79. RESIDENT AUTONOMY: ARE ATTENDINGS AROUND TOO MUCH?

Background According to guidelines from the ACGME, residents must demonstrate progressive autonomy over the course of training that affords them the ability to act in a supervisory role under faculty guidance in preparation for independent practice. As adult learning theory supports, autonomy within a supportive climate can have a significant impact in motivating learners to expand their knowledge base and practice methods. We created a needs assessment survey to help obtain information regarding the current opinions surrounding autonomy within our own residency program. Objective We sought to determine residents’ perception of autonomy during their pediatric residency training with a secondary objective of preliminary assessment for an attending-less rounding experience to address autonomy and supervisory elements within the residency curriculum. Methods In 2018, graduating PGY3 Pediatric residents and PGY4 combined Internal Medicine/Pediatric residents were electronically sent an anonymous novel survey. The questions focused on overall level of supervision as well as how valuable they would find rounding without an attending in terms of building their own autonomy. Numerical responses were collected for statistical interpretation. Results We obtained surveys from 33/36 graduating residents within their final month of residency training. Respondents reported a mean value of 72/100 (Scale: 0/100 = significantly unsupervised, 50/100 adequately supervised, 100/100 significantly over-supervised) when asked about their level of supervision on pediatric services. This cohort also reported a mean value of 82.42/100 and 83.27/100 when asked how valuable and how enjoyable, respectively, attending-less rounding on our Hospitalist service would be for resident autonomy. Conclusions Clinical settings within pediatric residency training programs can find it hard to balance autonomy given the extrinsic forces that are present. However, our residents demonstrate a perception of being over-supervised and support creating space for greater decision-making responsibilities and increased autonomy through revised inpatient service structure.