Healthy
Conditions
Keywords
Feasibility, Supervision, Assessing
Brief summary
OBJECTIVES: To develop, assess feasibility, and test the validity of the Resident Supervision Index (RSI), a survey tool for medical residents designed to measure quantitatively the level of supervision the resident received while caring for an outpatient during a patient care encounter. RESEARCH DESIGN: This is a prospective trial assessing the Residency Supervision Index (Index) applied to outpatient care encounters for content validity, test-retest reliability, and construct validity.
Detailed description
OBJECTIVES: To develop, assess feasibility, and test the validity of the Resident Supervision Index (RSI), a survey tool for medical residents designed to measure quantitatively the level of supervision the resident received while caring for an outpatient during a patient care encounter. RESEARCH DESIGN: This is a prospective trial assessing the Residency Supervision Index (Index) applied to outpatient care encounters for test-retest reliability and construct validity. METHODOLOGY: Trained interviewers administered the Index during face-to-face and in-clinic interviews with 60 consenting resident physicians and their 37 consenting attending physicians to descsribe the care they provided to 143 patients at the outpatient clinics involving 148 clinical encounters at the Loma Linda VA Medical Center. For each encounter, data comes from administering the Resident Supervision Index to the resident and attending. Baseline data describing each subject (attending physicians and resident physicians) came from face-to-face interviews. Test-retest reliability is assessed by re-administering the Index to residents for within 24 hours of the encounter. Concurrent validity is assessed by re-administering the Index to the attending physician responsible for the patient's care. CLINICAL RELATIONSHIPS: The study will help our understanding of how residents at VA medical centers receive training and are supervised for the purpose of both education and patient outcomes. IMPACT/SIGNIFICANCE: The instrument is planned for future studies to assess the association between resident supervision and training outcomes, clinical workload, patient outcomes, quality of care, and care costs.
Interventions
None listed
Sponsors
US Department of Veterans Affairs
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Males and females * Ages 18 and older
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Intraclass Correlation Coefficient Between Physician Resident and Attending Physician. | 24-hours | Describes agreement between physician resident and attending physician assessment of total resident supervision time for a given patient and patient care clinical encounter. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Intraclass Correlation Coefficient Assessing Test-retest Reliability for Resident Physicians | 24 hours | Assesses the test-retest reliability of repeated responses for resident physicians only to report the total time spent during resident supervision. |
| Intraclass Correlation Coefficient for Test-retest Reliability for Attending Physicians | 24 hours | Assesses the test-retest reliability among repeated responses to surveys administered to attending physicians only. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Physician Residents and Attending Physicians includes physician residents and attending physicians who were asked to sit through a face to face interview with a research assistant following a clinical encounter with a patient | 112 |
| Total | 112 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | not supervised, not eligible | 15 |
Baseline characteristics
| Characteristic | Physician Residents and Attending Physicians |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 0 Participants |
| Age, Categorical Between 18 and 65 years | 112 Participants |
| Sex: Female, Male Female | 40 Participants |
| Sex: Female, Male Male | 72 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 0 / 75 |
| serious Total, serious adverse events | 0 / 75 |
Outcome results
Primary
Intraclass Correlation Coefficient Between Physician Resident and Attending Physician.
Describes agreement between physician resident and attending physician assessment of total resident supervision time for a given patient and patient care clinical encounter.
Time frame: 24-hours
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Physician Residents and Attending Physicians | Intraclass Correlation Coefficient Between Physician Resident and Attending Physician. | .69 Intraclass Correlation Coefficient |
Secondary
Intraclass Correlation Coefficient Assessing Test-retest Reliability for Resident Physicians
Assesses the test-retest reliability of repeated responses for resident physicians only to report the total time spent during resident supervision.
Time frame: 24 hours
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Physician Residents and Attending Physicians | Intraclass Correlation Coefficient Assessing Test-retest Reliability for Resident Physicians | .93 Intraclass Correlation Coefficient |
Secondary
Intraclass Correlation Coefficient for Test-retest Reliability for Attending Physicians
Assesses the test-retest reliability among repeated responses to surveys administered to attending physicians only.
Time frame: 24 hours
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Physician Residents and Attending Physicians | Intraclass Correlation Coefficient for Test-retest Reliability for Attending Physicians | .88 Intraclass Correlation Coefficient |