The Role of Supervision in Creating Responsible and Competent Physicians

  • Patricia J. Hicks
    Address correspondence to Patricia J. Hicks, MD, The Children’s Hospital of Philadelphia, 34th & Civic Center Blvd, Main Hospital 9NW Room 64, Philadelphia, Pennsylvania 19104.
    Department of Pediatrics, The Children’s Hospital of Philadelphia, and the University of Pennsylvania School of Medicine, Philadelphia, Pa
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      Both the public and the medical profession seek a community of physicians that can be entrusted to provide the highest quality care in the safest manner. Pediatric educators are committed to the professional formation of pediatricians, while providing exemplary care for some of the most fragile and vulnerable children in our communities. All would agree that the development of physicians who are able to practice without direct supervision requires a critical balance of high vigilance and allowance of progressive responsibility.
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        • Kennedy T.J.T.
        • Lingard L.
        • Baker G.R.
        • et al.
        Clinical oversight: conceptualizing the relationship between supervision and safety.
        J Gen Int Med. 2007; 22: 1080-1085
        • Kennedy T.J.T.
        • Regehr G.
        • Baker G.R.
        • Lingard L.A.
        “Its a cultural expectation.” The pressure on medical trainees to work independently in clinical practice.
        Med Educ. 2009; 43: 645-653
        • Kennedy T.J.T.
        • Regehr G.
        • Baker G.R.
        • Lingard L.A.
        Progressive independence in clinical training: a tradition worth defending?.
        Acad Med. 2005; 80: S106-S111
        • Kennedy T.J.T.
        • Rehehr G.
        • Baker G.R.
        • Lingard L.
        Point-of-care assessment of medical trainee competence for independent clinical work.
        Acad Med. 2008; 83: S89-S92
      1. ACGME. Common Program Requirements: General Competencies 2007; Available at: Accessed June 1, 2010.

        • Stewart J.
        “Don’t hesitate to call”–the underlying assumptions.
        Clin Teach. 2007; 4: 6-9
        • Dreyfus H.L.
        • Dreyfus S.E.
        Five steps from novice to expert.
        in: Mind over Machine. The Free Press, New York, NY1986: 16-51
        • Ericsson K.A.
        • Prietula M.J.
        • Cokely E.T.
        The making of an expert.
        Harv Bus Rev. 2007; 85: 114-121
        • Ericsson K.A.
        Attaining excellence through deliberate practice: insights from the study of expert performance.
        in: Ferrari M.E. The Pursuit of Excellence through Education. Lawrence Erlbaum Associates, Mahwah, NJ2002
        • Lingard L.
        • Whyte S.
        • Espin S.
        • et al.
        Towards safer interprofessional communications: constructing a model of “utility” from preoperative team briefings.
        J Interprof Care. 2006; 20: 471-483
        • Burchard K.W.
        • Rowland-Morin P.A.
        • Coe N.P.
        • Garb J.L.
        A surgery oral examination: interrater agreement and the influence of rater characteristics.
        Acad Med. 1995; 70: 1044-1046
        • Guerin R.O.
        Disadvantages to using the oral examination.
        in: Mancall E.L. Bashook P.G. Assessing Clinical Reasoning: the Oral Examination of Medical Specialties. American Board of Medical Specialties, Evanston, IL1995: 41-48
        • Holden J.D.
        Hawthorne effects and research into professional practice.
        J Eval Clin Pract. 2001; 7: 65-70
        • Hicks P.J.
        • Schumacher D.J.
        • Benson B.J.
        • et al.
        The Pediatrics Milestones: conceptual framework, guiding principles, and approach to development.
        J Grad Med Educ. 2010; 2: 410-418
        • AAMC
        AAMC policy guidance on graduate medical education: assuring quality patient care and quality education.
        Acad Med. 2003; 78: 112-116