Patients Wary of Care from Surgical Residents

Patients Wary of Care from Surgical Residents
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Most patients approve of teaching facilities and training residents. However, a new study has found that consent rates plummet when patients are given detailed information about the role a resident will play in their surgical procedures.

Patient perceptions and willingness to participate in resident education were reviewed by researchers in a study published in a recent issue of Archives of Surgery. Overall, of the 300 patients who completed a questionnaire about their support of resident training, most expressed overall support:

  • 91% felt that their care would be equal to or better than at a private hospital.
  • 68% believed they derived benefit from participation.
  • 85% consented to having an intern participate in their surgical procedure.
  • 94% consented to having a resident participate in their surgical procedure.

However, consent rates plunged from 94% to 18% as the level of resident participation increased:

  • 58% consented when a junior resident would be assisting a staff surgeon.
  • 32% gave consent when a staff surgeon would be assisting the resident.
  • 26% consented when a staff surgeon would be observing the resident.
  • 18% gave consent when the resident would be performing the procedure without the staff surgeon present.

Although patients are not routinely informed of a resident’s role in surgical procedures, those questioned said that the information could influence their decision on whether to consent.

The researchers concluded that policymakers need to consider the variation in patients’ willingness to be treated by physicians in training — but that providing detailed informed consent could adversely affect resident participation and training.

Physician’s Weekly wants to know…

  • Should patients be provided with detailed informed consent if it adversely affects resident participation and training?

1 Comment

  1. In my Opinion, all patients should be provided with detailed informed consent information and detailed information about the actual performance of all parts of their procedures, even if it would affect the participation level of a resident, intern, or medical student.
    Attending physicians should be present and teaching at all points in surgical procedures, and I feel that patients would be positively inclined to allow participation at all levels of training if they knew that the attending physician would be constantly present and actively teaching at all points. There should be peer evaluation at times when not announced to make sure the attending physicians are actively teaching by verbal communication and/or demonstration and/or guiding the actions which are being performed by the trainee. Fear arises when there is inadequate information or misinformation whether it is intentional or unintentional so that the patient fears that he/she will not receive the highest level of care.
    I also believe that the trainees should be introduced early in the contact with patients and the patient should feel that the trainee is part of the medical/surgical team who will be evaluation and treating him/her, so that they are expecting a team approach, not surprised when they are given accurate information about level of participation during surgery. At no time would it be acceptable for a trainee of any level to do a surgical procedure without a well trained and teaching attending physician present.


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