On-Call Supervision and Resident Autonomy: From Micromanager to Absentee Attending

In addition to preventing resident fatigue, providing adequate supervision is a fundamental aspect of ensuring safe patient care in teaching hospitals. Attending physicians in a supervisory capacity may be held accountable for patient outcomes; an on-call capacity may be sufficient to establish a patient-physician relationship and duty to supervise. Given that they employ physicians-in-training for clinical care, sponsoring hospitals may be held vicariously liable for adverse outcomes caused by residents acting in accordance with their job description. Here, Farnan et al describe clinical supervision preferences for attending physicians and residents during times of critical clinical decision-making, specifically during the on-call period; identify clinical scenarios that residents and attending physicians perceive as those requiring supervision; and provide physician-in-training descriptions of the attributes of effective clinical supervisors.