Trust and entrustment: a conceptual and terminological look at the new paradigm of medical education 1 Danilo Blank Alexandre Marques Velho As with many curriculum innovation processes, conceptual ideas need to get translated in practice, and devil tends to be in details. Olle ten Cate 1 The role of trust in health care and medical education is coming up once again in academic and lay publications, at a time when political-pedagogical turmoils and confusing rhetorics in social networks blur the distinction between right and wrong 2-6 . In fact, the word trust has appeared in titles of editorials in the most prestigious medical journals, some even devoting space to series of articles on this topic, and particularly on entrustment processes – with the sense of building trustworthiness – in the realm of medical formation, as explicitized by Lynch and colleagues 6 : […] to enable trustworthiness in all relationships as a means of supporting and protecting professionalism, which in turn is necessary to achieve excellence in the health care system. […] We continue to consult with experts and learn about dimensions of trust. These experts have offered a number of suggestions, including making trust-building an explicit part of medical education and modeling it for residents and trainees […]. Although discussions about the role of medical education in consolidating public trust in physicians’ capability to provide quality health care to people are not new 7 , specific critical assessments of trust relationships between educators and learners, as well as the process of delegating responsibilities, has very recently appeared with more evidence in the medical literature 8-11 . These studies emphasize the relevance of formative assessment and the longitudinal character of teaching-learning processes, which have been well summarized by David Sklar, editor of the journal Academic Medicine 5 : Trust forms the foundation of the relationship between learner and teacher, providing the conditions for the transfer of information and the development of expertise. […] The learner, therefore, must trust that the teacher will guarantee the best interest of patients while simultaneously offering opportunities for the learner to engage at an appropriate level in directing real patient care. […] Institutional leaders can help promote trust between learners and teachers by improving the institutional learning environment. This can occur through supporting wellness programs; addressing and remediating any disruptive or disrespectful behaviors of teachers, staff, or learners; and making sure that organizational policies align with the values that are taught to learners. The consolidation of trust as a core concept and unifying principle of all levels of the competence- based medical education system was the second wave of the paradigmatic shift in professional training – which occurred in the first decade of the new millennium – in which the 1 This is the translation of the book chapter [Blank D, Marques-Velho A. Confiança e confiabilização: um olhar conceitual e terminológico sobre o novo paradigma da educação médica. In: Neumann CR, Gerbase MW, Blank D, Capp E, editors. Avaliação de competências no internato: atividades profissionais confiabilizadoras essenciais para a prática médica. Porto Alegre: UFRGS; 2019. 13-22. http://hdl.handle.net/10183/199672.] We acknowledge the insightful and enlightening review of terminologist Maria José Bocorny Finatto, retired full professor at the Institute of Linguistic and Literary Studies at UFRGS (Department of Linguistics, Philology and Literary Studies; Linguistics Section), researcher at the TERMISUL group (www.ufrgs.br/termisul) , who inspired and endorsed the academic perspective of the thesis this text sets forth. English version of the book chapter [Blank D, Marques-Velho A. Confiança e confiabilização: um olhar conceitual e terminológico sobre o novo paradigma da educação médica. In: Neumann CR, Gerbase MW, Blank D, Capp E, editors. Avaliação de competências no internato: atividades profissionais confiabilizadoras essenciais para a prática médica. Porto Alegre: UFRGS; 2019. 13-22.] ● Full text Portuguese version available at http://hdl.handle.net/10183/199672.] *