An argument-based approach to the validation of UHTRUST: can we measure how recent graduates can be trusted with unfamil

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An argument-based approach to the validation of UHTRUST: can we measure how recent graduates can be trusted with unfamiliar tasks? M. Wijnen-Meijer • M. Van der Schaaf • E. Booij • S. Harendza C. Boscardin • J. Van Wijngaarden • Th. J. Ten Cate



Received: 10 August 2012 / Accepted: 16 January 2013 / Published online: 12 February 2013  Springer Science+Business Media Dordrecht 2013

Abstract There is a need for valid methods to assess the readiness for clinical practice of medical graduates. This study evaluates the validity of Utrecht Hamburg Trainee Responsibility for Unfamiliar Situations Test (UHTRUST), an authentic simulation procedure to assess whether medical trainees are ready to be entrusted with unfamiliar clinical tasks near the highest level of Miller’s pyramid. This assessment, in which candidates were judged by clinicians, nurses and standardized patients, addresses the question: can this trainee be trusted with unfamiliar clinical tasks? The aim of this paper is to provide a validity argument for this assessment procedure. We collected data from various sources during preparation and administration of a UHTRUST-assessment. In total, 60 candidates (30 from the Netherlands and 30 from Germany) participated. To provide a validity argument for the UHTRUST-assessment, we followed Kane’s argument-based approach for validation. All available data were used to design a coherent and plausible argument. Considerable data was collected during the development of the assessment procedure. In addition, a generalizability study was conducted to evaluate the reliability of the scores given by assessors and to determine the proportion of variance accounted by candidates and assessors. It was found that most of Kane’s validity assumptions were defendable with accurate and often parallel lines of backing. UHTRUST can be used to compare the M. Wijnen-Meijer (&)  E. Booij  Th. J. Ten Cate Center for Research and Development of Education, University Medical Center Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands e-mail: [email protected] M. Van der Schaaf Department of Education, Utrecht University, Utrecht, The Netherlands S. Harendza Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany C. Boscardin  Th. J. Ten Cate Department of Medicine, University of California, San Francisco, CA, USA J. Van Wijngaarden Department Clinical Skills Training, University Medical Center Utrecht, Utrecht, The Netherlands

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readiness for clinical practice of medical graduates. Further exploration of the procedures for entrustment decisions is recommended. Keywords Argument based approach  Assessment  Authentic simulation  Coping with unfamiliar clinical situations  Entrustment decisions  Readiness for clinical practice  Validity

Introduction Background The goal of academic education is to ensure that students acquire knowledge within the domain of their future profession. Besides knowledge, complex skills such as communication skills