Dudek Nancy, Gofton Wade, Rekman Janelle, McDougall Allan
J Grad Med Educ. 2019 Jun;11(3):287-294. doi: 10.4300/JGME-D-18-01003.1.
Research suggests that workplace-based assessment (WBA) tools using entrustment anchors provide more reliable assessments than those using traditional anchors. There is a lack of evidence describing how and why entrustment anchors work.
The purpose of this study is to better understand the experience of residents and faculty with respect to traditional and entrustment anchors.
We used constructivist grounded theory to guide data collection and analysis (March-December 2017) and semistructured interviews to gather reflections on anchors. Phase 1 involved residents and faculty (n = 12) who had only used assessment tools with traditional anchors. Phase 2 involved participants who had used tools with entrustment anchors (n = 10). Data were analyzed iteratively.
Participants expressed that the pragmatic language of entrustment anchors made WBA (1) and justifiable; (2) as they explicitly link clinical assessment and learning progress; and (3) , enabling better feedback. Participants with no prior experience using entrustment anchors outlined contextual concerns regarding their use. Participants with experience described how they addressed these concerns. Participants expressed that entrustment anchors leave a gap in assessment information because they do not provide normative data.
Insights from this analysis contribute to a theoretical framework of benefits and challenges related to the adoption of entrustment anchors. This richer understanding of faculty and resident perspectives of entrustment anchors may assist WBA developers in creating more acceptable tools and inform the necessary faculty development initiatives that must accompany the use of these new WBA tools. .
研究表明,使用委托锚定的基于工作场所的评估(WBA)工具比使用传统锚定的工具提供更可靠的评估。目前缺乏关于委托锚定如何以及为何起作用的证据。
本研究的目的是更好地了解住院医师和教员在传统锚定和委托锚定方面的体验。
我们使用建构主义扎根理论来指导数据收集和分析(2017年3月至12月),并通过半结构化访谈来收集对锚定的看法。第一阶段涉及仅使用过带有传统锚定的评估工具的住院医师和教员(n = 12)。第二阶段涉及使用过带有委托锚定的工具的参与者(n = 10)。对数据进行迭代分析。
参与者表示,委托锚定的实用语言使WBA(1)合理且正当;(2)因为它们明确将临床评估与学习进度联系起来;(3)便于提供更好的反馈。没有使用委托锚定经验的参与者概述了使用它们时的背景问题。有经验的参与者描述了他们如何解决这些问题。参与者表示,委托锚定在评估信息方面存在差距,因为它们不提供规范数据。
该分析得出的见解有助于形成一个与采用委托锚定相关的益处和挑战的理论框架。对教员和住院医师对委托锚定观点的更深入理解可能有助于WBA开发者创建更易被接受的工具,并为使用这些新的WBA工具时必须开展的教员发展举措提供信息。