SUPERVISION IN THE OUTPATIENT-CLINIC - EFFECTS ON TEACHING AND PATIENT-CARE

Two levels of faculty supervision in a resident teaching clinic were c ompared. Attending physicians recorded their impressions of diagnoses, treatment, severity of illness, and resident performance from case pr esentation alone and again after personally evaluating the patient. Af ter direct evaluation, the attendings judged patients to be more serio usly ill and rated resident performance lower. Changes in diagnosis an d management were frequent. The attendings considered seeing the patie nt in person valuable for teaching in 18% of the cases, and for manage ment in 27% of the cases. Faculty-patient interaction doubled supervis ory time. Outpatient teaching and patient management are significantly affected when faculty see patients in person.