New systems should be put in place to ensure medical trainees in teaching hospitals are adequately supervised, according to two articles published in the Medical Journal of Australia.
Dr Craig Hore, an intensive care specialist from Port Macquarie Base Hospital in NSW, and his co-authors write that the least experienced doctors in hospitals can be the first called upon to review sick patients after hours.
Dr Hore said inadequate clinical supervision might be a contributing factor to increased death rates of seriously ill patients at weekends.
"There is evidence that supervision has a positive effect on patient outcomes, and that lack of supervision is harmful for patients. Hence, inadequate training and supervision can be contributing factors to serious adverse events," he said.
Dr Hore said specialists faced a number of impediments to providing effective training to junior doctors, including: competing interests and work pressures, a lack of education on effective supervision and institutional disincentives.
Supervision programs should have a clear structure, including ground rules and learning objectives and job descriptions for supervisors and trainees, he said.
Suggested responsibilities for clinical supervisors included the provision of adequate uninterrupted periods of supervision of trainees, participation in specific supervision trainee courses and the provision of advice, feedback and reassurance to trainees.
In an editorial in the MJA
, Professor Kevin Forsyth, Director and Dean of Education at the Royal Australasian College of Physicians, said the adequate supervision of trainees should be a high priority for the health system.
"Currently, the health sector is struggling to provide the human and financial resources required for effective supervision," Professor Forsyth said
The Medical Journal of Australia
is a publication of the Australian Medical Association.