How do attendings perceive housestaff autonomy? Attending experience, hospitalists, and trends over time

Abstract

BACKGROUND: Graduated supervision is necessary for residents to progress to independence, but it is unclear what factors influence attendings' perception of housestaff autonomy.

Supervision and autonomy of ophthalmology residents in the outpatient Clinic in the United States: a survey of ACGME-accredited programs

“…A number of models have been published suggesting that supervision can be enhanced without severely compromising trainee autonomy [9, 19, 25, 26]. While the authors believe that this study reasonably measures important of aspects of supervision in the outpatient clinic setting, they concede that autonomy is a perception [14, 27, 28] and may be much more difficult to measure. However, the significant body of published literature describing the tension between autonomy and supervision suggest that they most likely vary inversely [15, 29–32].…”

Promoting Resident Autonomy During Family-Centered Rounds: A Qualitative Study of Resident, Hospitalist, and Subspecialty Physicians

“…[1][2][3] Recent studies have suggested that provision of autonomy is an area of concern for faculty and residents. 4,5 Trainees express that they are not given enough opportunities to participate in clinical decision making, while faculty identify the challenges of supporting autonomy for residents in settings of high acuity, high patient census, and limited trainee experience. 6 Family-centered rounds (FCR), defined as interdisciplinary bedside rounds where the ''patient and family share in the control of the management plans,'' 7 have become a widely adopted model for rounds in the pediatric setting.…”

How Residents Develop Trust in Interns: A Multi-Institutional Mixed-Methods Study

“…5,7,13,14,33 Of 118 total residents, we e-mailed invitations to 30 using random purposive sampling based on training year. We invited PGY2 and PGY3 IM residents at UCSF for interviews.…”

“…[1][2][3][4][5][6] Trust relates to both the person doing the trusting (supervising physician) and the person who is trusted (trainee) and can entail a belief, decision, and action. [1][2][3][4][5][6] Trust relates to both the person doing the trusting (supervising physician) and the person who is trusted (trainee) and can entail a belief, decision, and action.…”

“…[1][2][3][4][5][6] Trust relates to both the person doing the trusting (supervising physician) and the person who is trusted (trainee) and can entail a belief, decision, and action. [8][9][10][11][12] Recently, medical educators have explored how faculty physicians (attendings) make decisions to trust trainees 5,[13][14][15][16][17][18][19][20] and have identified five key factors influencing these decisions: 7 In medicine, workplace-based assessment of trustworthiness is complex, occurring in a dynamic environment with rotational learning and duty hours restrictions that can limit contact between supervisors and trainees.…”