Skip to main content
Top
Published in: Perspectives on Medical Education 2/2017

Open Access 01-04-2017 | Eye-Opener

Applying occupational and organizational psychology theory to entrustment decision-making about trainees in health care: a conceptual model

Authors: Ylva Holzhausen, Asja Maaz, Anna T. Cianciolo, Olle ten Cate, Harm Peters

Published in: Perspectives on Medical Education | Issue 2/2017

Login to get access

Abstract

In medical contexts around the world, supervising physicians continuously decide what degree of supervision to apply as trainees carry out professional activities. Although the implications for patients can be far-reaching, little is known about how these entrustment decisions are formed. The concept of ‘Entrustable Professional Activities’ has initiated interest and valuable research on factors that may influence the entrustment decision process.
The aim of the current article is to link models of entrustment developed in the fields of occupational and organizational psychology and military psychology to medical education studies that have explored the factors influencing physicians’ entrustment decisions. We provide a conceptual framework of the entrustment decision-making process, which we suggest will contribute to the understanding of how supervising physicians arrive at the decision to entrust a medical trainee with a professional activity.
Literature
1.
go back to reference Kennedy TJ, Regehr G, Baker GR, Lingard LA. Progressive independence in clinical training: a tradition worth defending? Acad Med. 2005;80:106–11.CrossRef Kennedy TJ, Regehr G, Baker GR, Lingard LA. Progressive independence in clinical training: a tradition worth defending? Acad Med. 2005;80:106–11.CrossRef
2.
go back to reference ten Cate O, Hart D, Ankel F, et al. Entrustment Decision Making in Clinical Training. Acad Med. 2016;91:191–8.CrossRef ten Cate O, Hart D, Ankel F, et al. Entrustment Decision Making in Clinical Training. Acad Med. 2016;91:191–8.CrossRef
3.
go back to reference Gilhooly J, Schumacher DJ, West DC, Jones MD Jr. The Promise and Challenge of Entrustable Professional Activities. Pediatrics. 2014;133:78–9.CrossRef Gilhooly J, Schumacher DJ, West DC, Jones MD Jr. The Promise and Challenge of Entrustable Professional Activities. Pediatrics. 2014;133:78–9.CrossRef
4.
go back to reference Sklar DP. Competencies, milestones, and entrustable professional activities: what they are, what they could be. Acad Med. 2015;90:395–7.CrossRef Sklar DP. Competencies, milestones, and entrustable professional activities: what they are, what they could be. Acad Med. 2015;90:395–7.CrossRef
5.
go back to reference van Loon KA, Driessen EW, Teunissen PW, Scheele F. Experiences with EPAs, potential benefits and pitfalls. Med Teach. 2014;36:698–702.CrossRef van Loon KA, Driessen EW, Teunissen PW, Scheele F. Experiences with EPAs, potential benefits and pitfalls. Med Teach. 2014;36:698–702.CrossRef
6.
go back to reference Hauer KE, ten Cate O, Boscardin C, Irby DM, Iobst W, O’Sullivan PS. Understanding Trust as an Essential Element of Trainee Supervision and Learning in the Workplace. Adv Health Sci Educ Theory Pract. 2014;19:435–56. Hauer KE, ten Cate O, Boscardin C, Irby DM, Iobst W, O’Sullivan PS. Understanding Trust as an Essential Element of Trainee Supervision and Learning in the Workplace. Adv Health Sci Educ Theory Pract. 2014;19:435–56.
7.
go back to reference ten Cate O. Nuts and Bolts of Entrustable Professional Activities. J Grad Med Educ. 2013;5:157–8.CrossRef ten Cate O. Nuts and Bolts of Entrustable Professional Activities. J Grad Med Educ. 2013;5:157–8.CrossRef
8.
go back to reference ten Cate O, Chen HC, Hoff RG, Peters H, Bok H, van der Schaaf M. Curriculum development for the workplace using Entrustable Professional Activities (EPAs): AMEE Guide. Med Teach. 2015;37(99):983–1002.CrossRef ten Cate O, Chen HC, Hoff RG, Peters H, Bok H, van der Schaaf M. Curriculum development for the workplace using Entrustable Professional Activities (EPAs): AMEE Guide. Med Teach. 2015;37(99):983–1002.CrossRef
9.
go back to reference ten Cate O. Entrustability of professional activities and competency-based training. Med Educ. 2005;39:1176–7.CrossRef ten Cate O. Entrustability of professional activities and competency-based training. Med Educ. 2005;39:1176–7.CrossRef
10.
