OpenAnesthesia Multimedia Procedural Supervision -- Pediatric Anesthesiology Internet-Based Non-Technical Skills (PAINTS)
Mar 23, 2026
Zoe Brown, a third-year anesthesiology resident at UT Health Houston, gives a concise primer on procedural supervision and ACGME supervision levels. She walks through graded authority, when attendings should step in during central lines and pediatric airways, and practical decision points for adjusting oversight based on learner and patient risk.
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Supervision Shapes Clinical Judgment
- Supervision blends clinical oversight with mentorship to shape resident judgment and professionalism.
- Zoe Brown emphasizes that attendings' guidance and example profoundly influence how residents learn to manage complex care.
Follow ACGME Levels And Immediate Availability
- Use ACGME-defined supervision levels and ensure attendings remain responsible for patient care while granting graded autonomy.
- Zoe notes 'immediately available' means physically close enough to reestablish contact for urgent needs per the ASA.
Progressive Supervision For Central Line Placement
- Tailor supervision for central line placement by trainee level: CA1 direct presence, intermediate direct for critical steps, senior indirect with immediate availability.
- Zoe outlines specific attending actions: confirm indication, review ultrasound, coach sterile technique, and be ready to take over.