In a randomized clinical trial of 22 attending physicians each providing 2 different levels of supervision, increased supervision did not significantly reduce the rate of medical errors but did result in interns speaking less and residents reporting a decreased level of autonomy.
Residency training programs should reconsider the appropriate level of attending physician supervision when designing rounds to balance patient safety, excellent care, the needs of residents who are there to learn, and resident autonomy.
The relationship between resident work hours and patient safety has been studied extensively but less is known about the role of attending physician supervision on patient safety.
Increased direct supervision where attending physicians joined patient work rounds on previously admitted patients or standard supervision when attending physicians were available for rounds but didn't join (interventions); rate of medical errors (measures)
This was a randomized clinical trial (RCT). RCTs allow the strongest inferences to be made about the true effect of an intervention. However, not all RCT results can be replicated in real-world settings because patient characteristics or other variables may differ from those that were studied in the RCT.
Kathleen M. Finn, M.D., Massachusetts General Hospital, Boston, and coauthors
Conducted at a single medical center with a large academic residency program