Attendings Vary In Their Supervisory Role – A Lot

ATTENDINGS  This will not be news for our trainees.  Twenty-four internal medicine inpatient teaching service attendings were given a sample student presentation and interviewed regarding their supervisory style.  Different styles were characterized by “the relative prioritization of three competing activities – patient care, trainee supervision, and teaching.”  Two styles were at ends of the spectrum: the direct care style and the minimalist style.  In the direct care style, attendings provided direct patient care either in parallel with the trainee efforts (“I just do everything on my own”) or during many hours of rounding together.  In the minimalist style, attendings “relied heavily on the senior medical resident’s ability to run the team and provide teaching” (“I have been burned before”).  More attendings described an empowerment style or a mixed practice style, both of which involved greater trainee teaching and oversight.  Attendings “largely maintained their style affinity regardless of trainee ability and patient load,” and few had discussed their styles with trainees or other attendings — Laura Willett, MD.

Goldszmidt M Faden L, Dornan T, van Merriënboer J, Bordage G, Lingard L. Attending Physician Variability: A Model of Four Supervisory Styles. Acad Med. 2015 Apr.

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