Supervision and Progressive Responsibility

Level  / Action Pediatric Wards, Pediatric Intensive Care Unit (PICU), Emergency Department (ED), Continuity Care Clinic (CCC), and Neonatal Intensive Care Unit (NICU)
Preparation Orientation by Pediatric Cardiology Faculty Review – UF Pediatric Cardiology (PC) Goals & Objectives Orientation by senior Pediatric Cardiology Fellow:  Overlap duties the first week as senior PC Fellow works alongside junior PC Fellow

Expected objectives:  (1)  Safe, efficient, effective sign-out ; (2) Appropriate requests for supervision/assistance (direct, via phone); (3) Professional communication with patient, family, and Team; (4) Demonstrated reasonable data gathering, analysis and plan formulation; and (5) Detailed, effective, timely medical notes.

Pre-test/Self-reflection/Discussion (e.g., PGY4s):  (1) When is it important to call the attending PC?  (2) What resources are available to me to learn independently about direct patient care and management on-line and in “real-time”?  (3) What are the ways “I” can request and receive feedback from my attending?

Direct Supervision (DS) DS by attending 8:00 a.m.-5 p.m. weekdays and 8 a.m. – 4 p.m. on weekends DS by attending for all procedures
Indirect Supervision + DS
Immediately Available
For all fellows – attending is  immediately available  24 hours daily, if indicated (i.e. emergency procedures) and for indirect supervision with use of electronic device also.
Indirect Supervision + DS available DS available at all other times by attending, DS also available by physician extenders/nursing staff particularly during procedures (supervisor’s discretion, fellow’s request)
Oversight Review notes, encounters, procedures, performance on rounds – provide formative feedback daily (procedures) and monthly
Structure clinical observation (SCO) – both inpatient and outpatient setting as well as procedures
Submit evaluation of those – specifically communication, performance in urgent/ emergent situations, participation on the team, professionalism, analysis and decision making
Ongoing review during rotation with direct communication by faculty to fellow and PD for any issues /concerns
Ongoing review with nursing staff, PA/ARNP, office staff with direct communication by faculty to fellow for any issues/concerns
Evaluation Evaluations by self, peers, faculty, nursing/staff (360evaluation)
Family satisfaction form
Program Director (PD) reviews evaluations for advancing responsibility throughout year
Monthly PC Division meetings include Fellowship Program discussion(s) and performance of PC Fellows/compliance (i.e., Duty Hours reporting).