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01-06-2017 | Eye-Opener | Uitgave 3/2017 Open Access

Perspectives on Medical Education 3/2017

How do small groups make decisions?

A theoretical framework to inform the implementation and study of clinical competency committees

Tijdschrift:
Perspectives on Medical Education > Uitgave 3/2017
Auteurs:
Saad Chahine, Sayra Cristancho, Jessica Padgett, Lorelei Lingard
Belangrijke opmerkingen
Editor’s Note: Commentary by: P. Hemmer, doi 10.​1007/​s40037-017-0360-2

Abstract

In the competency-based medical education (CBME) approach, clinical competency committees are responsible for making decisions about trainees’ competence. However, we currently lack a theoretical model for group decision-making to inform this emerging assessment phenomenon. This paper proposes an organizing framework to study and guide the decision-making processes of clinical competency committees.
This is an explanatory, non-exhaustive review, tailored to identify relevant theoretical and evidence-based papers related to small group decision-making. The search was conducted using Google Scholar, Web of Science, MEDLINE, ERIC, and PsycINFO for relevant literature. Using a thematic analysis, two researchers (SC & JP) met four times between April–June 2016 to consolidate the literature included in this review.
Three theoretical orientations towards group decision-making emerged from the review: schema, constructivist, and social influence. Schema orientations focus on how groups use algorithms for decision-making. Constructivist orientations focus on how groups construct their shared understanding. Social influence orientations focus on how individual members influence the group’s perspective on a decision. Moderators of decision-making relevant to all orientations include: guidelines, stressors, authority, and leadership.
Clinical competency committees are the mechanisms by which groups of clinicians will be in charge of interpreting multiple assessment data points and coming to a shared decision about trainee competence. The way in which these committees make decisions can have huge implications for trainee progression and, ultimately, patient care. Therefore, there is a pressing need to build the science of how such group decision-making works in practice. This synthesis suggests a preliminary organizing framework that can be used in the implementation and study of clinical competency committees.
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