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Informed consent training improves surgery resident performance in simulated encounters with standardized patients - 14/08/15

Doi : 10.1016/j.amjsurg.2014.12.044 
Britta M. Thompson, Ph.D., M.S. a, b, , Rhonda A. Sparks, M.D. c, Jonathan Seavey, M.D. d, e, Michelle D. Wallace, B.S. c, Jeremy Irvan, M.D. d, Alexander R. Raines, M.D. d, Heather McClure, J.D. f, Mikio A. Nihira, M.D. g, Jason S. Lees, M.D. d
a University of Oklahoma College of Medicine, Office of Medical Education and Clinical Skills Education and Testing Center, 941 Stanton L. Young Boulevard, BSEB 115A, Oklahoma City, OK 73104, USA 
b PennState Hershey College of Medicine, Hershey, PA, USA 
c University of Oklahoma College of Medicine, Clinical Skills Education and Testing Center, Oklahoma City, OK, USA 
d Department of Surgery, University of Oklahoma College of Medicine, Oklahoma City, OK, USA 
e National Naval Medical Center, Bethesda, MD, USA 
f OU Physicians, Professional Liability, Patient Safety & Risk Management, Oklahoma City, OK, USA 
g Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine, Oklahoma City, OK, USA 

Corresponding author. Tel.: 717-531-0003 x281249; fax: 717-531-3925.

Abstract

Background

Although informed consent is vital to patient–physician communication, little training is provided to surgical trainees. We hypothesized that highlighting critical aspects of informed consent would improve resident performance.

Methods

Eighty (out of 88) surgical postgraduate year 1 surgical residents were randomly assigned to one of the 2 cases (laparoscopic cholecystectomy or ventral herniorrhaphy) and instructed to obtain and document informed consent with a standardized patient (SP) followed by a didactic training session. The residents then obtained and documented informed consent with the other case with the other SP. SPs graded encounters (“Checklist”); trained raters graded notes. Repeated measures multivariate analysis of variance (MANOVA) was used to determine differences between pre- and post-training and Checklist versus “Note” scores.

Results

Statistically significant pre- to post differences for Note (P < .01) and Checklist (P < .01) along with significant differences between Note and Checklist (P < .01) were noted.

Conclusions

Training improved surgery residents’ ability to discuss and document informed consent. Despite this improvement, significant differences between discussion and documentation persisted. Documentation training is a future area for improvement.

El texto completo de este artículo está disponible en PDF.

Highlights

Informed consent is a vital part of patient–physician communication, but little formalized training is provided to residents.
A training program was implemented to improve residents’ ability to conduct and document informed consent with standardized patients.
Analysis of pre- and post-training indicated that residents’ informed consent discussion and documentation improved.
Like pretraining, residents’ post-training documented less than they discussed with standardized patients.

El texto completo de este artículo está disponible en PDF.

Keywords : Informed consent, Resident education, Standardized patients, Communication


Esquema


 This project was funded, in part, through OU Physicians. No other support was provided.


© 2015  Elsevier Inc. Reservados todos los derechos.
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Vol 210 - N° 3

P. 578-584 - septembre 2015 Regresar al número
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