Patient Care Supervision Policy                 

Noorda-COM prepares students to become Osteopathic Physicians, trained to look at each individual person as a whole. This holistic approach to medical care trains students to integrate the patient into the healthcare process as a partner.

Noorda-COM’s curriculum includes required clinical experiences in a variety of clinical learning environments. The role of the Noorda-COM student is to participate in patient care in ways that are appropriate for the student’s level of training, experience and the clinical situation.

Noorda-COM’s curriculum includes required clinical experiences in a variety of clinical learning environments. The role of the Noorda-COM student is to participate in patient care in ways that are appropriate for the student’s level of training, experience and the clinical situation. Noorda-COM ensures that students in clinical learning situations, involving patient care, are under direct supervision by a licensed health care professional at all times.

AOA Code of Ethics

Noorda-COM adheres to the AOA Code of Ethics.

Practicing Medicine

Students must not represent themselves as a practicing physician, either directly or indirectly. Students are not employees of the healthcare sites and are prohibited from accepting any form of payment of gratuity for their clinical activities.

Patient Care Supervision

Supervision in the setting of undergraduate medical education provides safe and effective care to patients; ensures each student’s development of the skills, knowledge, and attitudes required of the “Core Entrustable Professional Activities” vital to the practice of medicine and establishes a foundation for continued growth. Although the attending physician is ultimately responsible for the care of the patient, the student shares, to the best of their ability, responsibility, and accountability for ensuring patient safety and quality patient care.

A Preceptor/ Supervising physician is a licensed, practicing physician, credentialed by Noorda-COM, who gives or oversees personal instruction, training, and supervision to a medical student.

There are four different types of supervision defined as follows:

  • Direct Supervision – The supervising physician is physically present with the student and patient.
  • Indirect Supervision with Direct Supervision immediately available – The supervising physician is physically within the confines of the site of patient care and is immediately available to provide Direct Supervision.
  • Indirect Supervision with Direct Supervision available – The supervising physician is not physically present within the confines of the site of patient care, but is immediately available via phone, and is available to provide Direct Supervision.
  • Oversight – The supervising physician is available to provide review of procedures/encounters with feedback provided after care is delivered.

Supervising faculty delegate portions of patient care to the student based on the needs of the patient and the skill of each student.

During a student’s time in the clinical environment, the preceptor must be available for supervision, consultation, and teaching, or designate an alternate preceptor. Although the supervising preceptor may not be with a student at all times, it is important to clearly assign students to another physician or non-physician provider who will serve as the student’s preceptor for any given time interval.

Preceptors can provide direct supervision of technical skills with gradually increased autonomy in accordance with the student’s demonstrated level of expertise:

  • First- and second-year medical students will be directly supervised at all times (supervising physician or designee present or immediately available).
  • Third- and fourth-year medical students will be supervised at a level appropriate to the clinical situation and student’s level of experience.

For some tasks, indirect supervision may be appropriate for some students. Direct supervision would be appropriate for advanced procedures. The supervising physician or provider may only supervise procedures in which they hold privileges and that are within their scope of practice. The preceptor or their designee must examine all patients seen by the student doctor. It is the responsibility of the precepting/supervising physician to assure that documentation in the patient’s medical record is appropriate. The preceptor should be aware of the student’s assigned activities at all times.

This policy was reviewed and revised in March 2024. For assistance with policies and procedures, please contact Alexa Levine (adlevine@noordacom.org).