Better Decision-Making: Shared Mental Models and the Clinical Competency Committee

Overview

Journal J Grad Med Educ

Date 2021 May 3

PMID 33936533

Citations 16

Authors

Laura Edgar

M Douglas Jones Jr

Braden Harsy

Morgan Passiment

Karen E Hauer

Affiliations

Soon will be listed here.

Abstract

Background: Shared mental models (SMMs) help groups make better decisions. Clinical competency committees (CCCs) can benefit from the development and use of SMMs in their decision-making as a way to optimize the quality and consistency of their decisions.

Objective: We reviewed the use of SMMs for decision making in graduate medical education, particularly their use in CCCs.

Methods: In May 2020, the authors conducted a narrative review of the literature related to SMMs. This review included the SMM related to teams, team functioning, CCCs, and graduate medical education.

Results: The literature identified the general use of SMMs, SMMs in graduate medical education, and strategies for building SMMs into the work of the CCC. Through the use of clear communication and guidelines, and a shared understanding of goals and expectations, CCCs can make better decisions. SMMs can be applied to Milestones, resident performance, assessment, and feedback.

Conclusions: To ensure fair and robust decision-making, the CCC must develop and maintain SMMs through excellent communication and understanding of expectations among members.

Citing Articles

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References

Hauer K, Ten Cate O, Boscardin C, Iobst W, Holmboe E, Chesluk B . Ensuring Resident Competence: A Narrative Review of the Literature on Group Decision Making to Inform the Work of Clinical Competency Committees. J Grad Med Educ. 2016; 8(2):156-64. PMC: 4857505. DOI: 10.4300/JGME-D-15-00144.1. View

Holmboe E, Hawkins R, Huot S . Effects of training in direct observation of medical residents' clinical competence: a randomized trial. Ann Intern Med. 2004; 140(11):874-81. DOI: 10.7326/0003-4819-140-11-200406010-00008. View

Warm E, Mathis B, Held J, Pai S, Tolentino J, Ashbrook L . Entrustment and mapping of observable practice activities for resident assessment. J Gen Intern Med. 2014; 29(8):1177-82. PMC: 4099463. DOI: 10.1007/s11606-014-2801-5. View

Lloyd R, Park Y, Tekian A, Marvin R . Understanding Assessment Systems for Clinical Competency Committee Decisions: Evidence from a Multisite Study of Psychiatry Residency Training Programs. Acad Psychiatry. 2019; 44(6):734-740. DOI: 10.1007/s40596-019-01168-x. View

Colbert C, French J, Herring M, Dannefer E . Fairness: the hidden challenge for competency-based postgraduate medical education programs. Perspect Med Educ. 2017; 6(5):347-355. PMC: 5630529. DOI: 10.1007/s40037-017-0359-8. View

Kinnear B, Warm E, Hauer K . Twelve tips to maximize the value of a clinical competency committee in postgraduate medical education. Med Teach. 2018; 40(11):1110-1115. DOI: 10.1080/0142159X.2018.1474191. View

Carraccio C, Iobst W, Philibert I . Milestones: Not Millstones but Stepping Stones. J Grad Med Educ. 2015; 6(3):589-90. PMC: 4535233. DOI: 10.4300/JGME-D-14-00343.1. View

Soleas E, Dagnone D, Stockley D, Garton K, van Wylick R . Developing Academic Advisors and Competence Committees members: A community approach to developing CBME faculty leaders. Can Med Educ J. 2020; 11(1):e46-e56. PMC: 7082482. DOI: 10.36834/cmej.68181. View

Hauer K . Seeking trust in entrustment: shifting from the planning of entrustable professional activities to implementation. Med Educ. 2019; 53(8):752-754. DOI: 10.1111/medu.13920. View

10.

Raaum S, Lappe K, Colbert-Getz J, Milne C . Milestone Implementation's Impact on Narrative Comments and Perception of Feedback for Internal Medicine Residents: a Mixed Methods Study. J Gen Intern Med. 2019; 34(6):929-935. PMC: 6544770. DOI: 10.1007/s11606-019-04946-3. View

11.

Lovell B . What do we know about coaching in medical education? A literature review. Med Educ. 2017; 52(4):376-390. DOI: 10.1111/medu.13482. View

12.

Carraccio C, Englander R . From Flexner to competencies: reflections on a decade and the journey ahead. Acad Med. 2013; 88(8):1067-73. DOI: 10.1097/ACM.0b013e318299396f. View

13.

Albano S, Quadri S, Farooqui M, Arangua L, Clark T, Fischberg G . Resident Perspective on Feedback and Barriers for Use as an Educational Tool. Cureus. 2019; 11(5):e4633. PMC: 6623994. DOI: 10.7759/cureus.4633. View

14.

Day L, Miles A, Ginsburg S, Melvin L . Resident Perceptions of Assessment and Feedback in Competency-Based Medical Education: A Focus Group Study of One Internal Medicine Residency Program. Acad Med. 2020; 95(11):1712-1717. DOI: 10.1097/ACM.0000000000003315. View

15.

Floren L, Donesky D, Whitaker E, Irby D, Ten Cate O, OBrien B . Are We on the Same Page? Shared Mental Models to Support Clinical Teamwork Among Health Professions Learners: A Scoping Review. Acad Med. 2017; 93(3):498-509. DOI: 10.1097/ACM.0000000000002019. View

16.

Watling C, Ginsburg S . Assessment, feedback and the alchemy of learning. Med Educ. 2018; 53(1):76-85. DOI: 10.1111/medu.13645. View

17.

La Macchia S, Louis W, Hornsey M, Leonardelli G . In Small We Trust: Lay Theories About Small and Large Groups. Pers Soc Psychol Bull. 2016; 42(10):1321-34. DOI: 10.1177/0146167216657360. View

18.

Wong B, Holmboe E . Transforming the Academic Faculty Perspective in Graduate Medical Education to Better Align Educational and Clinical Outcomes. Acad Med. 2015; 91(4):473-9. DOI: 10.1097/ACM.0000000000001035. View

19.

Hauer K, Chesluk B, Iobst W, Holmboe E, Baron R, Boscardin C . Reviewing residents' competence: a qualitative study of the role of clinical competency committees in performance assessment. Acad Med. 2015; 90(8):1084-92. DOI: 10.1097/ACM.0000000000000736. View

20.

Angus S, Moriarty J, Nardino R, Chmielewski A, Rosenblum M . Internal Medicine Residents' Perspectives on Receiving Feedback in Milestone Format. J Grad Med Educ. 2015; 7(2):220-4. PMC: 4512793. DOI: 10.4300/JGME-D-14-00446.1. View