Using Theory-Informed Group Processes to Make TIMELESS Promotion Decisions

Abstract

Competency-based medical education (CBME) depends on effective programs of assessment to achieve the desired outcomes and goals of training. Residency programs must be able to defend clinical competency committee (CCC) group decisions about learner readiness for practice, including decisions about time-variable resident promotion and graduation. In this article, the authors describe why CCC group decision-making processes should be supported by theory and review 3 theories they used in designing their group processes: social decision scheme theory, functional theory, and wisdom of crowds. They describe how these theories were applied in a competency-based, time-variable training pilot - Transitioning in Internal Medicine Education Leveraging Entrustment Scores Synthesis (TIMELESS) at the University of Cincinnati internal medicine residency program in 2020-2022 - to increase the defensibility of their CCC group decision-making. This work serves as an example of how use of theory can bolster validity arguments supporting group decisions about resident readiness for practice.