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Supervision and autonomy of ophthalmology residents in the outpatient clinic in the United States II: a survey of senior residents.

Publication ,  Journal Article
Singman, EL; Boland, MV; Tian, J; Green, LK; Srikumaran, D; Writing Committee of the Ophthalmology Program Directors’ Study Group (OPDSG),
Published in: BMC Med Educ
June 13, 2019

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.

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Published In

BMC Med Educ

DOI

EISSN

1472-6920

Publication Date

June 13, 2019

Volume

19

Issue

1

Start / End Page

202

Location

England

Related Subject Headings

  • Surveys and Questionnaires
  • Professional Autonomy
  • Ophthalmology
  • Medical Informatics
  • Internship and Residency
  • Humans
  • Ambulatory Care Facilities
  • 3904 Specialist studies in education
  • 3901 Curriculum and pedagogy
  • 3202 Clinical sciences
 

Citation

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Singman, E. L., Boland, M. V., Tian, J., Green, L. K., Srikumaran, D., & Writing Committee of the Ophthalmology Program Directors’ Study Group (OPDSG), . (2019). Supervision and autonomy of ophthalmology residents in the outpatient clinic in the United States II: a survey of senior residents. BMC Med Educ, 19(1), 202. https://doi.org/10.1186/s12909-019-1620-0
Singman, Eric L., Michael V. Boland, Jing Tian, Laura K. Green, Divya Srikumaran, and Divya 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 Med Educ 19, no. 1 (June 13, 2019): 202. https://doi.org/10.1186/s12909-019-1620-0.
Singman EL, Boland MV, Tian J, Green LK, Srikumaran D, 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 Med Educ. 2019 Jun 13;19(1):202.
Singman, Eric L., et al. “Supervision and autonomy of ophthalmology residents in the outpatient clinic in the United States II: a survey of senior residents.BMC Med Educ, vol. 19, no. 1, June 2019, p. 202. Pubmed, doi:10.1186/s12909-019-1620-0.
Singman EL, Boland MV, Tian J, Green LK, Srikumaran D, 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 Med Educ. 2019 Jun 13;19(1):202.
Journal cover image

Published In

BMC Med Educ

DOI

EISSN

1472-6920

Publication Date

June 13, 2019

Volume

19

Issue

1

Start / End Page

202

Location

England

Related Subject Headings

  • Surveys and Questionnaires
  • Professional Autonomy
  • Ophthalmology
  • Medical Informatics
  • Internship and Residency
  • Humans
  • Ambulatory Care Facilities
  • 3904 Specialist studies in education
  • 3901 Curriculum and pedagogy
  • 3202 Clinical sciences