S. E. Raper1, J. Joseph2 2University Of Pennsylvania Health System,Quality And Risk Management,Philadelphia, PA, USA 1Perelman School Of Medicine,Surgery,Philadelphia, PA, USA
Introduction: ~~Informed consent (IC) of the patient is a constantly evolving ethical imperative and legal duty imposed on surgeons prior to the performance of an operation. IC is also a risk management tool as well as a means for enhancing surgeon-patient communication. To update academic surgeons, a short course in IC was developed.
Methods: ~~Curriculum: 1) ethical principles and legal precedent; 2) current federal, state, and accreditation requirements; and 3) new developments including a federal requirement to disclose overlapping surgery. Success was defined as participation of > 80% of surgical faculty. A short post-test was developed to test comprehension and results tabulated as % correct. An anonymous Likert-scale evaluation tool was used to assess strengths and opportunities to improve future courses. The weighted average of each question was calculated.
Results:~~Of 100 surgery faculty members, 74 attended live and 10 online. A majority of respondents for the post-test got the answers correct for each of the five T/F questions, confirming comprehension (# in parentheses = % correct): 1) In [State], inadequate informed consent is legally a battery (93%); 2) In [State] a physician has an affirmative duty to disclose his/her professional credentials, training and experience performing the particular procedure for which consent is being secured (72%); 3) In [State], the standard for judging the adequacy of the informed consent is based on the consensus in the medical community on what information about the procedure, the risks and the alternatives is required to make an informed decision (57%); 4) In [State], qualified practitioners are allowed to provide information regarding informed consent (97%); 5) In [State], to recover in an action for lack of informed consent, the patient must prove that receiving the information that was not provided would have been a substantial factor in his/her decision to undergo the procedure (79%). Evaluations were positive for the seven questions; all with a weighted average of > 4.5 (Table, N=45). Free text responses provided opportunities to improve future courses (not shown).
Conclusion:~~A proper understanding of informed consent remains critically important in the practice of surgery, but the requirements continue to evolve. A short course updating surgeons on principles of informed consent quantitatively confirms the effectiveness of this approach to teaching IC as an important risk management tool and fostering good surgeon-patient communication skills.
