Measuring the Intensity of Resident Supervision in the Department of Veterans Affairs: The Resident Supervision Index

Abstract

The RSI is a feasible and reliable measure of resident supervision that is intended for research studies in graduate medical education focusing on education outcomes, as well as studies assessing quality of care, patient health outcomes, care costs, and clinical workload.

Progressive Independence in Clinical Training: Perspectives of a National, Multispecialty Panel of Residents and Fellows

“…Efforts have been made to objectively measure resident independence, resulting in the development of the Resident Supervision Index 7,11 and the Zwisch scale of operative independence. 12 Other initiatives designed to provide opportunities for independence include chief resident clinics and telephone triage systems with formative feedback [13][14][15] These interventions may serve as building blocks for the development and implementation of additional objective measurements of resident ability.…”

Measuring Progressive Independence With the Resident Supervision Index: Empirical Approach

“…Quantifying supervision and measuring progressive responsibility have policy implications for defining supervision standards and measuring GME educational outcomes. 14 Building on previous work, [1][2][3]15 the RSI method consists of a survey instrument (RSI Inventory), 8 scoring strategy (presented herein), theoretical framework (patient-centered optimal supervision), 9 and analytic framework (2-part model). 9 This article shows how RSI Inventory responses were scored to quantify different levels of supervision intensity that, taken together, profile supervision during encounters among residents, attending physicians, and patients in outpatient care settings.…”

“…The trial shows that RSI Inventory version 3.11 is both feasible and reliable in collecting information about time spent during supervision encounters, as described by Byrne et al 8 Patients were limited to those who had a diagnosis of diabetes or major depression. These diagnoses are highly prevalent among VA patients, and the patients often present with moderate case complexity.…”

“…A prior article has described the feasibility and psychometric reliability of the RSI Inventory as a survey instrument to collect supervision information from attending staff and residents (APPENDIX 1), 8 and in the companion article published in this issue of Journal of Graduate Medical Education, we describe the theory of patient-centered optimal supervision and derive the 2-part analytic models designed to test theory-driven hypotheses. 9 In this article, we introduce the final part of the 4-part RSI method by describing how RSI Inventory responses are scored to compute supervision intensity.…”

Measuring Progressive Independence With the Resident Supervision Index: Theoretical Approach

“…Theory is used to derive hypotheses, develop analytic models to test those hypotheses, and guide formulation of intensity scores 1 and collection of GME data. 2 …”