Domains Influencing Faculty Decisions on the Level of Supervision Required for Anesthesiology EPAs with Analysis of Feedback Comments

Objective: The purpose of this qualitative study was to examine responses related to entrustment and feedback comments from an assessment tool. Design: Qualitative analyses using semi-structured interviews and analysis of narrative comments. Setting: Main hospital OR suite at a large academic medical center. Participants: faculty, and residents who work in the OR suite. Results: Seven of the 14 theoretical domains from the Theoretical Domains Framework were identified as influencing faculty decision on entrustment: knowledge, skills, intention, memory/attention/decision processes, environmental context, and resources, beliefs of capabilities, and reinforcement. The majority (651/1116 (58.4%)) of faculty comments were critical/modest praise and relevant, consistent across all 6 EPAs. The written in feedback comments for all 1,116 Web App EPA assessments yielded a total of 1,599 sub-competency specific responses. These responses were mapped to core competencies, and at least once to 13 of the 23 ACGME subcompetencies. Conclusions: Domains identified as influencing faculty decision on entrustment were knowledge, skills, intention, memory/attention/decision processes, environmental context, and resources, beliefs of capabilities, and reinforcement. Most narrative feedback comments were critical/modest praise and relevant, consistent across each of the EPAs.