Supervising New PGY-1 Residents: Faculty Expectations vs. Residents’ Perceptions - A Case Study
Bibliographic record
Abstract
BACKGROUND: Postgraduate year-1 residents (PGY-1s) begin clinical practice in a setting where attending staff and senior residents are available to supervise their work. There is an expectation that, while being supervised and as they become more experienced, the PGY-1s will gradually take on more responsibilities and function independently.\nOBJECTIVE: To determine the degree of agreement between the level of supervision expected by clinical supervisors (CSs) and the level of supervision reported by PGY-1s.\nMETHODS: Using a nominal group technique, subject matter experts (SMEs) from multiple specialties defined “entrustable professional activities” (EPAs) for PGY-1s, that is, a set of activities to be performed independently by PGY-1s by the end of their first year of residency, regardless of specialty. We then surveyed and compared CSs and PGY-1s from one institution regarding levels of supervision expected and received during the daytime and nighttime for each EPA. \nRESULTS: The SMEs defined 10 EPAs (e.g., completing admission orders, obtaining informed consent), ratified by a national panel, and 113 CSs and 48 PGY-1s completed the survey. CSs had the same expectations regardless of the time of day. For three EPAs (managing intravenous fluids, obtaining informed consent, and obtaining advanced directives) the level of supervision reported by PGY-1s was lower than what CSs expected (p<0.001) regardless of the time of day (i.e., day versus night). For four more EPAs (initiating the management of critically ill patients, handing over the care of patients to colleagues, writing discharge prescriptions, and coordinating a patient discharge) the differences only occurred during nighttime work (p0.001). \nCONCLUSION: PGY-1s reported performing EPAs with less supervision than expected by CSs, especially during nighttime work. Using EPAs to guide the content of the undergraduate curriculum and during examinations could help better align CSs’ and PGY-1s’ expectations about early residency supervision.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".