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“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...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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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 |
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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 |
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