The "Key" or "Critical" Portions of an Operation: Understanding Attending Supervision and Resident Autonomy From a Legal Perspective.
| Title: | The "Key" or "Critical" Portions of an Operation: Understanding Attending Supervision and Resident Autonomy From a Legal Perspective. |
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| Authors: | Williams AM; Department of Surgery, University of Michigan, Ann Arbor, Michigan.; Chang EL; Department of Surgery, University of Michigan, Ann Arbor, Michigan.; Boothman R; Department of Surgery, University of Michigan, Ann Arbor, Michigan; Risk Management and Clinical Affairs, University of Michigan, Ann Arbor, Michigan.; Thompson-Burdine JA; Department of Surgery, University of Michigan, Ann Arbor, Michigan.; Minter RM; Department of Surgery, University of Wisconsin, Madison, Wisconsin.; Sandhu G; Department of Surgery, University of Michigan, Ann Arbor, Michigan. Electronic address: gurjit@med.umich.edu. |
| Source: | Journal of surgical education [J Surg Educ] 2020 Jul - Aug; Vol. 77 (4), pp. 931-938. Date of Electronic Publication: 2020 Mar 12. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Elsevier Country of Publication: United States NLM ID: 101303204 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-7452 (Electronic) Linking ISSN: 18787452 NLM ISO Abbreviation: J Surg Educ Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: New York, N.Y. : Elsevier |
| MeSH Terms: | Internship and Residency*; Clinical Competence ; Humans ; Professional Autonomy ; Surveys and Questionnaires ; Trust ; United States |
| Abstract: | Objective: To obtain a legal understanding of the "key" or "critical" portions of an operation, pertaining to attending supervision, resident autonomy, and patient safety.; Design: Snowball sampling, a subset of purposive sampling, was used to develop a population of 47 risk managers and legal counsel, who were given an online, qualitative questionnaire. Interpretive description was used to analyze qualitative data. Individual responses were coded with simultaneous categorization and assessment of underlying relationships.; Setting: Online, qualitative questionnaire.; Participants: Hospital risk managers and legal counsel from across the United States.; Results: Overall, 25 of 47 (53%) risk managers completed the survey. Qualitative responses could be organized into 3 major themes (1) variation in the definition of "key" or "critical" portions of an operation, (2) differing expectations of attending supervision and resident autonomy, and (3) the need for clear communication and trust among attendings, residents, and patients.; Conclusions: Among risk managers, the primary liaisons between surgeons and patients in malpractice litigation, there is widespread variation in understanding the "key" and "critical" portions of an operation and the dynamic between appropriate attending supervision and resident autonomy. Better collaboration and transparency between surgeons and legal experts are required to facilitate a shared mental model regarding attending supervision and resident autonomy.; (Copyright © 2020 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.) |
| Contributed Indexing: | Keywords: Interpersonal and Communication Skills; Practice-Based Learning and Improvement; Systems-Based Practice; autonomy; critical portion; key portion; medico-legal; resident training; surgery |
| Entry Date(s): | Date Created: 20200317 Date Completed: 20210621 Latest Revision: 20210621 |
| Update Code: | 20260130 |
| DOI: | 10.1016/j.jsurg.2020.02.022 |
| PMID: | 32173294 |
| Database: | MEDLINE |
Journal Article