When do supervising physicians decide to entrust residents with unsupervised tasks?

Area of Science:

• Medical Education
• Anesthesiology Training

Background:

• Patient care responsibilities enhance resident learning but may risk patient safety.
• Understanding factors influencing supervisor trust in residents is crucial for safe training.

Purpose of the Study:

• To investigate factors guiding clinical supervisors' decisions to entrust residents with critical patient-care tasks.
• To explore differences in perceptions between attending and resident anesthetists regarding entrustment.

Main Methods:

• Mixed-methods descriptive study at University Medical Center Utrecht.
• Surveys and structured interviews with attending and resident anesthetists.
• Utilized trigger case vignettes to elicit opinions on entrustment factors.

Main Results:

• Attending opinions on resident independence varied, especially for postgraduate years 2-4.
• PGY1 residents perceived themselves as competent, while PGY5 residents felt underutilized.
• Entrustment factors were categorized into resident, attending, clinical context, and task characteristics.

Conclusions:

• Significant discrepancies exist between residents' and attendings' expectations and self-assessments.
• Identified key factors influencing supervisor trust and resident autonomy.
• Recommended future research on entrustment drivers, patient outcomes, and justification tools.