scholarly journals “Languaging” tacit judgment in formal postgraduate assessment: the documentation of ad hoc and summative entrustment decisions

2020 ◽  
Vol 9 (6) ◽  
pp. 373-378 ◽  
Author(s):  
Anneke van Enk ◽  
Olle ten Cate

AbstractWhile subjective judgment is recognized by the health professions education literature as important to assessment, it remains difficult to carve out a formally recognized role in assessment practices for personal experiences, gestalts, and gut feelings. Assessment tends to rely on documentary artefacts—like the forms, standards, and policies brought in under competency-based medical education, for example—to support accountability and fairness. But judgment is often tacit in nature and can be more challenging to surface in explicit (and particularly written) form. What is needed is a nuanced approach to the incorporation of judgment in assessment such that it is neither in danger of being suppressed by an overly rigorous insistence on documentation nor uncritically sanctioned by the defense that it resides in a black box and that we must simply trust the expertise of assessors. The concept of entrustment represents an attempt to effect such a balance within current competency frameworks by surfacing judgments about the degree of supervision learners need to care safely for patients. While there is relatively little published data about its implementation as yet, one readily manifest variation in the uptake of entrustment relates to the distinction between ad hoc and summative forms. The ways in which these forms are languaged, together with their intended purposes and guidelines for their use, point to directions for more focused empirical inquiry that can inform current and future uptake of entrustment in competency-based medical education and the responsible and meaningful inclusion of judgment in assessment more generally.

2020 ◽  
pp. 20-34
Author(s):  
Ahmad AbdulAzeem Abdullah

Competency-based medical education has emerged recently as a novel model of medical training driven by its ability to reconcile the desired attributes in future physicians and address the overarching and demanding issues of the discipline in this century. The rising concerns of social accountability, patient safety, and cost effectiveness of medical education programs have contributed significantly to the popularity of this paradigm worldwide. This is translated in turn to the evolution of national competency frameworks for medical graduates that are increasingly implemented in different jurisdictions to standardize and ensure equivalent outcomes of medical curricula and readiness of their graduates to better serve their communities. Medical education in Sudan is deeply rooted in the history of the nation and the continent and is tinged with remarkable success and achievements. It is challenged nowadays with unprecedented expansion in basic medical education which may hinder the quality of medical schools’ programs and their graduates. This article explores the feasibility of one such framework in Sudan: the “SudanMeds” to ensure minimum standards and comparability of medical schools’ curricula and their outcomes across the Country. The framework would also arm the regulatory bodies with a tool for accreditation and recognition of basic medical education programs in Sudan and reflect quality assurance in their settings. Once this approach is deemed feasible, the contribution of all stakeholders from the highest top to the bottom – the government, the regulatory bodies, the public and civil organizations, and the medical schools’ community – is required to allow for creation, implementation, and follow-up of the “SudanMeds” framework. Keywords: Sudan, competency-based medical education, national competency frameworks, medical schools, basic medical education


Author(s):  
Imad Hassan

We think that the article titled “National Competency Frameworks for Medical Graduates: Is it Time for the “SudanMeds”? published in the Sudan Journal of Medical Sciences [1] is a timely publication. Competency-based medical education (CBME) is considered as a paradigm shift in medical education, the ultimate aim of which is the improvement of patient and society’s quality of care by training and creating highly skilled clinicians. A paradigm as defined by the Cambridge Dictionary is a situation in which the usual and accepted way of doing or thinking about something changes completely. The magnitude of change is so profound to the extent that it leads to a fundamental change in the approach or underlying assumptions, an example being the introduction of the Internet. Several such major “contemporary” shifts have colored the thinking processes and actions of healthcare professionals and leaders.  For example, the Patient Safety Paradigm and the Evidence-based Practice Paradigm.


2016 ◽  
Vol 28 (10) ◽  
pp. 1460-1464 ◽  
Author(s):  
R. Yadlapati ◽  
R. N. Keswani ◽  
J. E. Pandolfino

2020 ◽  
Vol 44 (6) ◽  
pp. 812-813 ◽  
Author(s):  
Bruce Fage ◽  
Tracy Alldred ◽  
Sarah Levitt ◽  
Amanda Abate ◽  
Mark Fefergrad

2017 ◽  
Vol 39 (6) ◽  
pp. 568-573 ◽  
Author(s):  
Jason R. Frank ◽  
Linda Snell ◽  
Robert Englander ◽  
Eric S. Holmboe ◽  

2021 ◽  
Vol 8 (1) ◽  
pp. 102-112
Author(s):  
Jay Narayan Shah ◽  
Jenifei Shah ◽  
Jesifei Shah ◽  
Ashis Shrestha ◽  
Nabees Man Singh Pradhan

Nepal is a small, lower-middle-income country; with a population of around 30 million. As per WHO, Nepal has a low doctor-patient ratio (0.7/1000) and even lower specialists (e.g., surgical) workforce (0.003/1000); additionally, data from Nepal Medical Council show the number of postgraduate specialists is 1/3rd of the total registered doctors. The mismatch in the doctor-patient ratio is further aggravated by the overwhelming number of doctors in urban areas; when 80% of the population are in rural Nepal. This inequitable discrepancy in the healthcare system requires: proper training of competent medical graduates, a fair distribution across the country, and effective changes in the healthcare system. Competency-based medical education plays an important role in: standardizing education, training competent doctors, and deploying them where they are needed the most. The Government of Nepal has recently established Medical Education Commission-which plans to oversee the entrance exams; and expand the postgraduate training to be conducted by private hospitals, previously not affiliated with any medical colleges or universities. Historically, Civil Medical School started training compounders and dressers in Nepal in 1934. A big milestone was achieved with the establishment of the Institute of Medicine under Tribhuvan University in 1972, which has continued to train all categories of health manpower needed in the country. In 2006 Nepal Medical Council developed “Regulations for Post-graduate Medical education”. Thereafter, several institutions started providing postgraduate training, for example: the BP Koirala Institute of Health Sciences, Kathmandu University, National Academy of Medical Sciences, and Patan Academy of Health Sciences (PAHS). The PAHS conducts PG programs and post-PG fellowships in line with competency-based medical education. In addition to formative assessments, research thesis, and a publishable article; PAHS requires its trainees to be certified in a pre-set of entrustable professional activities (EPAs) and to master eight Core Competencies domains in: Professionalism, Patient-centered care, Procedural skills, Clinical Reasoning, Communication, Scholarship, Leadership, Community orientation. The number of medical colleges in Nepal has since expanded to 24  (medical 21 and dental colleges 3). Private medical colleges make up about 3/4th of the total medical colleges in Nepal. This makes the inclusion and regulation of more components of the competency-based curriculum in postgraduate training programs, and its monitoring,  somewhat of a challenge.


Author(s):  
Elsie Kiguli-Malwadde ◽  
Francis Omaswa ◽  
oluwabunmi Olapade-Olaopa ◽  
Sarah Kiguli ◽  
Candice Chen ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document