Cargando…

“Could You Work in My Team?”: Exploring How Professional Clinical Role Expectations Influence Decision-Making of Assessors During Exit-Level Medical School OSCEs

Decision-making in clinical assessment, such as exit-level medical school Objective Structured Clinical Examinations (OSCEs), is complex. This study utilized an empirical phenomenological qualitative approach with thematic analysis to explore OSCE assessors' perceptions of the concept of a “pro...

Descripción completa

Detalles Bibliográficos
Autores principales: Malau-Aduli, Bunmi S., Hays, Richard B., D'Souza, Karen, Jones, Karina, Saad, Shannon, Celenza, Antonio, Turner, Richard, Smith, Jane, Ward, Helena, Schlipalius, Michelle, Murphy, Rinki, Garg, Nidhi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9120654/
https://www.ncbi.nlm.nih.gov/pubmed/35602481
http://dx.doi.org/10.3389/fmed.2022.844899
_version_ 1784710977194819584
author Malau-Aduli, Bunmi S.
Hays, Richard B.
D'Souza, Karen
Jones, Karina
Saad, Shannon
Celenza, Antonio
Turner, Richard
Smith, Jane
Ward, Helena
Schlipalius, Michelle
Murphy, Rinki
Garg, Nidhi
author_facet Malau-Aduli, Bunmi S.
Hays, Richard B.
D'Souza, Karen
Jones, Karina
Saad, Shannon
Celenza, Antonio
Turner, Richard
Smith, Jane
Ward, Helena
Schlipalius, Michelle
Murphy, Rinki
Garg, Nidhi
author_sort Malau-Aduli, Bunmi S.
collection PubMed
description Decision-making in clinical assessment, such as exit-level medical school Objective Structured Clinical Examinations (OSCEs), is complex. This study utilized an empirical phenomenological qualitative approach with thematic analysis to explore OSCE assessors' perceptions of the concept of a “prototypical intern” expressed during focus group discussions. Topics discussed included the concept of a prototypical intern, qualities to be assessed, and approaches to clinical assessment decision-making. The thematic analysis was then applied to a theoretical framework (Cultural Historical Activity Theory—CHAT) that explored the complexity of making assessment decisions amidst potentially contradicting pressures from academic and clinical perspectives. Ten Australasian medical schools were involved with 15 experienced and five less experienced assessors participating. Thematic analysis of the data revealed four major themes in relation to how the prototypical intern concept influences clinical assessors' judgements: (a) Suitability of marking rubric based on assessor characteristics and expectations; (b) Competence as final year student vs. performance as a prototypical intern; (c) Safety, trustworthiness and reliability as constructs requiring assessment and (d) Contradictions in decision making process due to assessor differences. These themes mapped well within the interaction between two proposed activity systems in the CHAT model: academic and clinical. More clinically engaged and more experienced assessors tend to fall back on a heuristic, mental construct of a “prototypical intern,” to calibrate judgements, particularly, in difficult situations. Further research is needed to explore whether consensus on desirable intern qualities and their inclusion into OSCE marksheets decreases the cognitive load and increases the validity of assessor decision making.
format Online
Article
Text
id pubmed-9120654
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-91206542022-05-21 “Could You Work in My Team?”: Exploring How Professional Clinical Role Expectations Influence Decision-Making of Assessors During Exit-Level Medical School OSCEs Malau-Aduli, Bunmi S. Hays, Richard B. D'Souza, Karen Jones, Karina Saad, Shannon Celenza, Antonio Turner, Richard Smith, Jane Ward, Helena Schlipalius, Michelle Murphy, Rinki Garg, Nidhi Front Med (Lausanne) Medicine Decision-making in clinical assessment, such as exit-level medical school Objective Structured Clinical Examinations (OSCEs), is complex. This study utilized an empirical phenomenological qualitative approach with thematic analysis to explore OSCE assessors' perceptions of the concept of a “prototypical intern” expressed during focus group discussions. Topics discussed included the concept of a prototypical intern, qualities to be assessed, and approaches to clinical assessment decision-making. The thematic analysis was then applied to a theoretical framework (Cultural Historical Activity Theory—CHAT) that explored the complexity of making assessment decisions amidst potentially contradicting pressures from academic and clinical perspectives. Ten Australasian medical schools were involved with 15 experienced and five less experienced assessors participating. Thematic analysis of the data