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.
- Clinical Clerkship,
- Clinical Competence,
- Communication,
- Decision Making,
- Emergency Medicine,
- Internal Medicine,
- Internship and Residency,
- Interpersonal Relations,
- Point-of-Care Systems,
- Reproducibility of Results
Available at: http://works.bepress.com/loreleilingard/11/
Dr. Lorelei Lingard is currently a faculty member at The University of Western Ontario.