M. Sturdevant1, Z. Aldaher1, S. Howerton1, A. Lee1, E. Simmerman Mabes1 1Medical College Of Georgia, Surgery, Augusta, GA, USA
Introduction:
Obtaining informed consent for a surgical procedure requires knowledge of procedural indications, steps, potential complications, and alternative treatment options. Studies indicate that consent is frequently obtained by the most junior physicians on surgical teams. This translates into interns frequently obtaining informed consent for procedures they have not observed and/or without appropriate supervision. Recognizing this issue we developed a standardized informed consent training curriculum for incoming interns.
Methods:
An informed consent training curriculum was designed through collaboration with surgical attendings. The curriculum was designed with the following objectives: the intern will understand key points required for each consent, have access to resources for necessary background knowledge of the procedure, and will have senior resident supervision until signed off as competent. Five incoming general surgery interns underwent training during orientation. Pre- and post-training surveys were performed by interns. An Informed Consent Competency Scale (ICCS) survey was created with a focus on a limited set of variables including knowledge of indications, operational steps, potential complications, and alternative treatment options. ICCS surveys are to be collected at 1, 3, 6, 9, and 12 months for each intern.
Results:
Five incoming categorical general surgery interns were polled on the number of times they had witnessed a surgeon obtain informed consent for a procedure for an average witnessed encounter of seven times. Pre and post consent training survey results were obtained during intern orientation with results in Figure 1; numeric values were assigned depending on answers with extremely uncomfortable=0, somewhat comfortable=1, neither comfortable or uncomfortable=2, somewhat comfortable=3 and extremely comfortable=4. A paired t test was performed.
Figure 1: Average numeric survey values assigned to survey responses with significant difference p<0.05 between pre and post survey responses.
Conclusion:
Although this project is still in its early stages, we are confident that the development of an informed consent training curriculum will improve the knowledge base and confidence of our interns before they are expected to obtain consent independently. A significant difference in the comfort of interns was already appreciated after conducting a brief training session to review the informed consent process with results demonstrated in Figure 1. With a formal training curriculum, we predict this will have a positive impact on both the patient care and our intern's capability to understand and explain common operative procedures and hope to impact other programs across the nation.