Resident Supervision Index: Assessing Feasibility and Validity

Study Overview
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Brief Summary
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OBJECTIVES: To develop, assess feasibility, and test the validity of the Resident Supervision Index (RSI), a survey tool for medical residents designed to measure quantitatively the level of supervision the resident received while caring for an outpatient during a patient care encounter. RESEARCH DESIGN: This is a prospective trial assessing the Residency Supervision Index (Index) applied to outpatient care encounters for content validity, test-retest reliability, and construct validity.

Detailed Description
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OBJECTIVES: To develop, assess feasibility, and test the validity of the Resident Supervision Index (RSI), a survey tool for medical residents designed to measure quantitatively the level of supervision the resident received while caring for an outpatient during a patient care encounter. RESEARCH DESIGN: This is a prospective trial assessing the Residency Supervision Index (Index) applied to outpatient care encounters for test-retest reliability and construct validity. METHODOLOGY: Trained interviewers administered the Index during face-to-face and in-clinic interviews with 60 consenting resident physicians and their 37 consenting attending physicians to descsribe the care they provided to 143 patients at the outpatient clinics involving 148 clinical encounters at the Loma Linda VA Medical Center. For each encounter, data comes from administering the Resident Supervision Index to the resident and attending. Baseline data describing each subject (attending physicians and resident physicians) came from face-to-face interviews. Test-retest reliability is assessed by re-administering the Index to residents for within 24 hours of the encounter. Concurrent validity is assessed by re-administering the Index to the attending physician responsible for the patient's care. CLINICAL RELATIONSHIPS: The study will help our understanding of how residents at VA medical centers receive training and are supervised for the purpose of both education and patient outcomes. IMPACT/SIGNIFICANCE: The instrument is planned for future studies to assess the association between resident supervision and training outcomes, clinical workload, patient outcomes, quality of care, and care costs.

Official Title
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Resident Supervision Index: Assessing Feasibility and Validity

Conditions
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Healthy

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Males and females Ages 18 and older Exclusion Criteria: None

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Residents and Attending Physicians<br>This group contains the residents and the attending physicians who consented to participate in the study. They participated in a survey administered by a research assistant. Both physician resident and attending physicians were administered the survey twice within 24-hours and their test-retest responses were compared for reliability. Responses to attending and resident physicians covering the care for the patient and clinical care encounter were compared for accuracy. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intraclass Correlation Coefficient Between Physician Resident and Attending Physician. | Describes agreement between physician resident and attending physician assessment of total resident supervision time for a given patient and patient care clinical encounter. | 24-hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intraclass Correlation Coefficient Assessing Test-retest Reliability for Resident Physicians | Assesses the test-retest reliability of repeated responses for resident physicians only to report the total time spent during resident supervision. | 24 hours | 
| Intraclass Correlation Coefficient for Test-retest Reliability for Attending Physicians | Assesses the test-retest reliability among repeated responses to surveys administered to attending physicians only. | 24 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Feasibility, Supervision, Assessing