Faculty mentor/PI email address
jim010@aol.com
Is your research Teaching and Learning based?
1
Keywords
Transition to practice; graduate medical education; autonomy; professional identity; uncertainty tolerance; milestones
Date of Presentation
5-6-2026 12:00 AM
Poster Abstract
Background: The transition from residency to independent attending practice represents a critical developmental inflection point. Although residents achieve competency-based milestones, many graduates report challenges related to decision ownership, uncertainty tolerance, and the assumption of final clinical authority. Traditional training emphasizes competence under supervision, while independent practice requires performance without supervision. Objective: To propose a conceptual framework that supports the transition from supervised training to independent clinical practice, aligned with ACGME Milestones. Methods: Conceptual synthesis of literature on preparedness for practice, entrustment, and professional identity formation, integrated with practical observations from graduate medical education. Results (Conceptual): Six domains central to transition readiness were identified: decision ownership, graduated autonomy, procedural independence, uncertainty tolerance, professional identity formation, and psychological safety. Conclusion: Transition-to-practice preparation extends milestone-based training by supporting the emergence of independent clinical performance through alignment of autonomy, accountability, and reflection.
Disciplines
Medical Education | Medicine and Health Sciences
Included in
A Conceptual Framework that Supports the Transition from Supervised Training to Independent Clinical Practice, Aligned with ACGME Milestones
Background: The transition from residency to independent attending practice represents a critical developmental inflection point. Although residents achieve competency-based milestones, many graduates report challenges related to decision ownership, uncertainty tolerance, and the assumption of final clinical authority. Traditional training emphasizes competence under supervision, while independent practice requires performance without supervision. Objective: To propose a conceptual framework that supports the transition from supervised training to independent clinical practice, aligned with ACGME Milestones. Methods: Conceptual synthesis of literature on preparedness for practice, entrustment, and professional identity formation, integrated with practical observations from graduate medical education. Results (Conceptual): Six domains central to transition readiness were identified: decision ownership, graduated autonomy, procedural independence, uncertainty tolerance, professional identity formation, and psychological safety. Conclusion: Transition-to-practice preparation extends milestone-based training by supporting the emergence of independent clinical performance through alignment of autonomy, accountability, and reflection.