Member accounts in the assessment of professional competence

Mehmet Ali Icbay; Timothy Koschmann

doi:10.1515/text-2014-0034

Article

Member accounts in the assessment of professional competence

Mehmet Ali Icbay
Mehmet Ali Icbay is currently working as Assistant Professor in the Department of Curriculum and Instruction at Çanakkale Onsekiz Mart University, Turkey. He received his PhD in Curriculum and Instruction from Middle East Technical University, Ankara. His research interests include the ethnomethological account of social organization in classroom settings. He is mainly interested in demonstrating how teaching and learning are accomplished by teachers and students together in the classrooms.
and Timothy Koschmann
Timothy Koschmann is a Professor of Medical Education at Southern Illinois University School of Medicine. He began his academic preparation in Philosophy (BA, University of Missouri- Kansas City), going on to complete advanced degrees in Experimental Psychology (MS, University of Wisconsin-Milwaukee) and Computer Science (PhD, Illinois Institute of Technology, 1987). In 2013 he was awarded an honorary doctorate at Göteborg University (Faculty of Education). His research focuses upon the practical organizations of instruction and learning.

Published/Copyright: February 27, 2015

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From the journal Text & Talk Volume 35 Issue 2

Abstract

The process of licensing within the medical profession is built on a practical work of defining what competences constitute the profession, of determining how these competences can be acquired, and of specifying how they can be assessed. In order to obtain a medical license in the United States, medical students are evaluated on the basis of clinical encounters with standardized patients. By demonstrating how medical students’ performances in clinical encounters are assessed, this study illustrates how the assessment of professional competence is practically accomplished. Because it frames the work of assessment as a situated interactional and practical work, the study focuses on how three faculty members in a series of panel meetings carried out the practical work of rating candidates’ performances. The data were taken from a corpus of audio-recorded panel meetings where the physician-raters first watched the video-recorded student performances, rated them individually, and finally reached a consensus collectively for each clinical encounter. In examining how they accomplished coming to an agreement for the examinees’ performances, we see that by using different local strategies, panelists made themselves accountable as both competent physicians and efficient raters. We also notice that panelists made a distinction between being accountable for efficient raters and being accountable for competent physicians when they were supposed to concede their ratings.

Keywords: accountability; performance-based assessment; ethnomethodology; professional competence; medical licensing; student performance

About the authors

Mehmet Ali Icbay

Mehmet Ali Icbay is currently working as Assistant Professor in the Department of Curriculum and Instruction at Çanakkale Onsekiz Mart University, Turkey. He received his PhD in Curriculum and Instruction from Middle East Technical University, Ankara. His research interests include the ethnomethological account of social organization in classroom settings. He is mainly interested in demonstrating how teaching and learning are accomplished by teachers and students together in the classrooms.

Timothy Koschmann

Timothy Koschmann is a Professor of Medical Education at Southern Illinois University School of Medicine. He began his academic preparation in Philosophy (BA, University of Missouri- Kansas City), going on to complete advanced degrees in Experimental Psychology (MS, University of Wisconsin-Milwaukee) and Computer Science (PhD, Illinois Institute of Technology, 1987). In 2013 he was awarded an honorary doctorate at Göteborg University (Faculty of Education). His research focuses upon the practical organizations of instruction and learning.

Acknowledgments

The work described here was supported in part by a grant (Grant #: 5R03MH74970-2) from the National Institute of Mental Health (NIMH) Division of Services and Intervention Research (DSIR).

