What Are the Key Features of Entrustment Decision-Making By Competency Committees? – ICE Blog

By: Daniel Schumacher (@DrDanSchumacher)

Competency committees are tasked with making decisions about trainee performance. Often, they simply provide a summative judgment about trainee performance at the end of a period of time they have reviewed. However, these committees should also make decisions about what they would allow trainees to do in the future based on their performance to date because competency committees are best positioned to determine advancement, promotion, and graduation decisions given they have access to and consider all available data about a trainee’s performance.

We have studied these forward-looking, or prospective, entrustment decisions made by competency committees.^1,2 One of our central findings is that this decision-making is most often carried out in a default, rather than deliberate, manner. In other words, committees tend to assume that trainees are able to continue advancing without actually considering whether this is true. The exception to this seems to be when red flags, or performance concerns, arise for individual trainees. While these findings uncover improvements that could be made with competency committee entrustment decision-making, our work has also found ways that more deliberate decisions can me made. The importance of trainee trustworthiness, especially the ability to know limits and seek help when needed, is a key feature to informing competency committee entrustment decisions. Thus, performance data focused on this should be sought to help competency committee decision-making.

A 3-minute video detailing the findings of our most recent paper², including the findings discussed above, can be found here:

About the author: DAN SCHUMACHER, MD, PHD, MED, is a tenured Professor of Pediatrics at the Cincinnati Children’s Hospital Medical center (CCHMC) and the University of Cincinnati College of Medicine. He is a pediatric emergency medicine physician and his research focuses on resident assessment.. 

References

1. Schumacher DJ, Michelson C, Winn AS, Turner DA, Elshoff E, Kinnear B. “Making prospective entrustment decisions: Knowing limits, seeking help and defaulting” Medical Education 2022; 56(9):892-900. PMID 35263474.
2. Schumacher DJ, Michelson C, Winn AS, Turner DA, Martini A, Kinnear B. “A Realist Synthesis of Prospective Entrustment Decision-Making by Entrustment/Clinical Competency Committees.” Medical Education 2023, Online ahead of print. PMID 38088227.

The views and opinions expressed in this post are those of the author(s) and do not necessarily reflect the official policy or position of The University of Ottawa . For more details on our site disclaimers, please see our ‘About’ page