Competence committees are groups of educators that monitor the progress of medical
trainees and decide when they should be promoted to the next stage of training. They
represent an important part of modern-day competency-based medical education
programs, yet relatively little is known about their implementation and decision-making
practices. This thesis seeks to fill a critical gap in the literature by generating empirical
evidence with respect to competence committee implementation and decision-making
practices across multiple programs. The first data chapter uses a multi-method approach
to examine competence committee implementation practices at a Canadian institution
over a three-year period. The second and third chapters examine how individuals and
groups make promotion decisions, respectively. These chapters also consider the role of
non-traditional data sources, such as anecdotal evidence, in competence committees’
decision-making processes. The final data chapter considers the role of social influences
and power and examines how factors such as members’ position on the committee,
gender, and race/ethnicity influence their contributions to the committee. This thesis
provides insight into some of the challenges that exist with respect to competence
committee implementation and offers potential solutions based on best practices across
multiple programs. It also highlights factors that can influence competence committee
decision making and discusses ways that their decision-making processes can be
optimized. Broader implications of this thesis, including the role of groups in solving
complex problems and the importance of diversity (both in terms of demographics and
functional specialization) in ensuring good decision-making outcomes, are also discussed. / Thesis / Doctor of Philosophy (PhD) / Competence committees are groups of experienced health professionals and educators
whose job is to determine whether physician learners (i.e., residents) are ready to
progress to the next stage of training and responsibility. These committees are relatively
new, and as a result, we do not know very much about how they make decisions. Given
the importance of competence committees in ensuring that physicians are able to provide
high-quality and safe patient care, the purpose of this thesis was to examine competence
committee implementation and decision-making practices at a Canadian academic centre.
This took place in two parts. First, we studied competence committees over a three-year
period using surveys, interviews, and observations. This helped us understand some of
their benefits and challenges. Next, we conducted a series of experiments to understand
how competence committee members make decisions both individually and as part of a
group. These experiments also helped us understand how competence committees make
sense of different types of data, such as prior knowledge about a resident or their
assessors. Finally, we examined how various aspects of members’ social identities, such
as their position on the committee, their gender, and their race/ethnicity, influence their
contributions to the committee. Collectively, the findings of this thesis help to advance
the scientific literature in the areas of medical education and group decision making. They
can also be used to optimize competence committee operations, which can in turn
positively impact patients, healthcare, and society.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/26182 |
| Date | January 2021 |
| Creators | Acai, Anita |
| Contributors | Sonnadara, Ranil R., Psychology |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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