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The Pediatric Forum |

Senior Resident Autonomy in a Pediatric Hospitalist System

Christopher P. Landrigan, MD, MPH; Sharon Muret-Wagstaff, PhD; Vincent W. Chiang, MD; Daniel J. Nigrin, MD, MS; Donald A. Goldmann, MD; Jonathan A. Finkelstein, MD, MPH
Arch Pediatr Adolesc Med. 2003;157(2):206-207. doi:10.1001/archpedi.157.2.206-a.
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We wish to respond to an editorial by Drs Kemper and Freed1 that accompanied our study2 of hospitalists and housestaff education in the September issue of the ARCHIVES. In this study, we found that hospitalists were rated higher as educators than traditional attending physicians, and that the introduction of a hospitalist system was associated with improved intern experience, skills, knowledge, and quality of life. Senior resident experience remained unchanged overall, but we observed nonsignificant decreases in senior resident reports of their decision-making abilities and autonomy. On the basis of these decreases, Drs Kemper and Freed expressed concern that improvements for interns in hospitalist systems might come at the price of a "loss of senior resident autonomy" and independent decision-making skills for senior residents.

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Figure 1.

Postgraduate year 3 senior residents' satisfaction with overall educational experience and autonomy on general pediatrics wards.

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Figure 2.

Skills and knowledge learned in the residency program as assessed by postgraduate year 3 senior residents.

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