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Background

Clinical supervisors make frequent assessments of medical trainees’ competence so they can provide appropriate opportunities for trainees to experience clinical independence. This study explored context-specific assessments of trainees’ competence for independent clinical work.

Method

In Phase One, 88 teaching team members from internal and emergency medicine were observed during clinical activities (216 hours), and 65 participants completed brief interviews. In Phase Two, 36 in-depth interviews were conducted using video vignettes. Data collection and analysis employed grounded theory methodology.

Results

Supervisors’ assessments of trainee trustworthiness for independent clinical work involved consideration of four dimensions: knowledge/skill, discernment of limitations, truthfulness, and conscientiousness. Supervisors’ reliance on language cues as a source of trustworthiness data was …