go back to reference Swing SR. The ACGME outcome project: retrospective and prospective. Med Teach. 2007;29:648–54.CrossRef Swing SR. The ACGME outcome project: retrospective and prospective. Med Teach. 2007;29:648–54.CrossRef
11.
go back to reference The FJRCMED. physician competency framework: Better standards, better physicians, better care. Royal College of Physicians and Surgeons of. Canada. vol 2005. 2005. The FJRCMED. physician competency framework: Better standards, better physicians, better care. Royal College of Physicians and Surgeons of. Canada. vol 2005. 2005.
12.
go back to reference Hawkins RE, Welcher CM, Holmboe ES, et al. Implementation of competency-based medical education: Are we addressing the concerns and challenges? Med Educ. 2015;49:1086–102.CrossRef Hawkins RE, Welcher CM, Holmboe ES, et al. Implementation of competency-based medical education: Are we addressing the concerns and challenges? Med Educ. 2015;49:1086–102.CrossRef
13.
go back to reference Holmboe ES, Batalden P. Achieving the Desired Transformation: Thoughts on Next Steps for Outcomes-Based Medical Education. Acad Med. 2015;90:1215–23.CrossRef Holmboe ES, Batalden P. Achieving the Desired Transformation: Thoughts on Next Steps for Outcomes-Based Medical Education. Acad Med. 2015;90:1215–23.CrossRef
14.
go back to reference Klamen DL, Williams RG, Roberts N, Cianciolo AT. Competencies, milestones, and EPAs – Are those who ignore the past condemned to repeat it? Med Teach. 2016;25:1–7. Klamen DL, Williams RG, Roberts N, Cianciolo AT. Competencies, milestones, and EPAs – Are those who ignore the past condemned to repeat it? Med Teach. 2016;25:1–7.
15.
go back to reference Malone K, Supri S. A critical time for medical education: the perils of competence-based reform of the curriculum. Adv Health Sci Educ Theory Pract. 2012;17:241–6.CrossRef Malone K, Supri S. A critical time for medical education: the perils of competence-based reform of the curriculum. Adv Health Sci Educ Theory Pract. 2012;17:241–6.CrossRef
16.
go back to reference Chang A, Bowen JL, Buranosky RA, et al. Transforming primary care training-patient-centered medical home entrustable professional activities for internal medicine residents. J Gen Intern Med. 2013;28:801–9.CrossRef Chang A, Bowen JL, Buranosky RA, et al. Transforming primary care training-patient-centered medical home entrustable professional activities for internal medicine residents. J Gen Intern Med. 2013;28:801–9.CrossRef
17.
go back to reference Jones MD, Rosenberg AA, Gilhooly JT, Carraccio CL. Perspective: Competencies, outcomes, and controversy-linking professional activities to competencies to improve resident education and practice. Acad Med. 2011;86:161–5.CrossRef Jones MD, Rosenberg AA, Gilhooly JT, Carraccio CL. Perspective: Competencies, outcomes, and controversy-linking professional activities to competencies to improve resident education and practice. Acad Med. 2011;86:161–5.CrossRef
18.
go back to reference Boyce P, Spratt C, Davies M, McEvoy P. Using entrustable professional activities to guide curriculum development in psychiatry training. BMC Med Educ. 2011;11:96.CrossRef Boyce P, Spratt C, Davies M, McEvoy P. Using entrustable professional activities to guide curriculum development in psychiatry training. BMC Med Educ. 2011;11:96.CrossRef
19.
go back to reference Shaughnessy AF, Sparks J, Cohen-Osher M, Goodell KH, Sawin GL, Gravel J. Entrustable Professional Activities in Family Medicine. J Grad Med Educ. 2013;5:112–8.CrossRef Shaughnessy AF, Sparks J, Cohen-Osher M, Goodell KH, Sawin GL, Gravel J. Entrustable Professional Activities in Family Medicine. J Grad Med Educ. 2013;5:112–8.CrossRef
20.
go back to reference Hauer KE, Kohlwes J, Cornett P, et al. Identifying Entrustable Professional Activities in Internal Medicine Training. J Grad Med Educ. 2013;5:54–9.CrossRef Hauer KE, Kohlwes J, Cornett P, et al. Identifying Entrustable Professional Activities in Internal Medicine Training. J Grad Med Educ. 2013;5:54–9.CrossRef
21.
go back to reference Leipzig RM, Sauvigné K, Granville LJ, et al. What Is a Geriatrician? American Geriatrics Society and Association of Directors of Geriatric Academic Programs End-of-Training Entrustable Professional Activities for Geriatric Medicine. J Am Geriatr Soc. 2014;62:924–9.CrossRef Leipzig RM, Sauvigné K, Granville LJ, et al. What Is a Geriatrician? American Geriatrics Society and Association of Directors of Geriatric Academic Programs End-of-Training Entrustable Professional Activities for Geriatric Medicine. J Am Geriatr Soc. 2014;62:924–9.CrossRef
