Abstract Rationale Autonomy is a critical aspect of medical education. Experiencing sufficient autonomy positively impacts residents as caregivers and learners, while lack of autonomy can lead to stress and burnout. Attending physicians play a significant role in fostering resident autonomy. However, balancing autonomy with adequate supervision is essential to ensure patient safety and effective learning. The objective of this study was to assess perceptions of resident autonomy in the Crouse ICU. Gaining a better understanding of residents’ perceptions of autonomy will provide grounds for future improvements in training and education. Methods A series of qualitative and quantitative survey questions created by researchers was distributed to residents following their first week rotating in the ICU between May 2025 - October 2025. Subjects included PGY-1 prelim year, PGY-1 categorical internal medicine (IM), PGY-1 categorical emergency medicine (EM), PGY-2 IM, PGY-2 EM, and PGY-3 IM residents. Night float residents were excluded as coverage is distinct with a different support model. Responses remained anonymous. Data was collected and analyzed using SurveyMonkey. Results 30 residents completed the survey. Subgroups comprised of 12 PGY-1s, 5 PGY-2s, and 13 PGY-3s. On a scale of no autonomy to full autonomy, the majority of respondents preferred moderate autonomy across all residency years, with 66.7% of PGY1s, 80.0% of PGY2s, and 53.9% of PGY3s favoring this level. By PGY3, however, 46.2% preferred high autonomy. Across clinical activities, PGY1 residents most often preferred moderate autonomy, particularly during rounds (66.7%) and codes (75.0%). By PGY2, preferences shifted toward greater autonomy, with 60-80% reporting moderate autonomy and up to 60% selecting high autonomy for pre-rounding and procedural tasks. Among PGY3 residents, nearly all desired moderate to high autonomy across domains, most notably in ongoing patient management (61.5% high autonomy) and consulting other services (38.5% high, 61.5% moderate). Across all training years, most residents reported being mostly or always satisfied with how attendings incorporated their input into clinical decision-making. Among PGY1s, 50.0% were mostly satisfied and 8.3% were always satisfied, while PGY2s showed even higher satisfaction, with 40.0% mostly satisfied and 40.0% always satisfied. By PGY3, satisfaction remained high, with 53.9% mostly satisfied and 15.4% always satisfied. Conclusions Resident autonomy and satisfaction with supervision increased across training years. PGY1s preferred structured guidance, while PGY2s and PGY3s sought greater independence, reflecting readiness for practice. Overall, residents reported high satisfaction with attending engagement, indicating a supportive environment that effectively balances supervision with progressive responsibility and clinical autonomy. This abstract is funded by: None
Davis et al. (Fri,) studied this question.