Trust Me

By Jonathan Sherbino (@sherbino)

I’ve been thinking about the role of trust in medical education.  Last night at midnight, I recorded a KeyLIME podcast  on how trust impacts the effectiveness of a team. (Keep an eye out for the podcast; it should be out in about a month.) Today, my RSS reader highlighted that JGME published a study by Teresa Chan  on how trust influences the relationship between physicians.

The KeyLIME podcast was about a paper by DeOrtentiss et al. It’s a classic social sciences manuscript.  What I mean is that the word count is more than double that of a typical medical education paper, and the introduction (not the discussion) is the longest section, referencing all of the related studies to provide context before even addressing the research hypothesis.  While there are some methodological flaws that keep me from highly endorsing the paper, the authors show:

• how an individual perceives the cohesion among members of the team, AND
• how an individual perceives the performance of a team will influence how much they trust the team.

The second paper by Chan et al. (disclaimer – I’m also an author), found that expertise, reputation, reliability, alignment of interests, engagement, and person-ability all influence the degree of trust between physicians. (If you’re interested in reading more about how trust and familiarity interact in this study, check it out here.)

When I read about trust, it typically is from business or organizational scholars.  Medical education can learn from these disciplines and others. (Side note: I think that medical education is not a discipline with a discrete and distinct domain of knowledge, rather it spans the social sciences, biological sciences and professions.) However, I worry that we have neglected the specific investigation of the impact of trust within medical education.  Teaching, feedback, team-based learning, inter/intra-professional learning, communities of practice etc. all build on a foundation of trust. Perhaps it’s time that medical education scholars return to this theme. Trust me, it’s important.

Image courtesy of  Stuart Miles/ FreeDigitalPhotos.net