L.M. Yarris is professor and residency program director, Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon.
Acad Med. 2019 Jun;94(6):760-762. doi: 10.1097/ACM.0000000000002643.
In this issue of Academic Medicine, Lundsgaard and colleagues present "Embracing Multiple Stakeholder Perspectives in Defining Trainee Competence," a qualitative exploration of how various stakeholders contribute to the understanding of trainee competence. Drawing on stakeholder theory from business management, the authors of that report explore how the perceptions of key stakeholders (leaders/administrators, nurses/nurse practitioners, trainees, and patients) either confirm, enhance, or complicate the picture of competence that emerges from the perspectives of senior physician supervisors.In this Invited Commentary, the author considers the potential effects of applying stakeholder theory to educational assessment and elaborates on Lundsgaard and colleagues' findings that additional stakeholder perceptions may be redundant in some instances and present conflicting understandings of competence in others. She also emphasizes the importance of a process of defining competence, and ultimately developing assessment programs, that includes measuring and illuminating conflicting perceptions of what constitutes competence. Finally, the author considers potential applications of Lundsgaard and colleagues' results for educators and assessors with comprehensive assessment programs already in place.There are limitations and risks to applying a conceptual framework that aims to increase value for a company to the training of physicians. However, with thoughtful application, incorporating multiple stakeholders into instrument development and workplace-based assessment may provide educators with a more nuanced picture of competence that incorporates the values of those ultimately impacted by trainee performance.
在本期《学术医学》中，Lundsgaard 及其同事发表了题为“在定义学员能力时拥抱多方利益相关者视角”的文章，对不同的利益相关者如何有助于理解学员能力进行了定性探讨。该报告的作者借鉴了来自企业管理的利益相关者理论，探讨了主要利益相关者（领导/管理人员、护士/执业护士、学员和患者）的看法如何从资深医师监督者的角度确认、增强或复杂化能力的画面。在这篇特邀评论中，作者考虑了将利益相关者理论应用于教育评估的潜在影响，并详细阐述了 Lundsgaard 及其同事的发现，即其他利益相关者的看法在某些情况下可能是多余的，而在其他情况下则对能力有相互矛盾的理解。她还强调了定义能力的过程的重要性，最终开发评估计划，包括衡量和阐明对构成能力的相互矛盾的看法。最后，作者考虑了 Lundsgaard 及其同事的研究结果对已经实施全面评估计划的教育工作者和评估者的潜在应用。将旨在为公司增加价值的概念框架应用于医师培训存在限制和风险。然而，经过深思熟虑的应用，将多个利益相关者纳入仪器开发和基于工作场所的评估中，可能会为教育工作者提供一个更细致入微的能力画面，其中包括最终受学员表现影响的人的价值观。