revealed four major themes in relation to how the prototypical intern concept influences clinical assessors' judgements: (a) Suitability of marking rubric based on assessor characteristics and expectations; (b) Competence as final year student vs. performance as a prototypical intern; (c) Safety, trustworthiness and reliability as constructs requiring assessment and (d) Contradictions in decision making process due to assessor differences. These themes mapped well within the interaction between two proposed activity systems in the CHAT model: academic and clinical. More clinically engaged and more experienced assessors tend to fall back on a heuristic, mental construct of a “prototypical intern,” to calibrate judgements, particularly, in difficult situations. Further research is needed to explore whether consensus on desirable intern qualities and their inclusion into OSCE marksheets decreases the cognitive load and increases the validity of assessor decision making. Frontiers Media S.A. 2022-05-06 /pmc/articles/PMC9120654/ /pubmed/35602481 http://dx.doi.org/10.3389/fmed.2022.844899 Text en Copyright © 2022 Malau-Aduli, Hays, D'Souza, Jones, Saad, Celenza, Turner, Smith, Ward, Schlipalius, Murphy and Garg. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Malau-Aduli, Bunmi S.
Hays, Richard B.
D'Souza, Karen
Jones, Karina
Saad, Shannon
Celenza, Antonio
Turner, Richard
Smith, Jane
Ward, Helena
Schlipalius, Michelle
Murphy, Rinki
Garg, Nidhi
“Could You Work in My Team?”: Exploring How Professional Clinical Role Expectations Influence Decision-Making of Assessors During Exit-Level Medical School OSCEs
title “Could You Work in My Team?”: Exploring How Professional Clinical Role Expectations Influence Decision-Making of Assessors During Exit-Level Medical School OSCEs
title_full “Could You Work in My Team?”: Exploring How Professional Clinical Role Expectations Influence Decision-Making of Assessors During Exit-Level Medical School OSCEs
title_fullStr “Could You Work in My Team?”: Exploring How Professional Clinical Role Expectations Influence Decision-Making of Assessors During Exit-Level Medical School OSCEs
title_full_unstemmed “Could You Work in My Team?”: Exploring How Professional Clinical Role Expectations Influence Decision-Making of Assessors During Exit-Level Medical School OSCEs
title_short “Could You Work in My Team?”: Exploring How Professional Clinical Role Expectations Influence Decision-Making of Assessors During Exit-Level Medical School OSCEs
title_sort “could you work in my team?”: exploring how professional clinical role expectations influence decision-making of assessors during exit-level medical school osces
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9120654/
https://www.ncbi.nlm.nih.gov/pubmed/35602481
http://dx.doi.org/10.3389/fmed.2022.844899
work_keys_str_mv AT malauadulibunmis couldyouworkinmyteamexploringhowprofessionalclinicalroleexpectationsinfluencedecisionmakingofassessorsduringexitlevelmedicalschoolosces
AT haysrichardb couldyouworkinmyteamexploringhowprofessionalclinicalroleexpectationsinfluencedecisionmakingofassessorsduringexitlevelmedicalschoolosces
AT dsouzakaren couldyouworkinmyteamexploringhowprofessionalclinicalroleexpectationsinfluencedecisionmakingofassessorsduringexitlevelmedicalschoolosces
AT joneskarina couldyouworkinmyteamexploringhowprofessionalclinicalroleexpectationsinfluencedecisionmakingofassessorsduringexitlevelmedicalschoolosces
AT saadshannon couldyouworkinmyteamexploringhowprofessionalclinicalroleexpectationsinfluencedecisionmakingofassessorsduringexitlevelmedicalschoolosces
AT celenzaantonio couldyouworkinmyteamexploringhowprofessionalclinicalroleexpectationsinfluencedecisionmakingofassessorsduringexitlevelmedicalschoolosces
AT turnerrichard couldyouworkinmyteamexploringhowprofessionalclinicalroleexpectationsinfluencedecisionmakingofassessorsduringexitlevelmedicalschoolosces
AT smithjane couldyouworkinmyteamexploringhowprofessionalclinicalroleexpectationsinfluencedecisionmakingofassessorsduringexitlevelmedicalschoolosces
AT wardhelena couldyouworkinmyteamexploringhowprofessionalclinicalroleexpectationsinfluencedecisionmakingofassessorsduringexitlevelmedicalschoolosces
AT schlipaliusmichelle couldyouworkinmyteamexploringhowprofessionalclinicalroleexpectationsinfluencedecisionmakingofassessorsduringexitlevelmedicalschoolosces
AT murphyrinki couldyouworkinmyteamexploringhowprofessionalclinicalroleexpectationsinfluencedecisionmakingofassessorsduringexitlevelmedicalschoolosces
AT gargnidhi couldyouworkinmyteamexploringhowprofessionalclinicalroleexpectationsinfluencedecisionmakingofassessorsduringexitlevelmedicalschoolosces