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Monday, February 27 • 10:00am - 10:45am
ARCHES - [Oral Presentation] 3. Relationship between Propensity to Trust and Entrustment-based Clinical Evaluations

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10:30 AM - 10:45 AM

Relationship between Propensity to Trust and Entrustment-based Clinical Evaluations 

M.B. Farmer, University of Colorado
J. Shea, C.J. Dine, J. Lapin, J.R. Kogan, University of Pennsylvania
Abstract Body: Introduction: Trust is an increasingly recognized construct in medical education both for its role in clinical education and its utility in evaluation. The decision to trust a trainee with less supervision can be used as an indicator of competency. For example, entrustable professional activities are increasingly being used to assess ACGME competencies and milestones. Given the central role of trust, it is important to understand the factors that affect entrustment decisions. The field of personality psychology has long recognized trust as an element of personality, noting some people are generally more trusting than others. To best achieve the goal of measuring the trainee’s competency, it is important to elucidate and alleviate supervisor-dependent factors (sources of error). Research Question: To determine if there is a relationship between clinical supervisors’ natural propensity to trust (personality trait) and their entrustment-based evaluations of trainees. Methods: 196 internal medicine attendings at the University of Pennsylvania were invited to participate. Propensity to trust was measured using the Trust facet of the NEO Personality Inventory-3 Big Five personality survey; the Ideas facet was used as control trait. Each facet contained 8 statements rated on a 5-point scale (Strongly Disagree to Strongly Agree). Participants were emailed the questionnaire; three reminders were sent to non-responders. Results were correlated with attendings’ previously completed entrustment-based clinical competency evaluations of internal medicine interns (PGY1) and residents (PGY2/3). This study was IRB approved. Results: 137 attending physicians participated (70%). Of these, 118 (60%) had sufficient evaluation data (> 6 evaluations each of interns and residents) for analysis. No correlation existed between either personality trait (Trust and Ideas) and participants’ ratings of trainees using an entrustment-based evaluation scale [for trust: r = -0.010, p = 0.913; r = 0.009, p = 0.927; for ideas: r = 0.026, p = 0.780; r = 0.060, p = 0.517, for evaluations of PGY1s and PGY2-3s, respectively]. Discussion: Trust as a personality trait does not seem to measurably effect how attendings complete entrustment based evaluations suggesting trainee trustworthiness (competence) may be a key determinant of trust in longitudinal clinical relationships. Propensity to trust may be most important in novel situations, diminishing as information is gained about the trustworthiness of the individual being trusted. Propensity to trust may be less important for grounded, summative entrustment decisions, such as those formal clinical evaluations intend to measure. Generalizability of findings is limited given the single institution study of internal medicine attendings. 

Monday February 27, 2017 10:00am - 10:45am

Attendees (4)