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A Systematic Review: The Effect of Clinical Supervision on Patient and Residency Education Outcomes

Farnan, Jeanne M. MD, MHPE; Petty, Lindsey A. MD; Georgitis, Emily MD; Martin, Shannon MD; Chiu, Emily; Prochaska, Meryl; Arora, Vineet M. MD, MAPP

doi: 10.1097/ACM.0b013e31824822cc
Graduate Medical Education

Purpose To summarize the literature regarding the effect of clinical supervision on patient and educational outcomes, especially in light of the recent (2010) Accreditation Council for Graduate Medical Education report that recommends augmented supervision to improve resident education and patient safety.

Method The authors searched the English-language literature from 1966 to 2010 using electronic databases and a hand search. They included studies that described a controlled design, and they have relayed the effects of supervision on patient- and education-related outcomes. Two authors abstracted prescribed data from the reviewed studies. The authors rated the quality of each study using the Medical Education Research Study Quality Instrument.

Results Twenty-four articles across a variety of specialties (i.e., psychiatry, emergency medicine, surgery, anesthesia, and internal medicine) met inclusion criteria. Studies demonstrated that enhanced supervision in already-supervised activities resulted in improved patient- or education-related outcomes. Studies were limited by small sample sizes, nonrandomized designs, and a lack of objective measures of clinical supervision.

Conclusions Enhanced clinical supervision of trainees has been associated with improved patient- and education-related outcomes in published studies. Future work should focus on developing validated measures of the effects of clinical supervision.

Dr. Farnan is assistant professor, Department of Medicine, Pritzker School of Medicine, University of Chicago, Chicago, Illinois.

Dr. Petty is a third-year internal medicine and pediatrics resident, Department of Medicine, Pritzker School of Medicine, University of Chicago, Chicago, Illinois.

Dr. Georgitis was, at the time of this research, a resident, Department of Medicine, Pritzker School of Medicine, University of Chicago, Chicago, Illinois, and is now a fellow, Pulmonary and Critical Care, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Dr. Martin is a fellow in hospital medicine, Department of Medicine, Pritzker School of Medicine, University of Chicago, Chicago, Illinois.

Ms. Chiu is an undergraduate student studying economics, University of Michigan, Ann Arbor, Michigan.

Ms. Prochaska is project manager, Department of Medicine, Pritzker School of Medicine, University of Chicago, Chicago, Illinois.

Dr. Arora is associate professor, Department of Medicine, Pritzker School of Medicine, University of Chicago, Chicago, Illinois.

Please see the end of this article for information about the authors.

Correspondence should be addressed to Dr. Farnan, 5841 S. Maryland Ave., MC 2007, AMB W216, Chicago, IL 60637; telephone: (773) 834-8904; fax: (773) 834-2238; e-mail: farnan@medicine.bsd.uchicago.edu.

First published online February 22, 2012

© 2012 Association of American Medical Colleges