Graded Autonomy in Medical Education -- Managing Things That Go Bump in the Night.

The authors focus on the training of medical residents to make decisions on their own during night shifts. Topics discussed include changes in the model of graded autonomy caused by the 1984 death of patient Libby Zion in a New York emergency department, studies showing that resident-training methods involving shorter work hours and lesser autonomy did not help improve patient safety, and transitions that occur when physicians become independent practitioners.