Academic medicine : journal of the Association of American Medical Colleges
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The COVID-19 pandemic poses an unprecedented challenge to U. S. health systems, particularly academic health centers (AHCs) that lead in providing advanced clinical care and medical education. No phase of AHC efforts is untouched by the crisis, and medical schools, prioritizing learner welfare, are in the throes of adjusting to suspended clinical activities and virtual classrooms. ⋯ The learning agenda for these roles maps to HSS competencies, an evolving requirement for all students. The COVID-19 pandemic has provided a unique opportunity to harness the capability of students to improve health. Other AHCs may find this operational framework useful both during the COVID-19 pandemic and as a blueprint for responding to future challenges that disrupt systems of education and health care in the United States.
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Clinical teachers are continuously entrusting trainees with care responsibilities in health care settings. Entrustable professional activities employ entrustment decision making as an approach to assessment in the workplace. Various scales have been created to measure "entrustment," all basically expressing the level or type of supervision a trainee requires for safe and high-quality care. ⋯ Finally, some scales are retrospective ("how much supervision was provided?"), and others are prospective ("how much supervision will be needed in the near future?"). Although retrospective scales reflect observed behavior, prospective scales truly focus on entrustment and ask for more holistic judgment, as they include a broader evaluation and a risk estimation to enable a decision about increase of autonomy. The analysis concludes with a discussion about entrustment for unsupervised practice and supervision of others, as well as the program, context, and specialty specificity of scales.
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Resident-sensitive quality measures (RSQMs) are quality measures that are likely performed by an individual resident and are important to care quality for a given illness of interest. This study sought to explore how individual clinical competency committee (CCC) members interpret, use, and prioritize RSQMs alongside traditional assessment data when making a summative entrustment decision. ⋯ Participants used RSQMs to varying extents in their review of resident data and found such data helpful to varying degrees, supporting the inclusion of RSQMs as resident assessment data for CCC review.