How medical residents perceive the quality of supervision provided by attending doctors in the clinical setting

Busari, Jamiu O; Weggelaar, Nielske M; Knottnerus, A.C.; Greidanus, P.; Scherpbier, and Albert J J A

doi:10.1111/j.1365-2929.2005.02190.x

Cited by 76 publications

(80 citation statements)

References 20 publications

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“…Busari et al 3 have offered a glimpse of residents' views regarding supervision. Their survey of 38 pediatric residents found that most residents in their study rated the supervision they received favorably.…”

Section: Background and Literature Reviewmentioning

confidence: 99%

How Residents View Their Clinical Supervision: A Reanalysis of Classic National Survey Data

Baldwin¹,

Daugherty²,

Ryan³

2010

Journal of Graduate Medical Education

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Background Concerns over patient safety have made adequacy of clinical supervision an important component of care in teaching settings. Yet, few studies have examined residents' perceptions about the quality and adequacy of their supervision. We reanalyzed data from a survey conducted in 1999 to explore residents' perspectives on their supervision. Methods A national, multispecialty survey was distributed in 1999 to a 14.5% random sample of postgraduate year 2 (PGY-2) and PGY-3 residents. The response rate was 64.4%. Residents (n = 3604) were queried about how often they had cared for patients “without adequate supervision” during their preceding year of training. Results Of responding residents, 21% (n = 737) reported having seen patients without adequate supervision at least once a week, with 4.5% saying this occurred almost daily. Differences were found across specialties, with 45% of residents in ophthalmology, 46% in neurology, and 44% in neurosurgery stating that they had experienced inadequate supervision at least once a week throughout the year, compared with 1.5% of residents in pathology and 3% in dermatology. Inadequate supervision was found to be inversely correlated with residents' positive ratings of their learning, time with attendings, and overall residency experience (P < .001 for all), and positively correlated with negative features of training, including medical errors, sleep deprivation, stress, conflict with other medical personnel, falsifying patient records, and working while impaired (P < .001). Conclusions In residents' self-report, inadequate clinical supervision correlates with other reported negative aspects of training. Collectively, this may detrimentally affect resident learning and patient safety.

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Section: Background and Literature Reviewmentioning

confidence: 99%

How Residents View Their Clinical Supervision: A Reanalysis of Classic National Survey Data

Baldwin¹,

Daugherty²,

Ryan³

2010

Journal of Graduate Medical Education

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“…Recent narrative studies have suggested that a collaborative approach to supervision, coupled with constructive feedback, is preferred by trainees. 12 Kennedy and colleagues 13 described a conceptual model for clinical oversight, ranging from monitoring routine activities to intervening to provide direct patient care. However, there is currently no effective model describing clinical supervision in internal medicine residency training that addresses both the role of the attending or supervising physician and the resident physician in the supervisory relationship.…”

mentioning

confidence: 99%

Strategies for Effective On-Call Supervision for Internal Medicine Residents: The Superb/Safety Model

Farnan¹,

Johnson²,

Meltzer³

et al. 2010

Journal of Graduate Medical Education

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Background Supervision is central to resident education and patient safety, yet there is little published evidence to describe a framework for clinical supervision. The aim of this study was to describe supervision strategies for on-call internal medicine residents. Methods Between January and November 2006, internal medicine residents and attending physicians at a single hospital were interviewed within 1 week of their final call on the general medicine rotation. Appreciative inquiry and critical incident technique were used to elicit perspectives on ideal and suboptimal supervision practices. A representative portion of transcripts were analyzed using an inductive approach to develop a coding scheme that was then applied to the entire set of transcripts. All discrepancies were resolved via discussion until consensus was achieved. Results Forty-four of 50 (88%) attending physicians and 46 of 50 (92%) eligible residents completed an interview. Qualitative analysis revealed a bidirectional model of suggested supervisory strategies, the “SUPERB/SAFETY” model; an interrater reliability of 0.70 was achieved. Suggestions for attending physicians providing supervision included setting expectations, recognizing uncertainty, planning communication, having easy availability, reassuring residents, balancing supervision, and having autonomy. Suggested resident strategies for seeking supervision from attending physicians included seeking input early, contacting for active clinical decisions or feeling uncertain, end of life issues, transitions in care, or help with systems issues. Common themes suggested by trainees and attending physicians included easy availability and preservation of resident decision-making autonomy. Discussion Residents and attending physicians have explicit expectations for optimal supervision. The SUPERB/SAFETY model of supervision may be an effective resource to enhance the clinical supervision of residents.

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“…providing and progressively withdrawing support as appropriate), encouraging learners to articulate their thinking, encouraging learners to reflect on their experiences and helping learners to explore and pursue their learning goals. [3][4][5][6] In practice, however, the provision of clinical supervision has been found to be suboptimal and highly variable from one setting to the next, even in the critical task of providing constructive feedback based on observations of learner performance. [6][7][8] Improving the current state of affairs requires an examination of its root causes.…”

Section: Introductionmentioning

confidence: 99%

“…Lack of time is a commonly cited environmental constraint and a difficult one to tackle, requiring institutional-level interventions. 6,10,11 Insufficient knowledge and skills have also been identified 6,8,10,12 figure 1 The integrative model of behaviour prediction. Adapted from Fishbein 9 involved in teaching with medical students and/or residents also suggest that issues of beliefs and identity are relevant to the provision of good clinical teaching.…”

Section: Introductionmentioning

confidence: 99%

Beliefs, identities and educational practice: a Q methodology study of general practice supervisors

Dory

Audetat

Rees

2015

Education for Primary Care

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How medical residents perceive the quality of supervision provided by attending doctors in the clinical setting

Abstract: This study shows that medical residents enjoy supervision from collaborative, understanding and patient attending doctors. Medical residents prefer to be treated as adult learners and enjoy feedback that is constructive, measured and adapted to their professional needs.

Cited by 76 publications

References 20 publications

How Residents View Their Clinical Supervision: A Reanalysis of Classic National Survey Data

How Residents View Their Clinical Supervision: A Reanalysis of Classic National Survey Data

Strategies for Effective On-Call Supervision for Internal Medicine Residents: The Superb/Safety Model

Beliefs, identities and educational practice: a Q methodology study of general practice supervisors

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