22.
go back to reference Kennedy TJT, Regehr G, Baker GR, Lingard L. Point-of-care assessment of medical trainee competence for independent clinical work. Acad Med. 2008;83:89–92.CrossRef Kennedy TJT, Regehr G, Baker GR, Lingard L. Point-of-care assessment of medical trainee competence for independent clinical work. Acad Med. 2008;83:89–92.CrossRef
23.
go back to reference Sterkenburg A, Barach P, Kalkman C, Gielen M, ten Cate O. When do supervising physicians decide to entrust residents with unsupervised tasks? Acad Med. 2010;85:1408–17.CrossRef Sterkenburg A, Barach P, Kalkman C, Gielen M, ten Cate O. When do supervising physicians decide to entrust residents with unsupervised tasks? Acad Med. 2010;85:1408–17.CrossRef
24.
go back to reference Choo KJ, Arora VM, Barach P, Johnson JK, Farnan JM. How do supervising physicians decide to entrust residents with unsupervised tasks? A qualitative analysis. J Hosp Med. 2014;9:169–75.CrossRef Choo KJ, Arora VM, Barach P, Johnson JK, Farnan JM. How do supervising physicians decide to entrust residents with unsupervised tasks? A qualitative analysis. J Hosp Med. 2014;9:169–75.CrossRef
25.
go back to reference Dijksterhuis MG, Voorhuis M, Teunissen PW, et al. Assessment of competence and progressive independence in postgraduate clinical training. Med Educ. 2009;43:1156–65.CrossRef Dijksterhuis MG, Voorhuis M, Teunissen PW, et al. Assessment of competence and progressive independence in postgraduate clinical training. Med Educ. 2009;43:1156–65.CrossRef
26.
go back to reference Teman NR, Gauger PG, Mullan PB, Tarpley JL, Minter RM. Entrustment of general surgery residents in the operating room: factors contributing to provision of resident autonomy. J Am Coll Surg. 2014;219:778–87.CrossRef Teman NR, Gauger PG, Mullan PB, Tarpley JL, Minter RM. Entrustment of general surgery residents in the operating room: factors contributing to provision of resident autonomy. J Am Coll Surg. 2014;219:778–87.CrossRef
27.
go back to reference Hauer KE, Oza SK, Kogan JR, et al. How clinical supervisors develop trust in their trainees: A qualitative study. Med Educ. 2015;49:783–95.CrossRef Hauer KE, Oza SK, Kogan JR, et al. How clinical supervisors develop trust in their trainees: A qualitative study. Med Educ. 2015;49:783–95.CrossRef
28.
go back to reference Mayer RC, Davis JH, Schoorman FD. An Integrative Model of Organizational Trust. Acad Manage J. 1995;20:709–34. Mayer RC, Davis JH, Schoorman FD. An Integrative Model of Organizational Trust. Acad Manage J. 1995;20:709–34.
29.
go back to reference Cianciolo AT, Evans KM, DeCostanza AH, Pierce LG. Trust in Distributed Operations. In: Stanton NA, editor. Trust in Military Teams. Surrey. Ashgate Publishing Group; 2011. pp. 89–106. Cianciolo AT, Evans KM, DeCostanza AH, Pierce LG. Trust in Distributed Operations. In: Stanton NA, editor. Trust in Military Teams. Surrey. Ashgate Publishing Group; 2011. pp. 89–106.
30.
go back to reference Davis JH, Schoorman FD, Mayer RC, Hwee Hoon T. The trusted general manager and business unit performance: Empirical evidence of a competitive. Strateg Manag J. 2000;21:563–76.CrossRef Davis JH, Schoorman FD, Mayer RC, Hwee Hoon T. The trusted general manager and business unit performance: Empirical evidence of a competitive. Strateg Manag J. 2000;21:563–76.CrossRef
31.
go back to reference Mayer RC, Gavin MB. Trust in Management and Performance: Who Minds the Shop while the Employees Watch the Boss? Acad Manage J. 2005;48:874–88.CrossRef Mayer RC, Gavin MB. Trust in Management and Performance: Who Minds the Shop while the Employees Watch the Boss? Acad Manage J. 2005;48:874–88.CrossRef
32.
go back to reference Schoorman FD, Mayer RC, Davis JH. An Integrative Model of Organizational Trust: Past, Present, and Future. Acad Manage Rev. 2007;32:344–54.CrossRef Schoorman FD, Mayer RC, Davis JH. An Integrative Model of Organizational Trust: Past, Present, and Future. Acad Manage Rev. 2007;32:344–54.CrossRef
33.
go back to reference Sutcliffe KM, Lewton E, Rosenthal MM. Communication failures: An insidious contributor to medical mishaps. Acad Med. 2004;79:186–94.CrossRef Sutcliffe KM, Lewton E, Rosenthal MM. Communication failures: An insidious contributor to medical mishaps. Acad Med. 2004;79:186–94.CrossRef
