Department of Medicine Publications

Title

Point-of-care Assessment of Medical Trainee Competence for Independent Clinical Work

Document Type

Article

Publication Date

10-2008

Journal

Academic Medicine

Volume

83

Issue

10 Suppl

First Page

89

Last Page

92

URL with Digital Object Identifier

http://dx.doi.org/10.1097/ACM.0b013e318183c8b7

Abstract

BACKGROUND: Clinical supervisors make frequent assessments of medical trainees' competence so they can provide appropriate opportunities for trainees to experience clinical independence. This study explored context-specific assessments of trainees' competence for independent clinical work.

METHOD: In Phase One, 88 teaching team members from internal and emergency medicine were observed during clinical activities (216 hours), and 65 participants completed brief interviews. In Phase Two, 36 in-depth interviews were conducted using video vignettes. Data collection and analysis employed grounded theory methodology.

RESULTS: Supervisors' assessments of trainee trustworthiness for independent clinical work involved consideration of four dimensions: knowledge/skill, discernment of limitations, truthfulness, and conscientiousness. Supervisors' reliance on language cues as a source of trustworthiness data was revealed.

CONCLUSIONS: This study provides an initial exploration of context-specific competence assessments, which affect both patient safety and education, and provides a novel framework for study of the links between language use and competence.

Notes

Dr. Lorelei Lingard is currently a faculty member at The University of Western Ontario.

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