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      Applying occupational and organizational psychology theory to entrustment decision-making about trainees in health care: a conceptual model

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          Abstract

          In medical contexts around the world, supervising physicians continuously decide what degree of supervision to apply as trainees carry out professional activities. Although the implications for patients can be far-reaching, little is known about how these entrustment decisions are formed. The concept of ‘Entrustable Professional Activities’ has initiated interest and valuable research on factors that may influence the entrustment decision process.

          The aim of the current article is to link models of entrustment developed in the fields of occupational and organizational psychology and military psychology to medical education studies that have explored the factors influencing physicians’ entrustment decisions. We provide a conceptual framework of the entrustment decision-making process, which we suggest will contribute to the understanding of how supervising physicians arrive at the decision to entrust a medical trainee with a professional activity.

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          Most cited references37

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          Entrustability of professional activities and competency-based training.

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            Communication failures: an insidious contributor to medical mishaps.

            To describe how communication failures contribute to many medical mishaps. In late 1999, a sample of 26 residents stratified by medical specialty, year of residency, and gender was randomly selected from a population of 85 residents at a 600-bed U.S. teaching hospital. The study design involved semistructured face-to-face interviews with the residents about their routine work environments and activities, the medical mishaps in which they recently had been involved, and a description of both the individual and organizational contributory factors. The themes reported here emerged from inductive analyses of the data. Residents reported a total of 70 mishap incidents. Aspects of "communication" and "patient management" were the two most commonly cited contributing factors. Residents described themselves as embedded in a complex network of relationships, playing a pivotal role in patient management vis-à-vis other medical staff and health care providers from within the hospital and from the community. Recurring patterns of communication difficulties occur within these relationships and appear to be associated with the occurrence of medical mishaps. The occurrence of everyday medical mishaps in this study is associated with faulty communication; but, poor communication is not simply the result of poor transmission or exchange of information. Communication failures are far more complex and relate to hierarchical differences, concerns with upward influence, conflicting roles and role ambiguity, and interpersonal power and conflict. A clearer understanding of these dynamics highlights possibilities for appropriate interventions in medical education and in health care organizations aimed at improving patient safety.
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              Trust in Management and Performance: Who Minds the Shop While the Employees Watch the Boss?

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                Author and article information

                Contributors
                harm.peters@charite.de
                Journal
                Perspect Med Educ
                Perspect Med Educ
                Perspectives on Medical Education
                Bohn Stafleu van Loghum (Houten )
                2212-2761
                2212-277X
                10 March 2017
                10 March 2017
                April 2017
                : 6
                : 2
                : 119-126
                Affiliations
                [1 ]GRID grid.6363.0, Dieter Scheffner Center for Medical Education and Educational Research, , Charité-Universitätsmedizin Berlin, ; Berlin, Germany
                [2 ]GRID grid.280418.7, Department of Medical Education, , Southern Illinois University School of Medicine, ; Springfield, IL USA
                [3 ]GRID grid.7692.a, Center for Research and Development of Education, , University Medical Center Utrecht, ; Utrecht, The Netherlands
                Article
                336
                10.1007/s40037-017-0336-2
                5383570
                28284011
                6b236397-9176-4692-8736-a7df79bf3a38
                © The Author(s) 2017

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100002331, Stiftung Mercator Schweiz;
                Award ID: 08-295/Charité
                Funded by: FundRef http://dx.doi.org/10.13039/501100004963, Seventh Framework Programme;
                Award ID: 619349
                Categories
                Eye-Opener
                Custom metadata
                © The Author(s) 2017

                Education
                entrustment,entrustable professional activities,trust
                Education
                entrustment, entrustable professional activities, trust

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