134 - Defining the Effective Supervisory Resident: Perspectives from Interns, Seniors, and Attending Physicians

Publication Number: 4131.134

Emily A. Lang, Weill Cornell Medicine, New York, NY, United States; Pamela Fazzio, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Anna Weiss, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States

Background: The supervisory role is a critical component of residency training that requires senior residents to teach and supervise junior residents, manage patient care, and collaborate with attending physicians. Despite recent research suggesting that one's role on the medical team influences their definition of an effective supervisory resident, few studies have fully explored how the perception of an effective supervisory resident varies by role.

Objective: We sought to identify the behaviors that first-year residents (interns), third-year residents (seniors), and attending physicians associate with effective supervisory residents, and to explore how these perceptions vary by role.

Design/Methods: We developed and administered an anonymous electronic survey to interns, seniors, and general pediatric hospitalist physicians who serve as attendings on resident teams at our children's hospital. Participants used a Likert scale to rate the importance of individual behaviors, then ranked the five behaviors they deemed most important for a supervisory resident's efficacy. We used Kruskal Wallis ANOVAs with post-hoc Mann-Whitney U tests and Pearson's chi-squared tests to identify differences between groups.

Results: Interns (n = 25), seniors (n = 27), and attending physicians (n = 39) completed the survey (alpha = 0.79). While there was overlap among groups regarding the qualities identified as most relevant for supervising residents, there was no single behavior perceived by all groups as critical for the success of a supervisory resident. Interns and seniors emphasized being approachable and supporting interns' emotional well-being; interns and attendings identified the importance of maintaining clear communication; seniors and attendings highlighted the need to allow interns to present their own plans. We found statistically significant differences between groups, such that seniors and attendings viewed allowing interns to present their own plans and double-checking interns' work as more important than interns; attendings rated probing for thought process behind decisions as more important than interns; seniors and interns placed higher value on debriefing traumatic events than attendings (all corrected p-values < 0.05).

Conclusion(s): Interns, seniors, and attending physicians have differing perceptions of the behaviors that define effective supervisory residents. Further work should thoroughly define the expectations of the supervisory resident role to guide development of clear assessment frameworks used to evaluate residents' competency as supervisors prior to graduation.

Figure 1. Most important behaviors of effective supervisory residents.
Items that were rated most highly or ranked most frequently as critical components of effective supervisory residents are depicted by group. Items in overlapping circles were endorsed by more than one group.

Figure 2. Importance of supervisory resident behaviors by group.
The average score and standard error for each item on the Likert scaled portion of the survey are depicted by group. Statistically significant differences are denoted by asterisks.