A Graduated Responsibility Supervising Resident Experience Using Mastery Learning Principles

This article was migrated. The article was marked as recommended. Introduction: Supervising other residents and independently running an emergency department (ED) is different from anything residents are asked to do in their early years of residency. There is often little training for this new responsibility. We created a new supervising experience that allows residents to progressively master skills associated with independently running an ED. Methods: We created an experience where PGY-3 residents supervised at our community site, removing the difficulties associated with an academic site such as junior residents and multiple consultants but requiring them to perform all other duties expected of the attending. Residents were scheduled in blocks of 4 shifts to allow them to iteratively improve their performance. Mastery was defined as 23 of 24 points across two shift evaluations, with 3 points available across 4 domains of Organization, Leadership/Communication, Flow and Patient Care. Residents who achieved this standard were allowed to progress to a more advanced supervising experience. Results: Eighty three percent of PGY-3 residents (10/12) achieved the mastery standard by the end of the year. Residents scored highest in Leadership/Communication (2.67 out of 3). They scored lowest on Flow (2.41 out of 3). Ninety percent of residents felt that the experience prepared them for being an attending. Discussion: A mastery learning-based supervising experience successfully allows residents to progressively acquire skills associated with running a busy ED. We plan to continue to evaluate the effectiveness of this intervention by examining the number of residents meeting the mastery standard as well as feedback from residents and faculty.