Department of Pediatrics, University of Calgary, 28 Oki Dr. NW, Calgary, AB, T3B 6A8, Canada.
Department of Community Health Sciences, University of Calgary, Calgary, Canada.
BMC Med Educ. 2023 Oct 10;23(1):748. doi: 10.1186/s12909-023-04693-4.
The implementation of competency-based medical education and utilization of competence committees (CC) represents a paradigm shift in residency education. This qualitative study aimed to explore the methods used by two operational CC and their members to make decisions about progression and competence of their residents.
An instrumental case study methodology was used to study the CC of two postgraduate training programs. Transcripts from observed CC meetings, member interviews, and guiding documents were analyzed using a constructivist grounded theory approach to reveal themes explaining the decision-making process.
Our study found that the CC followed a process that began within a social decision schema model and evolved to a discussion that invoked social influence theory, shared mental models, and social judgment scheme to clarify the points of contention. We identified that the CC decision-making was at risk of bias, primarily influenced by the group composition, the group orientation and individual members' mindset, as well as their personal experiences with the trainees.
Increased awareness of the sources of bias in CC functioning and familiarity with the CC role in competency-based medical education would enable committees to provide valuable feedback to all trainees regardless of their trajectory.
基于能力的医学教育的实施和能力委员会（CC）的利用代表了住院医师教育的范式转变。这项定性研究旨在探讨两个运作中的 CC 及其成员用来决定住院医师的进展和能力的方法。
采用工具案例研究方法研究了两个研究生培训项目的 CC。使用建构主义扎根理论方法分析了观察到的 CC 会议记录、成员访谈和指导文件，以揭示解释决策过程的主题。
我们的研究发现，CC 遵循一个始于社会决策模式的过程，并演变为一个讨论，该讨论援引了社会影响理论、共享心理模型和社会判断模式来澄清争议点。我们发现，CC 的决策制定存在偏见风险，主要受到组成成员、团队定位和个人成员思维模式以及他们与受训者的个人经验的影响。
提高对 CC 运作中偏见来源的认识，并熟悉 CC 在基于能力的医学教育中的作用，将使委员会能够为所有受训者提供有价值的反馈，而不论他们的轨迹如何。
