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Safety steps: A framework for promoting safe trainee autonomy in clinical emergencies.
Kathryn Grace Kompa1, Janet Monroe2, Virginia Brady2
1Massachusetts General Hospital, Boston, Massachusetts, USA.
Journal of Hospital Medicine
|June 24, 2026
Summary
Hospitalists face challenges balancing trainee autonomy and patient safety during emergencies. This article offers a framework to improve early career trainee learning and independence in urgent medical situations.
Area of Science:
- Medical Education
- Patient Safety
- Clinical Emergency Management
Background:
- Hospitalists grapple with empowering trainees during critical events while ensuring patient well-being.
- Clinical emergencies like hypotension and hypoxic respiratory failure demand swift, confident action from medical teams.
Purpose of the Study:
- To propose a framework for managing clinical emergencies that supports trainee development.
- To enhance early career hospitalist trainee learning, confidence, and independence.
- To foster a learning environment prioritizing both patient safety and trainee growth.
Main Methods:
- The study proposes a conceptual framework for urgent medical situations.
- Strategies focus on creating a supportive learning environment during emergencies.
- The framework aims to balance trainee autonomy with patient safety.
Main Results:
- Implementation of the framework is expected to improve trainee skills in high-stakes scenarios.
- The proposed strategies are designed to build trainee confidence and independence.
- A balanced approach can lead to better outcomes in clinical emergencies.
Conclusions:
- A structured framework can effectively address the challenge of trainee autonomy during emergencies.
- Prioritizing a supportive learning environment is key to enhancing trainee performance and safety.
- This approach promotes professional growth for early career hospitalists in critical care settings.
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