Supervision and Progressive Responsibility


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 the patient, family, and Team
  4. Demonstrated reasonable data gathering, analysis and plan formulation
  5. Detailed, effective, timely medical notes

Pre-test/Self-reflection/Discussion (e.g., PGY4s): 

  • When is it important to call the attending PC? 
  • What resources are available to me to learn independently about direct patient care and management on-line and in “real-time”? 
  • 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 the use of electronic devices 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)


  • 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 an 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 the fellow for any issues/concerns


  • Evaluations by self, peers, faculty, nursing/staff (360evaluation)
  • Family satisfaction form the Program Director (PD) reviews evaluations for advancing responsibility throughout the year
  • Monthly PC Division meetings include Fellowship Program discussion(s) and performance of PC Fellows/compliance (i.e., Duty Hours reporting)