34.
go back to reference Pullon S. Competence, respect, and trust: Key features of successful interprofessional nurse-doctor relationships. J Interprof Care. 2008;22:133–47.CrossRef Pullon S. Competence, respect, and trust: Key features of successful interprofessional nurse-doctor relationships. J Interprof Care. 2008;22:133–47.CrossRef
35.
go back to reference Lancaster G, Kolakowsky-Hayner S, Kovacich J, Greer-Williams N. Interdisciplinary communication and collaboration among physicians, nurses, and unlicensed assistive personnel. J Nurse Schol. 2015;47:275–84.CrossRef Lancaster G, Kolakowsky-Hayner S, Kovacich J, Greer-Williams N. Interdisciplinary communication and collaboration among physicians, nurses, and unlicensed assistive personnel. J Nurse Schol. 2015;47:275–84.CrossRef
36.
go back to reference Tiyyagura G, Balmer D, Chaudoin L, et al. The greater good: how supervising physicians make entrustment decisions in the pediatric emergency department. Acad Pediatr. 2014;14:597–602.CrossRef Tiyyagura G, Balmer D, Chaudoin L, et al. The greater good: how supervising physicians make entrustment decisions in the pediatric emergency department. Acad Pediatr. 2014;14:597–602.CrossRef
37.
go back to reference Bordage G. Conceptual frameworks to illuminate and magnify. Med Educ. 2009;43:312–9.CrossRef Bordage G. Conceptual frameworks to illuminate and magnify. Med Educ. 2009;43:312–9.CrossRef
38.
go back to reference Cianciolo AT, Kegg JA. Behavioral Specification of the Entrustment Process. J Grad Med Educ. 2013;5:10–2.CrossRef Cianciolo AT, Kegg JA. Behavioral Specification of the Entrustment Process. J Grad Med Educ. 2013;5:10–2.CrossRef
39.
go back to reference Wijnen-Meijer M, van der Schaaf M, Nillesen K, Harendza S, ten Cate O. Essential facets of competence that enable trust in medical graduates: a ranking study among physician educators in two countries. Perspect Med Educ. 2013;2:290–7.CrossRef Wijnen-Meijer M, van der Schaaf M, Nillesen K, Harendza S, ten Cate O. Essential facets of competence that enable trust in medical graduates: a ranking study among physician educators in two countries. Perspect Med Educ. 2013;2:290–7.CrossRef
40.
go back to reference Wilson TD. The Proper Protocol: Validity and Completeness of Verbal Reports. Psychol Sci. 1994;5:249–52.CrossRef Wilson TD. The Proper Protocol: Validity and Completeness of Verbal Reports. Psychol Sci. 1994;5:249–52.CrossRef
41.
go back to reference Eccles DW. Verbal reports of cognitive processes. In: Tenenbaum G, Eklund RC, Kamata A, editors. Measurement in sport and exercise psychology. Champaign: Human Kinetics; 2012. pp. 103–17. Eccles DW. Verbal reports of cognitive processes. In: Tenenbaum G, Eklund RC, Kamata A, editors. Measurement in sport and exercise psychology. Champaign: Human Kinetics; 2012. pp. 103–17.
42.
go back to reference Wood TJ. Exploring the role of first impressions in rater-based assessments. Adv Health Sci Educ Theory Pract. 2014;19:409–27.CrossRef Wood TJ. Exploring the role of first impressions in rater-based assessments. Adv Health Sci Educ Theory Pract. 2014;19:409–27.CrossRef
43.
go back to reference Pimmer C, Pachler N, Genewein U. Reframing clinical workplace learning using the theory of distributed cognition. Acad Med. 2013;88:1239–45.CrossRef Pimmer C, Pachler N, Genewein U. Reframing clinical workplace learning using the theory of distributed cognition. Acad Med. 2013;88:1239–45.CrossRef
44.
go back to reference Gigerenzer G. Gut Feelings. The intelligence of the unconscious. New York. Group: Penguin; 2007, pp 1–280. Gigerenzer G. Gut Feelings. The intelligence of the unconscious. New York. Group: Penguin; 2007, pp 1–280.
Metadata
Title
Applying occupational and organizational psychology theory to entrustment decision-making about trainees in health care: a conceptual model
Authors
Ylva Holzhausen
Asja Maaz
Anna T. Cianciolo
Olle ten Cate
Harm Peters
Publication date
01-04-2017
Publisher
Bohn Stafleu van Loghum
Published in
Perspectives on Medical Education / Issue 2/2017
Print ISSN: 2212-2761
Electronic ISSN: 2212-277X
DOI
https://doi.org/10.1007/s40037-017-0336-2

Other articles of this Issue 2/2017

Perspectives on Medical Education 2/2017 Go to the issue