Improving Resident Supervision and Resident Care
In the last few years, a lot has changed in the manner in which medical residents are providing patient care, creating new hardships for program directors related to resident supervision and residency program oversight. Residency directors are seeking smarter solutions regarding resident supervision and program evaluation.
Residents Are Being Tasked with More Patient Care
Residents in academic centers being asked to do more and more patient care, eating up education time.
The corporate impact (and government funding impact) on residencies has also altered the training regimen for students. In the last 10 years, income per resident, paid by the Centers for Medicare and Medicaid Services (CMS) and the Health Resources and Services Administration (HRSA) is up nearly 50%. That means residents are billing out 50% more work than they used to. At the same time, cost claims made to the CMS and HRSA by the hospitals are up 70%. That is, hospitals are claiming that government reimbursed costs have climbed 70%, while billing for the same residents to patients is up 50%.
Effectively, the corporate owners of residencies have managed a 120% increase in the value of having a resident, in just 10 years.
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.
When supervision is inadequate, patient outcomes can poor and resident deficiencies persist unchecked. When residents work alone, they also may feel uncomfortable reaching out to program faculty or attending physicians for help.
- Concern over revealing a knowledge gap.
- A desire to make decisions on their own.
- Perception that the attending physician does not want to be called.
How to fix resident knowledge gaps.
“Supervision is a fundamental principle of medical education.”
5 Tips for More Effective Resident Supervision
Set clear expectations up front. Specifically outline in what circumstances you want the resident to notify you about a patient’s condition.
Be available. Attending physicians should answer all calls while on service. Don’t deny resident calls in an effort to grow autonomy.
Address uncertainty. Faculty members should assure residents, especially junior trainees, that uncertainty is part of education and they should not feel bad about asking for help.
Make discussions worthwhile. Conversations should be a back-and-forth dialogue between the resident and attending physician.
Focus on patient safety. Because residents can sometimes resent supervision, program leaders and attending physicians should focus on patient safety – and the “team” – when supervising trainees.
For More Information
Med-Challenger has been providing online education services to residencies for two decades. Our all-in-one residency education platform is designed for program directors and the problems residency programs, their faculty, and residents face every day.
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