment in the context of entrustment.

Hauer et al. provide a model for how trust enables clinical participation through five factors:

  • The trainee earns trust as a result of competence and experience, attitudes and habits of mind, insight, self-confidence and willingness to ask for help
  • The supervisor entrusts trainee based on own clinical competence, assessment expertise, familiarity with clinical context, attitudes and propensity to trust, and accountability
  • The relationship between the supervisor and trainee entrustment is informed by shared expectations, amount of contact between supervisor and trainee
  • Entrustment is dependent on context – familiarity and affordances in the workplace, workload, timing of observation and workplace culture
  • Entrustment is dependent on task complexity, patient complexity, and risk

How has your institution used these domains to frame your assessment tools? Share your experiences on Twitter at #MedEdPearls and read prior posts on the Harvard Macy Community Blog!

Additional Resources:

  1. Hauer KE, ten Cate O, Boscardin C, Irby DM, Iobst W, O’Sullivan PS. 2014. Understanding trust as an essential element of trainee supervision and learning in the workplace. Advances in Health Sciences Education 19:435–456.
  2. Association of American Medical Colleges. 2017. Core Entrustable Professional Activities for Entering Residency.

About the MedEdPearls Author

The MedEdPearls are a collaborative, peer-reviewed, monthly brief intended to provide practical tips and strategies for medical and health professions educators to enhance teaching and learning.

Shanu Gupta Headshot.

Shanu Gupta

MD

  • Associate Professor of Internal Medicine, University of South Florida Morsani College of Medicine
  • Program Director, Academy of Distinguished Educators, University of South Florida Morsani College of Medicine
  • Jean Bailey, PhD – Virginia Commonwealth University School of Medicine
  • Carrie Bowler, EdD, MS, MLSCM (ASCP) – Mayo Clinic School of Continuous Professional Development
  • Kristina Dzara, PhD, MMSc (Educators ’16; Assessment ’16; HCE 2.0 ’17) – Saint Louis University School of Medicine
  • Shanu Gupta, MD, SFHM – University of South Florida Morsani College of Medicine and Tampa General Hospital
  • Jennifer Hillyer, PhD – Northeast Ohio Medical University
  • Larry Hurtubise, PhD, MA (HCE 2.0 '16) – The Ohio State University
  • Anna Lama, EdD, MA – West Virginia University School of Medicine
  • Machelle Linsenmeyer, EdD, NAOME (Assessment ’07) – West Virginia School of Osteopathic Medicine
  • Skye McKennon, PharmD, BCPS, ACSM-GEI – Washington State University Elson S. Floyd College of Medicine
  • Rachel Moquin, EdD, MA – Washington University School of Medicine
  • Stacey Pylman, PhD – Michigan State University College of Human Medicine
  • Leah Sheridan, PhD – Northeast Ohio Medical University
  • Lonika Sood, MBBS, MHPE – Washington State University Elson S. Floyd College of Medicine
  • Mark Terrell, EdD – Lake Erie College of Osteopathic Medicine
  • Stacey Wahl, PhD – Virginia Commonwealth University School of Medicine

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