Supervision Models in Training Environments

NCT ID: NCT05075278

Last Updated: 2023-02-08

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 20 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2021-07-07
• Study Completion Date: 2022-07-30

Brief Summary

Attending physicians often supervise novice junior residents in a direct one-to-one format. Alternatively, a senior resident can be paired with a new trainee under the non-direct (but immediately available) supervision of an attending physician. Resident supervision has been considered an important step towards independent practice. Both models are ubiquitous in the United States, but no study to date has been performed if one model is better than the other with respect to supervision scores.

Detailed Description

Supervision of residents is a cornerstone of ACGME accreditation and a critical focus of any training program. A nine-faceted, validated survey has been used to assess quality and effectiveness of supervision in training environments. Residents that assign poor scores for faculty members also tend to poorly evaluate the department-at-large. Further, residents that evaluate supervisors unfavorably also tend to report more patient safety mishaps in the context of a less safe work environment. Previous literature that used this supervision scale concluded that residents who reported mean department-wide supervision scores less than 3 (frequent) reported significantly more frequent occurrences of mistakes with negative consequences to patients and medication errors.

Attending physicians often supervise novice junior residents in a direct one-to-one format. Alternatively, a senior resident can be paired with a new trainee under the non-direct (but immediately available) supervision of an attending physician. Resident supervision has been considered an important step towards independent practice.. Both models are ubiquitous in the United States, but no study to date has been performed if one model is better than the other with respect to supervision scores.

Conditions

Supervision; Anesthesia

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: OTHER
• Blinding Strategy: SINGLE

Study Groups

Attending physician for direct 1:1 supervision

Participants will be assigned to an attending physician for direct 1:1 supervision. The participants will fill out a survey at the end of the day for 16 consecutive days.

Group Type: ACTIVE_COMPARATOR

Survey

Intervention Type: BEHAVIORAL

A survey will be completed by the participants at the conclusion of each day.

Senior resident for direct 1:1 supervision

Participants will be assigned to an senior resident as a direct supervisor with oversight from an attending physician (in accordance with CMS/ACGME staffing criteria). The participants will fill out a survey at the end of the day for 16 consecutive days.

Group Type: EXPERIMENTAL

Survey

Intervention Type: BEHAVIORAL

A survey will be completed by the participants at the conclusion of each day.

Interventions

Survey

A survey will be completed by the participants at the conclusion of each day.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• New incoming anesthesia residents assigned to healthy patients (ASA physical status classifications of 1 or 2).

Exclusion Criteria

• New incoming anesthesia residents assigned to patients with ASA physical status classifications 3 or greater.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 75 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Rhode Island Hospital

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Christopher Malgieri, MD

Role: PRINCIPAL_INVESTIGATOR

Rhode Island Hospital

Locations

Rhode Island Hospital

Providence, Rhode Island, United States

Countries

United States

References

De Oliveira GS Jr, Rahmani R, Fitzgerald PC, Chang R, McCarthy RJ. The association between frequency of self-reported medical errors and anesthesia trainee supervision: a survey of United States anesthesiology residents-in-training. Anesth Analg. 2013 Apr;116(4):892-7. doi: 10.1213/ANE.0b013e318277dd65. Epub 2013 Feb 5.

Reference Type: BACKGROUND

PMID: 23385057 (View on PubMed)

De Oliveira GS Jr, Dexter F, Bialek JM, McCarthy RJ. Reliability and validity of assessing subspecialty level of faculty anesthesiologists' supervision of anesthesiology residents. Anesth Analg. 2015 Jan;120(1):209-213. doi: 10.1213/ANE.0000000000000453.

Reference Type: BACKGROUND

PMID: 25268396 (View on PubMed)

Riveros Perez E, Jimenez E, Yang N, Rocuts A. Evaluation of Anesthesiology Residents' Supervision Skills: A Tool to Assess Transition Towards Independent Practice. Cureus. 2019 Feb 26;11(2):e4137. doi: 10.7759/cureus.4137.

Reference Type: BACKGROUND

PMID: 31058020 (View on PubMed)

de Oliveira Filho GR, Dal Mago AJ, Garcia JH, Goldschmidt R. An instrument designed for faculty supervision evaluation by anesthesia residents and its psychometric properties. Anesth Analg. 2008 Oct;107(4):1316-22. doi: 10.1213/ane.0b013e318182fbdd.

Reference Type: RESULT

PMID: 18806047 (View on PubMed)

Other Identifiers

1734757

Identifier Type: -

Identifier Source: org_study_id