1
|
Acai A, Cupido N, Weavers A, Saperson K, Ladhani M, Cameron S, Sonnadara RR. Competence committees: The steep climb from concept to implementation. MEDICAL EDUCATION 2021; 55:1067-1077. [PMID: 34152027 DOI: 10.1111/medu.14585] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 05/07/2021] [Accepted: 06/03/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Competence committees (CCs) are groups of educators tasked with reviewing resident progress throughout their training, making decisions regarding the achievement of Entrustable Professional Activities and recommendations regarding promotion and remediation. CCs have been mandated as part of competency-based medical education programmes worldwide; however, there has yet to be a thorough examination of the implementation challenges they face and how this impacts their functioning and decision-making processes. This study examined CC implementation at a Canadian institution, documenting the shared and unique challenges that CCs faced and overcame over a 3-year period. METHODS This study consisted of three phases, which were conceptually and analytically linked using Moran-Ellis and colleagues' notion of 'following a thread.' Phase 1 examined the early perceptions and experiences of 30 key informants using a survey and semi-structured interviews. Phase 2 provided insight into CCs' operations through a survey sent to 35 CC chairs 1-year post-implementation. Phase 3 invited 20 CC members to participate in semi-structured interviews to follow up on initial themes 2 years post-implementation. Detailed observation notes from 16 CC meetings across nine disciplines were used to corroborate the findings from each phase. RESULTS Response rates in each phase were 83% (n = 25), 43% (n = 15) and 60% (n = 12), respectively. Despite the high degree of support for CCs among faculty and resident members, several ongoing challenges were highlighted: adapting to programme size, optimising membership, engaging residents, maintaining capacity among members, sharing and aggregating data and developing a clear mandate. DISCUSSION Findings of this study reinforce the importance of resident engagement and information sharing between disciplines. Challenges faced by CCs are discussed in relation to the existing literature to inform a better understanding of group decision-making processes in medical education. Future research could compare implementation practices across sites and explore which adaptations lead to better or worse decision-making outcomes.
Collapse
Affiliation(s)
- Anita Acai
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
- Office of Education Science, Department of Surgery, McMaster University, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Nathan Cupido
- Office of Education Science, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Aliana Weavers
- Office of Education Science, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Karen Saperson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Moyez Ladhani
- McMaster Postgraduate Medical Education Office, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Sharon Cameron
- McMaster Postgraduate Medical Education Office, McMaster University, Hamilton, ON, Canada
| | - Ranil R Sonnadara
- Office of Education Science, Department of Surgery, McMaster University, Hamilton, ON, Canada
- Department of Surgery, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
2
|
Ekpenyong A, Padmore JS, Hauer KE. The Purpose, Structure, and Process of Clinical Competency Committees: Guidance for Members and Program Directors. J Grad Med Educ 2021; 13:45-50. [PMID: 33936532 PMCID: PMC8078071 DOI: 10.4300/jgme-d-20-00841.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Andem Ekpenyong
- Andem Ekpenyong, MD, MHPE, is Associate Professor, Department of Internal Medicine, Rush University Medical Center
| | - Jamie S. Padmore
- Jamie S. Padmore, DM, is Professor and Senior Associate Dean for Medical Education, Georgetown University Medical Center, and Vice President, Academic Affairs, and Designated Institutional Official, MedStar Health
| | - Karen E. Hauer
- Karen E. Hauer, MD, PhD, is Associate Dean, Competency Assessment and Professional Standards, and Professor of Medicine, University of California, San Francisco
| |
Collapse
|
3
|
Sapp JE, Torre DM, Larsen KL, Holmboe ES, Durning SJ. Trust in Group Decisions: a scoping review. BMC MEDICAL EDUCATION 2019; 19:309. [PMID: 31412860 PMCID: PMC6693175 DOI: 10.1186/s12909-019-1726-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 07/24/2019] [Indexed: 05/10/2023]
Abstract
BACKGROUND Trust is a critical component of competency committees given their high-stakes decisions. Research from outside of medicine on group trust has not focused on trust in group decisions, and "group trust" has not been clearly defined. The purpose was twofold: to examine the definition of trust in the context of group decisions and to explore what factors may influence trust from the perspective of those who rely on competency committees through a proposed group trust model. METHODS The authors conducted a literature search of four online databases, seeking articles published on trust in group settings. Reviewers extracted, coded, and analyzed key data including definitions of trust and factors pertaining to group trust. RESULTS The authors selected 42 articles for full text review. Although reviewers found multiple general definitions of trust, they were unable to find a clear definition of group trust and propose the following: a group-directed willingness to accept vulnerability to actions of the members based on the expectation that members will perform a particular action important to the group, encompassing social exchange, collective perceptions, and interpersonal trust. Additionally, the authors propose a model encompassing individual level factors (trustor and trustee), interpersonal interactions, group level factors (structure and processes), and environmental factors. CONCLUSIONS Higher degrees of trust at the individual and group levels have been associated with attitudinal and performance outcomes, such as quality of group decisions. Developing a deeper understanding of trust in competency committees may help these committees implement more effective and meaningful processes to make collective decisions.
