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Jeanne Marie Farnan, MD; Holly J. Humphrey, MD; Vineet Arora, MD, MA

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

We commend Singh et al¹ on their thought-provoking and important work. While we certainly agree that patient handoffs are rife with the potential for error and patient harm secondary to breakdowns in communication,² laying the onus of supervision squarely on the attending physician is an issue we call into question.

The struggle between resident autonomy and the duty to supervise is constant, with trainees wishing to assert their independence and the hidden curriculum reinforcing their actions.³ Levels of supervision have been defined within specific specialties, such that there is a graded amount of attending physician involvement: direct, which requires the physical presence of the attending physician during the key aspect of patient care; participatory, with faculty providing oversight before or during the care of the patient; and indirect, which involves the faculty reviewing the care given to patients . . . [Full Text of this Article]

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