2019
DOI: 10.1186/s12909-019-1732-6
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Learning to drive: resident physicians’ perceptions of how attending physicians promote and undermine autonomy

Abstract: Background Providing appropriate levels of autonomy to resident physicians is an important facet of graduate medical education, allowing learners to progress toward the ultimate goal of independent practice. While studies have identified the importance of autonomy to the development of resident physicians, less is known about resident perspectives on their “lived experiences” with autonomy and ways in which clinical educators either promote or undermine it. The current study aims to provide an emp… Show more

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Cited by 27 publications
(36 citation statements)
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“…[2][3][4][5][6][7][8][9][10] Though there are many articles on clinical teaching where there is implicit information on autonomy and learners, 11 and Carbo provides a toolkit to teach learners autonomy, 12 little is published that provides explicit strategies for assessing learner readiness for independent practice and supporting resident autonomy. 13 Family medicine residents are expected to progressively develop the ability to independently care for patients over the course of their 3-year residency. Initial direct supervision of all aspects of care gradually shifts to increasing levels of resident independence over time.…”
Section: Introductionmentioning
confidence: 99%
See 3 more Smart Citations
“…[2][3][4][5][6][7][8][9][10] Though there are many articles on clinical teaching where there is implicit information on autonomy and learners, 11 and Carbo provides a toolkit to teach learners autonomy, 12 little is published that provides explicit strategies for assessing learner readiness for independent practice and supporting resident autonomy. 13 Family medicine residents are expected to progressively develop the ability to independently care for patients over the course of their 3-year residency. Initial direct supervision of all aspects of care gradually shifts to increasing levels of resident independence over time.…”
Section: Introductionmentioning
confidence: 99%
“…14 Resident complaints about the degree of independence they are granted, either too much or too little, fail to consider whether there are resident issues at play such as where the resident is inexperienced, or has not demonstrated evidence of good clinical decision-making. 13 Additionally, the resident concerns do not consider the environment and patient factors affecting the entrustment issues. 14 Faculty members may not always be able to judge how much resident autonomy is appropriate or desired, leading to frustration on the part of more senior residents and potentially insufficient supervision for more junior residents.…”
Section: Introductionmentioning
confidence: 99%
See 2 more Smart Citations
“…6,7 Autonomy has long been studied in conjunction with the development of physicians in training, linking learner autonomy with increased learner confidence, improved clinical decision-making skills, increased sense of patient responsibility and ownership, increased readiness of independent practice and an enhanced development of professional identity. [8][9][10][11][12] Within the clinical learning environment, autonomy provides opportunities for learners to make 'real' decisions for patient care, facilitating the development of confidence in clinical decision making and responsibility for patient care. 8 Alternatively, decreased autonomy can foster feelings of ambivalence in learners leading to decreased feelings of responsibility along with a decreased sense of 'professional becoming' due to decreased opportunity to take on the role of physician.…”
mentioning
confidence: 99%