Appendix

Transcription conventions

[text]: The start and end points of overlapping speech
=: The break and subsequent continuation of a single utterance
(# of seconds): A number in parentheses indicates the time, in seconds, of a pause in speech
(.): A brief pause, usually less than 0.2 seconds
.: Falling pitch or intonation
,: A temporary rise or fall in intonation
↑: Raising intonation
↓: Falling intonation
-: An abrupt halt or interruption in utterance
>text<: Indicates that the enclosed speech is delivered more rapidly than usual for the speaker
<text>: Indicates that the enclosed speech is delivered more slowly than usual for the speaker
°: Whisper, reduced volume, or quiet speech
ALL CAPS: Shouted or increased volume speech
:: Prolongation of a sound
(hhh): Audible exhalation
.hhh: Audible inhalation
(text): Speech which is unclear or in doubt in the transcript
((text)): Comment/extralinguistic information
(): Uncertain/unclear parts

References

Antaki, Charles. 1996. Explanation slots as resources in interaction. British Journal of Social Psychology35(3). 415–432.10.1111/j.2044-8309.1996.tb01105.xSearch in Google Scholar

Antaki, Charles. 2006. Producing a “cognition”. Discourse Studies8(1). 9–15.10.1177/1461445606059545Search in Google Scholar

Atkinson, J. Maxwell & PaulDrew. 1979. Order in court: The organization of verbal interaction in judicial settings. London: Macmillan Press.Search in Google Scholar

Atkinson, J. Maxwell & JohnHeritage (eds.). 1984. Structures of social action: Studies in conversation analysis. New York: Cambridge University Press.Search in Google Scholar

Buttny, Richard. 1987. Sequence and practical reasoning in accounts episodes. Communication Quarterly35(1). 67–83.10.1080/01463378709369671Search in Google Scholar

Buttny, Richard. 1990. Blame-accounts in therapy: The negotiation of relational meanings. Semiotica78(3/4). 219–247.10.1515/semi.1990.78.3-4.219Search in Google Scholar

Buttny, Richard. 1993. The social accountability of communication. London: Sage.Search in Google Scholar

Drew, Paul. 1992. Contested evidence in courtroom cross-examinations: The case of a trial for rape. In PaulDrew & JohnHeritage (eds.), Talk at work: Interaction in institutional settings, 470–519. New York: Cambridge University Press.Search in Google Scholar

Firth, Alan. 1995. Accounts in negotiation discourse: A single-case analysis. Journal of Pragmatics23(2). 199–226.10.1016/0378-2166(94)00003-WSearch in Google Scholar

Freidson, Eliot. 1988. Professional powers: A study of the institutionalization of formal knowledge. Chicago: University of Chicago Press.Search in Google Scholar

Freidson, Eliot. 2001. Professionalism, the third logic: On the practice of knowledge. Chicago: University of Chicago Press.Search in Google Scholar

Garfinkel, Harold. 1967. Studies in ethnomethodology. Englewood Cliffs, NJ: Prentice-Hall.Search in Google Scholar

Garfinkel, Harold. 2002. Ethnomethodology’s program: Working out Durkheim’s aphorism. Lanham, MA: Rowman & Littlefield.Search in Google Scholar

Garfinkel, Harold. 2006. Seeing sociologically: The routine grounds of social action. Boulder, CO: Paradigm.Search in Google Scholar

Giddens, Anthony. 1990. The consequences of modernity. Stanford, CA: Stanford University Press.Search in Google Scholar

Goffman, Erving. 1972. Relations in public: Microstudies of the public order. New York: Harper and Row.Search in Google Scholar

Goodwin, Charles. 1994. Professional vision. American Anthropologist96(3). 606–633.10.1525/aa.1994.96.3.02a00100Search in Google Scholar

Goodwin, Charles & Marjorie HarnessGoodwin. 1987. Assessments and the construction of context. In AlessandroDuranti & CharlesGoodwin (eds.), Rethinking context: Language as an interactive phenomenon, 147–189. New York: Cambridge University Press.Search in Google Scholar

Harik, Polina, Brian E. Clauser, IrinaMargolis, Gerald F. Dillon & John R. Boulet. 2006. Relationships among the subcomponents of the USMLE step 2 clinical skills examination, the step 1, and the step 2 clinical knowledge examinations. Academic Medicine81(10). S21–S24.Search in Google Scholar

Harre, Rom. 1977. The ethogenic approach: Theory and practice. In L. Berkowitz (ed.), Advances in social psychology, 284–314. New York: Academic Press.10.1016/S0065-2601(08)60360-3Search in Google Scholar

