Domains Influencing Faculty Decisions on the Level of Supervision Required for Anesthesiology EPAs with Analysis of Feedback Comments

• Published in: Journal of surgical education 2024-05, Vol.81 (5), p.741-752
• Main Authors: Tanaka, Pedro, Soo Park, Yoon, Chen, Chien-Yu, Yumul, Roya, Macario, Alex
• Format: Article
• Language: English
• Subjects: Anesthesiology - education; Clinical Competence; Competency-Based Education - methods; Decision Making; Education, Medical, Graduate - methods; entrustable professional activities; Faculty, Medical; Feedback; Female; Humans; Internship and Residency; Learner assessment; Male; Qualitative Research; work-based assessment
• ISSN: 1931-7204; 1878-7452
• DOI: 10.1016/j.jsurg.2024.02.003

•Question: How do anesthesiology faculty make entrustment decisions for residents and how does the Web App tool support feedback for learning?•Findings: The study identified seven theoretical domains that influence faculty decision-making on entrusting tasks to learners. The majority of faculty feedback comments were critical or modestly praising.•Meaning: Various factors that can influence a faculty member's decision on whether to entrust a task to a learner in a medical education context. Narrative feedback comments provided by the faculty were generally critical or modestly praising and consistent across different EPAs. The purpose of this qualitative study was to examine responses related to entrustment and feedback comments from an assessment tool. Qualitative analyses using semi-structured interviews and analysis of narrative comments. Main hospital OR suite at a large academic medical center. faculty, and residents who work in the OR suite. Seven of the 14 theoretical domains from the Theoretical Domains Framework were identified as influencing faculty decision on entrustment: knowledge, skills, intention, memory/attention/decision processes, environmental context, and resources, beliefs of capabilities, and reinforcement. The majority (651/1116 (58.4%)) of faculty comments were critical/modest praise and relevant, consistent across all 6 EPAs. The written in feedback comments for all 1,116 Web App EPA assessments yielded a total of 1,599 sub-competency specific responses. These responses were mapped to core competencies, and at least once to 13 of the 23 ACGME subcompetencies. Domains identified as influencing faculty decision on entrustment were knowledge, skills, intention, memory/attention/decision processes, environmental context, and resources, beliefs of capabilities, and reinforcement. Most narrative feedback comments were critical/modest praise and relevant, consistent across each of the EPAs.