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dc.contributor.authorCastanelli Damian J.en_US
dc.contributor.authorWeller Jennifer M.en_US
dc.contributor.authorMolloy Elizabethen_US
dc.contributor.authorBearman Margareten_US
dc.description.abstractPurpose: In competency-based medical education, workplace-based assessment provides trainees with an opportunity for guidance and supervisors the opportunity to judge the trainees' clinical practice. Learning from assessment is enhanced when trainees reveal their thinking and are open to critique, which requires trust in the assessor. If supervisors knew more about how trainees come to trust them in workplace-based assessment, they could better engender trainee trust and improve trainees' learning experience. Method: From August 2018 to September 2019, semistructured interviews were conducted with 17 postgraduate anesthesia trainees across Australia and New Zealand. The transcripts were analyzed using constructivist grounded theory methods sensitized by a sociocultural view of learning informed by Wenger's communities of practice theory. Results: Participants described a continuum from a necessary initial trust to an experience-informed dynamic trust. Trainees assumed initial trust in supervisors based on accreditation, reputation, and a perceived obligation of trustworthiness inherent in the supervisor's role. With experience and time, trainees' trust evolved based on supervisor actions. Deeper levels of trainee trust arose in response to perceived supervisor investment and allowed trainees to devote more emotional and cognitive resources to patient care and learning rather than impression management. Across the continuum from initial trust to experience-informed trust, trainees made rapid trust judgments that were not preceded by conscious deliberation; instead, they represented a learned "feel for the game." Conclusions: While other factors are involved, our results indicate that the trainee behavior observed in workplace-based assessment is a product of supervisor invitation. Supervisor trustworthiness and investment in trainee development invite trainees to work and present in authentic ways in workplace-based assessment. This authentic engagement, where learners "show themselves" to supervisors and take risks, creates assessment for learning.en_US
dc.subjectmedical educationen_US
dc.subjectNew Zealanden_US
dc.subjectworkplace-based assessmenten_US
dc.titleHow trainees come to trust supervisors in workplace-based assessment: A grounded theory studyen_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleAcademic Medicine: Journal of the Association of American Medical Collegesen_US
dc.description.affiliatesMonash Universityen_US
dc.description.affiliatesMonash Healthen_US
dc.description.affiliatesDeakin Universityen_US
dc.description.affiliatesUniversity of Aucklanden_US
dc.description.affiliatesAuckland City Hospitalen_US
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Appears in Collections:Scholarly and Clinical
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