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6 Tips for More Effective Resident Supervision

Julie McCoy, August 19, 2010

Between the Accreditation Council for Graduate Medical Education's (ACGME) call for more stringent supervision standards and charges of improper amounts of resident supervision, Texas's Parkland Hospital's—resident supervision is a hot button issue for hospitals.

Supervision is a fundamental principle of medical education, but it hasn't been a focus of accreditation, educational, professional, or governmental organizations' standards until recently. The lack of attention means that residents may not be receiving appropriate supervision during training.

“Supervision really requires attending physicians to be proactive in providing supervision, and residents understanding and appreciating that role and seeking supervision,” Jeanne M. Farnan, MD, MHPE, assistant professor of medicine at the University of Chicago explains. 

Faculty usually are not trained on how to provide proper supervision, making it even more important to encourage residents to actively seek help when they need it, says Vineet M. Arora, MD, MA, assistant professor of medicine, internal medicine associate program director, and assistant dean for curricular innovation at the Pritzker School of Medicine and the University of Chicago.

The following are reasons why residents feel uncomfortable contacting their attending physicians: 

  • Concern over revealing a knowledge gap. Residents fail to call because they're afraid the attending physician will think that they're not as smart as their peers, and they are hesitant to admit that they do not know something. Both attending physicians and residents must view uncertainty as an impetus for the resident to reach out to the supervisor, Farnan says.
  • A desire to make decisions on their own. “Often, calling an attending and asking a question will interfere with the resident's own decision-making style and their own processing of the case,” Farnan explains. Residents want to talk to the attending physician about the case without having their clinical decision-making influenced by the attending physician. 
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