A138 CONCEPTUALIZING ENTRUSTMENT IN ENDOSCOPIC TRAINING
Notice bibliographique
Résumé
Abstract Background Competency-based medical education (CBME), an educational paradigm that prioritizes development of measurable skills over time in training, is currently being instituted across North American residency training programs. A fundamental goal of CBME is entrustment – the process whereby supervisors come to trust trainees to perform specific tasks without supervision. How entrustment decisions are made with respect to endoscopic training has not been elucidated. Aims We aimed to: (1) identify the factors trainers consider in making endoscopic entrustment decisions and (2) characterize this entrustment decision-making process. Methods A qualitative, interview-based study was conducted using a constructivist grounded theory approach. A purposive sample of endoscopic trainers from across North America were recruited with representation from adult and pediatric gastroenterology, general surgery, and family medicine. Consenting trainers undertook audio-recorded, semi-structured interviews designed to elicit how they make endoscopic entrustment decisions and the factors they consider in making these decisions. Interview transcripts were analyzed using constant comparison, and themes were identified iteratively, working toward an explanatory framework that highlighted relationships among themes. Recruitment continued alongside analysis until theoretical saturation, determined as the point at which no new insights arose from the data. Results Twenty-three trainer interviews were conducted, comprising 8 (34.8%) with adult gastroenterologists, 7 (30.4%) with general surgeons, 6 (26.1%) with pediatric gastroenterologists, and 2 (8.7%) with family physicians. Of those interviewed, 10 (43.5%) practiced in Canada and 13 (56.5%) practiced in the United States. Interviewees conceptualized entrustment as a continuum rather than a binary (yes/no) decision. Entrustment decision-making was found to be a complex process, involving factors related to the: (1) trainee (insight into their own abilities, technical skills, nontechnical skills); (2) trainer (perceived self-competence, disposition, prioritization of trainee learning relative to competing demands); (3) trainer-trainee relationship (duration of exposure); (4) patient (acuity, comorbidity, comfort); (5) procedure (complexity); and (6) environment (time constraints, equipment, presence of anesthesiologist). These factors directly and indirectly contributed to the themes of trainee readiness, trainer comfort, and patient safety, which collectively predicted endoscopic entrustment decisions. Conclusions Entrustment in endoscopic training is a complex process incorporating multiple factors. Clarification of this process and identification of predictive factors informs the development of endoscopic assessment tools and curricula uniquely suited to CBME. Funding Agencies CAG
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,016 | 0,020 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,004 | 0,002 |
| Études des sciences et des technologies | 0,007 | 0,032 |
| Communication savante | 0,008 | 0,011 |
| Science ouverte | 0,003 | 0,010 |
| Intégrité de la recherche | 0,002 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».