195 - Successful “Senioring:” Intern Perspectives on Characteristics and Behaviors of Effective Supervisory Residents

Publication Number: 195.6844

Emily A. Lang, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Anna Weiss, Children's Hospital of Philadelphia/Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States; Pamela Fazzio, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States

Background: The supervisory role of senior residents entails teaching and supervising junior residents (interns). Despite the close working relationship between these groups, most literature describing the senior resident role fails to incorporate residents’ perspectives on what defines a successful senior resident.

Objective: We sought to 1) identify the characteristics and behaviors that interns associate with effective senioring, and 2) explore how interns’ perceptions of senior resident characteristics change over time.

Design/Methods: Based on our prior narrative review of the senior resident role, we developed and administered an anonymous electronic survey to two classes of pediatric residents: one in the final month of intern year and another in their fourth month of internship. Participants used a Likert scale (1-5) to rate the importance of each senior resident characteristic, then ranked the five characteristics they deemed most important for a senior resident’s efficacy. We used Mann-Whitney U and Pearson’s chi squared tests to identify differences between groups.

Results: Twenty-five interns from each class completed the survey. Early interns rated the following senior resident characteristics and behaviors most highly: being approachable, supporting emotions, cultivating a positive attitude, and clearly communicating. End-of-year interns emphasized the importance of expressing respect for team members, being approachable, allowing interns to present their own plans, and facilitating attendance at teaching sessions. Both groups ranked responsibility for patient care, clearly communicating, cultivating a positive attitude, and allowing interns to present their own plans as the most important characteristics for senior residents. Early interns also ranked emotional support as an important aspect of senioring, while end-of-year interns emphasized the importance of helping with tasks. The two classes had differing perspectives on the importance of facilitating attendance at teaching sessions, helping with tasks, identifying the thought processes behind clinical decisions, handling conflicts effectively, and stating expectations (all p values < 0.05).

Conclusion(s): Interns value senior residents who are approachable, cultivate positive team attitudes, maintain clear communication, and enable them to present their plans. While early interns place higher value on emotional support, more established interns appreciate help with task completion and prioritizing attendance at teaching sessions. Future “senioring” curricula may incorporate these perspectives when guiding senior residents on their roles.

Figure 1. Means of senior resident characteristics by group.
PAS Figures_JPEG.001.jpegThe average score and standard error for each item on the Likert scaled portion of the survey is depicted by group. Statistically significant differences are denoted by two asterixis. End-of-year interns’ scores are drawn in pink and early interns’ scores are shown in blue.

Figure 2. Ranking of senior resident characteristics.
PAS Figures_JPEG.002.jpegThe total number of times that an item was ranked as one of five most important characteristics for senior resident efficacy is depicted by group. Statistically significant differences between groups are denoted by two asterixis. End of year interns’ rankings are drawn in pink and early interns’ rankings are shown in blue.