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Mieczkowski AE, Gonzaga AMR, Kraemer K, et al. Perceptions of Resident Autonomy in Internal Medicine, Pediatrics, and Internal Medicine-Pediatrics. Cureus. 2021;13(3):e13805doi: 10.7759/cureus.13805.
Mieczkowski, A. E., Gonzaga, A. M. R., Kraemer, K., Habicht, R., Friedland, A. R., Rubio, D., & Van Deusen, R. (2021). Perceptions of Resident Autonomy in Internal Medicine, Pediatrics, and Internal Medicine-Pediatrics. Cureus, 13(3), e13805. https://doi.org/10.7759/cureus.13805
Mieczkowski, Alexandra E, et al. "Perceptions of Resident Autonomy in Internal Medicine, Pediatrics, and Internal Medicine-Pediatrics." Cureus vol. 13,3 (2021): e13805. doi: https://doi.org/10.7759/cureus.13805
Mieczkowski AE, Gonzaga AMR, Kraemer K, Habicht R, Friedland AR, Rubio D, Van Deusen R. Perceptions of Resident Autonomy in Internal Medicine, Pediatrics, and Internal Medicine-Pediatrics. Cureus. 2021 Mar 10;13(3):e13805. doi: 10.7759/cureus.13805. PMID: 33842175; PMCID: PMC8027953.
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Cureus. 2021 Mar 10;13(3):e13805. doi: 10.7759/cureus.13805.

Perceptions of Resident Autonomy in Internal Medicine, Pediatrics, and Internal Medicine-Pediatrics.

Cureus

Alexandra E Mieczkowski, Alda Maria R Gonzaga, Kevin Kraemer, Robert Habicht, Allen R Friedland, Doris Rubio, Reed Van Deusen

Affiliations

  1. Division of General Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, USA.
  2. Division of General Academic Pediatrics, University of Pittsburgh Medical Center, Pittsburgh, USA.
  3. Department of Medicine, University of Maryland Medical Center, Baltimore, USA.
  4. Department of Pediatrics, University of Maryland Medical Center, Baltimore, USA.
  5. Department of Medicine-Pediatrics, ChristianaCare, Newark, USA.
  6. Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, USA.

PMID: 33842175 PMCID: PMC8027953 DOI: 10.7759/cureus.13805

Abstract

BACKGROUND: Although graduated autonomy is an essential component of residency training, we have an incomplete understanding of resident and attending faculty perceptions of autonomy.

OBJECTIVE: In this study, we assessed differences in perceived autonomy among residents and faculty in pediatrics, internal medicine, and combined internal medicine-pediatrics.

METHODS: We surveyed senior-level (PGY-2-5) residents and faculty in pediatrics, internal medicine, and combined internal medicine-pediatrics in three large, urban training centers in November 2014. The survey included domain items such as general perceptions of autonomy, case management, rounding structure, and individual resident and faculty factors that may interplay with the granting or receiving of autonomy.

RESULTS: Of 489 eligible respondents, 215 (44%) responded. Internal medicine-pediatrics residents were more likely than categorical pediatrics residents and pediatrics faculty to disagree that they received an appropriate level of autonomy while on inpatient pediatrics general wards (mean = 2.7 relative to 4.0 and 4.3, categorical residents and faculty; 5-point Likert scale; P < .001). On a 5-point Likert scale, the internal medicine-pediatrics residents were more likely to agree that they received too much oversight on pediatrics general ward rotations (mean, 3.9) compared to internal medicine general ward rotations (mean, 1.9) with a

CONCLUSIONS: Internal medicine-pediatrics residents have differing perceptions of autonomy from their categorical peers as well as categorical supervising faculty. Combined Internal medicine-pediatrics residents' perceived oversight on pediatrics rotations differently from their categorical pediatrics peers and also differently from their experiences on internal medicine wards. A better understanding of combined internal medicine-pediatrics residents' perceptions of autonomy and supervision can help inform future work regarding autonomy-supportive strategies to optimize learning.

Copyright © 2021, Mieczkowski et al.

Keywords: autonomy; im-peds; inpatient; internal medicine; med-peds; pediatrics; resident; trainee

Conflict of interest statement

The authors have declared that no competing interests exist.

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