Supervision and autonomy of ophthalmology residents in the outpatient clinic in the United States II: a survey of senior residents
Abstract Background A balance between autonomy and supervision can be difficult to obtain in medical education. In this study, we sought to determine whether the presence and level of supervision of ophthalmology resident outpatient clinic correlates with metrics of resident success, professionalism...
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| Format: | Article |
| Language: | English |
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BMC
2019-06-01
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| Series: | BMC Medical Education |
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| Online Access: | http://link.springer.com/article/10.1186/s12909-019-1620-0 |
| _version_ | 1811315326692884480 |
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| author | Eric L. Singman Michael V. Boland Jing Tian Laura K. Green Divya Srikumaran The Writing Committee of the Ophthalmology Program Directors’ Study Group (OPDSG) |
| author_facet | Eric L. Singman Michael V. Boland Jing Tian Laura K. Green Divya Srikumaran The Writing Committee of the Ophthalmology Program Directors’ Study Group (OPDSG) |
| author_sort | Eric L. Singman |
| collection | DOAJ |
| description | Abstract Background A balance between autonomy and supervision can be difficult to obtain in medical education. In this study, we sought to determine whether the presence and level of supervision of ophthalmology resident outpatient clinic correlates with metrics of resident success, professionalism and stress. Methods A survey was emailed to all US ophthalmology program directors requesting it be forwarded to PGY4 residents. Questions included whether their program provided a resident-hosted outpatient clinic, and if so, whether residents were mandated to discuss every patient with faculty. Residents were assigned to three categories based on this question (0: no clinic, 1: mandated faculty input, 2: discretionary faculty input). Success metrics included numbers of manuscripts submitted, OKAP scores and success in obtaining fellowships. Professionalism metrics included rating comfort obtaining informed consent, breaking bad news, managing time in clinic, and confidence in providing care in various settings. Residents affirming participation in a continuity clinic also provided perceptions of the level of supervision and how the clinic affected stress. Results Category 1 residents perceived somewhat too much supervision, while category 2 residents felt that they had somewhat insufficient supervision. The majority of residents in either category did not feel that the continuity clinic affected their overall stress, although those who reported a change in stress usually indicated that the presence of the clinic increased stress. There were no other statistically significant differences between the responses from any category. Conclusions The presence of a resident-hosted continuity clinic neither adds nor detracts from the success or sense of professionalism of ophthalmology residents. However, when such a clinic is present, the degree of supervision appears to correlate inversely with resident perception of autonomy. These results suggest that the decision of a training program to offer a clinic hosted by residents offering comprehensive continuity care can be informed primarily by faculty and trainee philosophy and personal preferences without comprising education quality, clinical efficiency, residents’ perception of stress or their success in fellowship matching. |
| first_indexed | 2024-04-13T11:28:13Z |
| format | Article |
| id | doaj.art-15be347c41c440769b0ce9ab53ea602c |
| institution | Directory Open Access Journal |
| issn | 1472-6920 |
| language | English |
| last_indexed | 2024-04-13T11:28:13Z |
| publishDate | 2019-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Education |
| spelling | doaj.art-15be347c41c440769b0ce9ab53ea602c2022-12-22T02:48:38ZengBMCBMC Medical Education1472-69202019-06-011911710.1186/s12909-019-1620-0Supervision and autonomy of ophthalmology residents in the outpatient clinic in the United States II: a survey of senior residentsEric L. Singman0Michael V. Boland1Jing Tian2Laura K. Green3Divya Srikumaran4The Writing Committee of the Ophthalmology Program Directors’ Study Group (OPDSG)General Eye Services, Wilmer Eye Institute, Johns Hopkins School Of MedicineGeneral Eye Services, Wilmer Eye Institute, Johns Hopkins School Of MedicineBloomberg School of Public Health, Johns Hopkins UniversityLifebridge Health Krieger Eye InstituteGeneral Eye Services, Wilmer Eye Institute, Johns Hopkins School Of MedicineAbstract Background A balance between autonomy and supervision can be difficult to obtain in medical education. In this study, we sought to determine whether the presence and level of supervision of ophthalmology resident outpatient clinic correlates with metrics of resident success, professionalism and stress. Methods A survey was emailed to all US ophthalmology program directors requesting it be forwarded to PGY4 residents. Questions included whether their program provided a resident-hosted outpatient clinic, and if so, whether residents were mandated to discuss every patient with faculty. Residents were assigned to three categories based on this question (0: no clinic, 1: mandated faculty input, 2: discretionary faculty input). Success metrics included numbers of manuscripts submitted, OKAP scores and success in obtaining fellowships. Professionalism metrics included rating comfort obtaining informed consent, breaking bad news, managing time in clinic, and confidence in providing care in various settings. Residents affirming participation in a continuity clinic also provided perceptions of the level of supervision and how the clinic affected stress. Results Category 1 residents perceived somewhat too much supervision, while category 2 residents felt that they had somewhat insufficient supervision. The majority of residents in either category did not feel that the continuity clinic affected their overall stress, although those who reported a change in stress usually indicated that the presence of the clinic increased stress. There were no other statistically significant differences between the responses from any category. Conclusions The presence of a resident-hosted continuity clinic neither adds nor detracts from the success or sense of professionalism of ophthalmology residents. However, when such a clinic is present, the degree of supervision appears to correlate inversely with resident perception of autonomy. These results suggest that the decision of a training program to offer a clinic hosted by residents offering comprehensive continuity care can be informed primarily by faculty and trainee philosophy and personal preferences without comprising education quality, clinical efficiency, residents’ perception of stress or their success in fellowship matching.http://link.springer.com/article/10.1186/s12909-019-1620-0AutonomySupervisionResidentOphthalmologyEducationOutpatient |
| spellingShingle | Eric L. Singman Michael V. Boland Jing Tian Laura K. Green Divya Srikumaran The Writing Committee of the Ophthalmology Program Directors’ Study Group (OPDSG) Supervision and autonomy of ophthalmology residents in the outpatient clinic in the United States II: a survey of senior residents BMC Medical Education Autonomy Supervision Resident Ophthalmology Education Outpatient |
| title | Supervision and autonomy of ophthalmology residents in the outpatient clinic in the United States II: a survey of senior residents |
| title_full | Supervision and autonomy of ophthalmology residents in the outpatient clinic in the United States II: a survey of senior residents |
| title_fullStr | Supervision and autonomy of ophthalmology residents in the outpatient clinic in the United States II: a survey of senior residents |
| title_full_unstemmed | Supervision and autonomy of ophthalmology residents in the outpatient clinic in the United States II: a survey of senior residents |
| title_short | Supervision and autonomy of ophthalmology residents in the outpatient clinic in the United States II: a survey of senior residents |
| title_sort | supervision and autonomy of ophthalmology residents in the outpatient clinic in the united states ii a survey of senior residents |
| topic | Autonomy Supervision Resident Ophthalmology Education Outpatient |
| url | http://link.springer.com/article/10.1186/s12909-019-1620-0 |
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