Numbers Encapsulate, Words Elaborate

Toward the Best Use of Comments for Assessment and Feedback on Entrustment Ratings

Bibliographic Data

ID21615154
AuthorsShiphra Ginsburg (0000-0002-4595-6650, is professor of medicine, Department of Medicine, Sinai Health System and Faculty of Medicine, University of Toronto, scientist, Wilson Centre for Research in Education, University of Toronto, Toronto, Ontario, Canada, and Canada Research Chair in Health Professions Education; ORCID:., corresponding author), Christopher J Watling (is professor and director, Centre for Education Research and Innovation, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; ORCID:.), Christopher Watling (0000-0001-9686-795X, Western University), Daniel J Schumacher (0000-0001-5507-8452, is associate professor of pediatrics, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio; ORCID:.), Andrea Gingerich (0000-0001-5765-3975, is assistant professor, Northern Medical Program, University of Northern British Columbia, Prince George, British Columbia, Canada; ORCID:.), Rose Hatala (0000-0003-0521-2590, is professor, Department of Medicine, and director, Clinical Educator Fellowship, Center for Health Education Scholarship, University of British Columbia, Vancouver, British Columbia, Canada; ORCID:.)
Year2021
Volume96
Issue7S
PagesS81-S86
Publication date2021-07-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAcademic Medicine (JOURNAL)
Journal identifiersISSN: 1040-2446 • E-ISSN: 1938-808X
PublisherOxford University Press (OUP) (PUBLISHER)
DOI10.1097/acm.0000000000004089
PMID34183607
OpenAlexW3176879039
LanguageEN
Citations received26
References cited56

The adoption of entrustment ratings in medical education is based on a seemingly simple premise: to align workplace-based supervision with resident assessment. Yet it has been difficult to operationalize this concept. Entrustment rating forms combine numeric scales with comments and are embedded in a programmatic assessment framework, which encourages the collection of a large quantity of data. The implicit assumption that more is better has led to an untamable volume of data that competency committees must grapple with. In this article, the authors explore the roles of numbers and words on entrustment rating forms, focusing on the intended and optimal use(s) of each, with a focus on the words. They also unpack the problematic issue of dual-purposing words for both assessment and feedback. Words have enormous potential to elaborate, to contextualize, and to instruct; to realize this potential, educators must be crystal clear about their use. The authors set forth a number of possible ways to reconcile these tensions by more explicitly aligning words to purpose. For example, educators could focus written comments solely on assessment; create assessment encounters distinct from feedback encounters; or use different words collected from the same encounter to serve distinct feedback and assessment purposes. Finally, the authors address the tyranny of documentation created by programmatic assessment and urge caution in yielding to the temptation to reduce words to numbers to make them manageable. Instead, they encourage educators to preserve some educational encounters purely for feedback, and to consider that not all words need to become data

CLARITY · Documentation · Epistemology · Formative assessment · Mathematics education · Medical education · Operationalization · Premise · Temptation · Clinical Reasoning and Diagnostic Skills · Computer Science · Health Sciences Research and Education · Innovations in Medical Education · Medicine · Psychology · Social Psychology

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