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Record W3007499719 · doi:10.1136/bmjqs-2019-010673

Allowing failure so trainees can thrive: the importance of guided autonomy in medical education

2020· letter· en· W3007499719 on OpenAlexaboutno aff
Rachel B. Atkinson, Douglas S. Smink

Bibliographic record

VenueBMJ Quality & Safety · 2020
Typeletter
Languageen
FieldMedicine
TopicClinical Reasoning and Diagnostic Skills
Canadian institutionsnot available
Fundersnot available
KeywordsPatient safetyMistakeAutonomyMedicineCommitMedical educationQuality (philosophy)Variety (cybernetics)NursingBest practiceObligationHealth careComputer science

Abstract

fetched live from OpenAlex

The delicate balance between resident autonomy and patient safety is an essential topic in medical education. Without a doubt, it is imperative to preserve the quality and safety of care for patients. As a result, clinician educators are constantly challenged by their obligation to provide the best possible patient care while educating the next generation of trainees. How are educators who are committed to patient safety but also want to prepare trainees for independent practice expected to educate within these constraints? Said differently, is it acceptable for an educator to allow a trainee to make a mistake under supervision to teach them to avoid mistakes in the future? In this issue of BMJ Quality and Safety , Klasen et al 1 summarise their findings from 19 semistructured interviews with clinical supervisors who allow their trainees to commit errors for educational purposes. The supervisors, who practice in a variety of procedural and non-procedural specialities in Switzerland and Canada, described a total of 79 examples of permitting clinical failure. The nature of these failures ranged widely from technical to communication to diagnostic errors and allowed for impactful, specific feedback. Specific themes of this feedback included sensory feedback to improve technical skills and emotional feedback to develop resilience. Supervisors were careful, …

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.003
metaresearch head score (Gemma)0.123
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch, Research integrity
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Commentary · Consensus signal: Commentary
Teacher disagreement score0.120
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0030.123
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0010.002
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.055
GPT teacher head0.424
Teacher spread0.369 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designNot applicable
Domainnot available
GenreCommentary

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations5
Published2020
Admission routes1
Has abstractyes

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