A Comparison of Resident Self-Perception and Pediatric Hospitalist Perceptions of the Supervisory Needs of New Interns

Abstract

Objectives: The Association of American Medical Colleges published a list of entrustable professional activities (EPAs) that graduating medical students should be able to perform on day 1 of residency without direct supervision. We sought to explore the perceptions of residents and pediatric hospitalists about the level of supervision new interns need in conducting these EPAs.

Methods: An electronic survey was sent to pediatric hospitalists who supervise interns in a large pediatric residency program in which they were asked to rate the amount of supervision they perceive new interns need when performing 11 EPAs. Another survey was sent to residents in which they were asked how much supervision they needed at the beginning of their intern year when performing the same EPAs. Hospitalist and resident responses were compared.

Results: The majority of hospitalists thought new interns could perform only 5 of the 11 EPAs without direct supervision. For 5 of the EPAs, residents' perceptions of their own abilities to perform the EPA independently as interns were significantly greater than the hospitalists' perceptions of interns' abilities. For example, 91% of residents thought they were able to recommend and interpret common diagnostic and screening tests when they were interns without direct supervision, compared with only 30% of attending physicians (P < .001).

Conclusions: Hospitalists and residents in a pediatric residency training program reported that new interns were not consistently able to perform the Association of American Medical Colleges' core EPAs without supervision. Furthermore, residents and pediatric hospitalists perceived new interns' abilities to perform the EPAs without direct supervision significantly differently.