Heritage, John. 1988. Explanations as accounts: A conversation analytic perspective. In CharlesAntaki (ed.), Analyzing everyday explanations: A case book of methods, 127–144. London: Sage.Search in Google Scholar

Heritage, John & GeoffreyRaymond. 2005. The terms of agreement: Indexing epistemic authority and subordination in talk-in-interaction. Social Psychology Quarterly68(1). 15–38.10.1177/019027250506800103Search in Google Scholar

Hoppe, Ruth B., Ann M. King, Kathleen M. Mazor, Gail E. Furman, PenelopeWick-Garcia, HeatherCorcoran-Ponisciak & Peter J. Katsufrakis. 2013. Enhancement of the assessment of physician–patient communication skills in the United States medical licensing examination. Academic Medicine88(11). 1670–1675.10.1097/ACM.0b013e3182a7f75aSearch in Google Scholar

Lane, Suzanne. 2010. Performance assessment: The state of the art. Stanford, CA: Stanford University.Search in Google Scholar

MacKenzie, C. Ronald. 2007. Professionalism and medicine. Hospital for Special Surgery Journal3. 222–227.10.1007/s11420-007-9054-3Search in Google Scholar

Maynard, Douglas. 2010. Demur, defer, and deter: Concrete, actual practices for negotiation in interaction. Negotiation Journal26(2). 125–143.Search in Google Scholar

McGaghie, William. 1991. Professional competence evaluation. Educational Researcher20(1). 3–9.10.3102/0013189X020001003Search in Google Scholar

Myers, Greg. 1998. Displaying opinions: Topics and disagreement in focus groups. Language in Society27(1). 85–111.10.1017/S0047404500019734Search in Google Scholar

Papadakis, Maxine. 2004. The step 2 clinical-skills examination. New England Journal of Medicine350(17). 1703–1705.10.1056/NEJMp038246Search in Google Scholar

Pomerantz, Anita. 1984a. Agreeing and disagreeing with assessments: Some features of preferred/dispreferred turn shapes. In J. Maxwell Atkinson & JohnHeritage (eds.), Structures of social action: Studies in conversation analysis, 57–101. New York: Cambridge University Press.10.1017/CBO9780511665868.008Search in Google Scholar

Pomerantz, Anita. 1984b. Giving a source or basis: The practice in conversation of telling how I know. Journal of Pragmatics8(5/6). 607–625.10.1016/0378-2166(84)90002-XSearch in Google Scholar

Sacks, Harvey. 1987. On the preferences for agreement and contiguity in sequences in conversation. In GrahamButton & John R. Lee (eds.), Talk and social organization, 54–69. Clevedon: Multilingual Matters.Search in Google Scholar

Scott, Marvin B. & Stanford M. Lyman. 1968. Accounts. American Sociological Review33(1). 46–62.10.2307/2092239Search in Google Scholar

Sigerist, Henry E. 1935. The history of medical licensure. Journal of American Medical Association104(13). 1057–1060.10.1001/jama.1935.02760130007002Search in Google Scholar

Van Zanten, Marta, John R. Boulet, DanetteMcKinley, AndreDeChamplain & Ann C. Jobe. 2007. Assessing the communication and interpersonal skills of graduates of international medical schools as part of the United States medical licensing (USMLE) step 2 clinical skills (CS) exam. Academic Medicine82(10). S65–S68.10.1097/ACM.0b013e318141f40aSearch in Google Scholar

Vu, Nu Viet & HowardBarrows. 1994. Use of standardized patients in clinical assessments: Recent developments and measurement find. Academic Medicine23(3). 23–30.10.3102/0013189X023003023Search in Google Scholar

Wass, Val, CeesP. M.van der Vleuten, John Shatzer & RogerJones. 2001. Assessment of clinical competence. Lancet357. 945–949.10.1016/S0140-6736(00)04221-5Search in Google Scholar

Published Online: 2015-2-27

Published in Print: 2015-3-1

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Articles in the same Issue

https://doi.org/10.1515/text-2014-0034

Keywords for this article

accountability; performance-based assessment; ethnomethodology; professional competence; medical licensing; student performance