Towards accountability-centred practices: governance in OSCEs subordinating patient and practitioner clinical experience.

Autor: Kearney GP; Centre for Medical Education, Queen's University Belfast, Whitla Medical Building, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland. g.kearney@qub.ac.uk., Corman MK; School of Culture, Media & Society, The University of the Fraser Valley, Abbotsford, BC, Canada., Johnston JL; Centre for Medical Education, Queen's University Belfast, Whitla Medical Building, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland., Hart ND; Centre for Medical Education, Queen's University Belfast, Whitla Medical Building, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland., Gormley GJ; Centre for Medical Education, Queen's University Belfast, Whitla Medical Building, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland.
Jazyk: angličtina
Zdroj: Advances in health sciences education : theory and practice [Adv Health Sci Educ Theory Pract] 2023 Dec; Vol. 28 (5), pp. 1593-1613. Date of Electronic Publication: 2023 May 18.
DOI: 10.1007/s10459-023-10238-7
Abstrakt: New public management ideals and standards have become increasingly adhered to in health professions education; this is particularly apparent in high-stakes assessment, as a gateway to practice. Using an Institutional Ethnographic approach, we looked at the work involved in running high-stakes Objective Structured Clinical Exams (OSCEs) throughout an academic year including use of observations, interviews and textual analysis. In our results, we describe three types of 'work'-standardising work, defensibility work and accountability work-summarising these in the discussion as an Accountability Circuit, which shows the organising role of texts on people's work processes. We show how this form of governance mandates a shift towards accountability-centred practices, away from practices which are person-centred; this lens on accountability-centring during high-stakes assessments invites critique of the often-unquestioned emphasis of new public management in health professions education.
(© 2023. The Author(s).)
Databáze: MEDLINE
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