Policy on Clinical Supervision

The Zucker School of Medicine is committed to patient care, patient and student safety, and to the medical education of students; therefore, students must be appropriately supervised when participating in clinical activities.

Supervisors must either hold a faculty appointment and be credentialed at the clinical site where supervision is occurring, or be supervised in their teaching and assessment role by a credentialed individual who has a faculty appointment. Such individuals may include physicians, residents, fellows, and other licensed health professionals supervising an activity within their scope of expertise or practice.

Supervisors with faculty appointments who delegate supervision to residents, fellows, and other licensed health professionals are responsible for ensuring that these delegates are appropriately credentialed by the hospital and capable of medical student supervision within the scope of their practice as delineated by the credentialing body at the clinical site. Delegation of supervision does not waive the supervising physician's responsibility for the student.

All faculty members, residents, and fellows, and allied health professionals involved in teaching/assessment of medical students are required to review and sign-off on this clinical supervision policy via the Educator's Pledge or its equivalent.

Students may be supervised at one of two broad levels as determined by the supervisor:

  1. Direct observation: the supervisor is present with the student and the patient
  2. Immediately Available Indirect Supervision: the supervisor or a delegate, while not in the presence of the student and/or patient, is immediately available to the learner and at the site of care to provide direct supervision

Determination of the appropriate level of supervision is made by the supervisor, based on many factors, including:

  1. Level of training of the student;
  2. Previous experience and skill of the student with the clinical activity and setting;
  3. Familiarity of the supervisor with the abilities of the student; and
  4. Acuity of activity and level of risk to patient.

The supervisor is responsible for assigning progressive responsibility to each student, according to the factors listed above. Students may not perform procedures without direct supervision.

The supervisor or delegate reviews and independently verifies all student findings, assessments, and care plans, and documents this review.

The course/clerkship ("course") director is responsible for communicating policies and procedures related to supervision to all supervisors and potential delegates participating in the course, and for monitoring compliance with the policies and procedures.

The course director is responsible for developing and communicating standard procedures through which students can report concerns regarding adequate and appropriate supervision of what they may deem a violation of this policy. Procedures may include but are not limited to reporting mistreatment or negative learning environment, direct reporting to a course director, coordinator, or other school officials, and documenting concerns in course evaluations at the end of the course.