Collapse
Affiliation(s)
- Jason E. Sapp
- Department of Medicine, Division of Health Professions Education, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814 USA
- Department of Medicine, Tripler Army Medical Center, 1 Jarrett White Rd, Tripler AMC, HI 96859 USA
| | - Dario M. Torre
- Department of Medicine, Division of Health Professions Education, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814 USA
| | - Kelsey L. Larsen
- Department of Medicine, Division of Health Professions Education, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814 USA
| | - Eric S. Holmboe
- Milestones Development and Evaluation, Accreditation Council for Graduate Medical, Education, Suite 2000, 401 North Michigan Avenue, Chicago, IL 60611 USA
| | - Steven J. Durning
- Department of Medicine, Division of Health Professions Education, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814 USA
| |
Collapse
|
4
|
Black S, Capdeville M, Augoustides JGT, Nelson EW, Patel PA, Feinman JW, Gordon EK, Lockman JL, Yanofsky SD. The Clinical Competency Committee in Adult Cardiothoracic Anesthesiology-Perspectives From Program Directors Around the United States. J Cardiothorac Vasc Anesth 2019; 33:1819-1827. [PMID: 30679070 DOI: 10.1053/j.jvca.2019.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Indexed: 11/11/2022]
Abstract
The clinical competency committee offers a fellowship program a structured approach to assess the clinical performance of each trainee in a comprehensive fashion This special article examines the structure and function of this important committee in detail. Furthermore, the strategies for the optimal functioning of this committee are also discussed as a way to enhance the overall quality of the fellowship program.
Collapse
Affiliation(s)
- Stephanie Black
- Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Michelle Capdeville
- Department of Cardiothoracic Anesthesiology, Cleveland Clinic Lerner College of Medicine, Cleveland, OH
| | - John G T Augoustides
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
| | - Eric W Nelson
- Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, SC
| | - Prakash A Patel
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Jared W Feinman
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Emily K Gordon
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Justin L Lockman
- Anesthesiology and Critical Care, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Samuel D Yanofsky
- Children's Hospital of Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
| |
Collapse
|
5
|
Acai A, Sonnadara RR, O'Neill TA. Getting with the times: a narrative review of the literature on group decision making in virtual environments and implications for promotions committees. PERSPECTIVES ON MEDICAL EDUCATION 2018; 7:147-155. [PMID: 29797289 PMCID: PMC6002284 DOI: 10.1007/s40037-018-0434-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
INTRODUCTION Concerns around the time and administrative burden of trainee promotion processes have been reported, making virtual meetings an attractive option for promotions committees in undergraduate and postgraduate medicine. However, whether such meetings can uphold the integrity of decision-making processes has yet to be explored. This narrative review aimed to summarize the literature on decision making in virtual teams, discuss ways to improve the effectiveness of virtual teams, and explore their implications for practice. METHODS In August 2017, the Web of Science platform was searched with the terms 'decision making' AND 'virtual teams' for articles published within the last 20 years. The search yielded 336 articles, which was narrowed down to a final set of 188 articles. A subset of these, subjectively deemed to be of high-quality and relevant to the work of promotions committees, was included in this review. RESULTS Virtual team functioning was explored with respect to team composition and development, idea generation and selection, group memory, and communication. While virtual teams were found to potentially offer a number of key benefits over face-to-face meetings including convenience and scheduling flexibility, inclusion of members at remote sites, and enhanced idea generation and external storage, these benefits must be carefully weighed against potential challenges involving planning and coordination, integration of perspectives, and relational conflict among members, all of which can potentially reduce decision-making quality. DISCUSSION Avenues to address these issues and maximize the outcomes of virtual promotions meetings are offered in light of the evidence.
Collapse
Affiliation(s)
- Anita Acai
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Ontario, Canada
- Office of Education Science, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Ranil R Sonnadara
- Office of Education Science, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
| | - Thomas A O'Neill
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|