‘All by myself’: interns’ reports of their experiences taking consent in Irish hospitals

Heaney, Roisin; Murray, Michael J.; Heaney, Aine; Doherty, Eva

doi:10.1007/s11845-018-1782-5

Cited by 11 publications

(5 citation statements)

References 18 publications

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“…Second, literature reported that junior doctors obtain surgical consent frequently, yet this process was likely undertaken sub‐optimally with some patients not being provided adequate information they need to make an informed decision (Heaney et al, 2019; Wood et al, 2016). This is an important consideration given that failure to disclose complications has been reported to account for the majority of surgical legal claims for all surgeons (Gogos et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

“…Despite this, there is convincing evidence about the use of teach-back communication techniques, interactive digital and multimedia interventions may improve patient comprehension of information during informed consent for surgery (Glaser et al, 2020;Michalski et al, 2016;Seely et al, 2022). For example, a recent systematic review reports 100% improvement in patient comprehension with the use of teach-back and 85% improvement with the use of interactive digital applications (Glaser et al, 2020) Second, literature reported that junior doctors obtain surgical consent frequently, yet this process was likely undertaken suboptimally with some patients not being provided adequate information they need to make an informed decision (Heaney et al, 2019;Wood et al, 2016). This is an important consideration given that failure to disclose complications has been reported to account for the majority of surgical legal claims for all surgeons (Gogos et al, 2011).…”

Section: Summary Of Key Findingsmentioning

confidence: 99%

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Exploring healthcare professionals' perspective of the process of obtaining consent for adult patient's having planned surgery: A scoping review

Gardiner

Gillespie

Latimer

et al. 2023

Journal of Clinical Nursing

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AimThe aim of this scoping review was to provide an overview of the literature about the process of obtaining consent from adult patients undergoing planned surgery from the healthcare professionals' perspective and analyse knowledge gaps.BackgroundThe process of obtaining consent for planned elective surgery manifests an individual's fundamental right to decide what happens to their body. The process is often suboptimal and problematic, placing a significant resource burden on health systems globally. Deficiencies in the documentation on consent forms have also been shown to increase the risk of operating room error.DesignScoping review.MethodsArksey and O′Malley's (International Journal of Social Research Methodology, 8, 2005 and 19) five‐step scoping review methodology was used.ResultsFifty‐three articles were included; 39 primary and 14 secondary research publications. Three key findings were identified; there is currently low‐level evidence about surgical consent processes to inform clinical practice; junior doctors obtain surgical consent frequently, yet this process was likely undertaken sub‐optimally; and current knowledge gaps include capacity assessment, decision‐making and pre‐procedural consent checks.ConclusionPlanned surgical consent processes are complex, and both surgeons and perioperative nurses are essential during the process. While surgeons have responsibility to obtain consent, perioperative nurses provide a safety net in the surgical consent process checking the surgical consent information is correct and has been understood by the patient. Such actions may influence consent validity and patient safety in the operating room. Knowledge gaps about capacity assessment, decision‐making, pre‐procedural checks and the impact of junior doctors obtaining consent on patient understanding, safety and legal claims are evident.Relevance to clinical practiceThis review highlights the importance of the surgical nurse's role in the planned surgical consent process. While the responsibility for obtaining surgical consent lies with the surgeon, the nurse's role verifying consent information is crucial as they act as a safety net and can reduce error in the operating room.No patient or public contributionThe authors declare that no patient or public contribution was made to this review in accordance with the aim to map existing literature from the healthcare professionals' perspective.

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Section: Discussionmentioning

confidence: 99%

Section: Summary Of Key Findingsmentioning

confidence: 99%

Exploring healthcare professionals' perspective of the process of obtaining consent for adult patient's having planned surgery: A scoping review

Gardiner

Gillespie

Latimer

et al. 2023

Journal of Clinical Nursing

View full text Add to dashboard Cite

show abstract

“…The reason for this duality may be that shared decision-making between clinicians and patients requires a longer time to establish than the limited clinical time that is usually available [10][11]. In addition, it is especially difficult to communicate with dying patients, and providing a good IC session requires experience [9,29]. In this regard, we believe that by asking both parties questions during medical-mediation, mediators can extract more information from patients such their concerns and anxieties, and they can make it clear that clinicians truly care.…”

Section: Discussionmentioning

confidence: 99%

“…Clinician barriers include lack of patients' understanding, excessive use of technical medical terms, lack of clinical experience, lack of understanding of IC procedures, and time pressure [7][8][9]. Time pressure is a particularly important barrier to good implementation of IC [10][11].…”

Section: Introductionmentioning

confidence: 99%

Benefits of Medical-Mediation in Informed Consent: Evaluating Clinicians’ Perspectives

Nakanishi¹,

Hayasaka²,

Endo³

et al. 2021

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“… 14 Another study of Irish surgical interns found that 57% had never received a formal explanation of the procedure from a senior colleague and 73.3% had never been supervised while taking consent. 15 …”

Section: Introductionmentioning

confidence: 99%

Consent-GPT: is it ethical to delegate procedural consent to conversational AI?

Allen,

Earp,

Koplin

et al. 2023

J Med Ethics

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Obtaining informed consent from patients prior to a medical or surgical procedure is a fundamental part of safe and ethical clinical practice. Currently, it is routine for a significant part of the consent process to be delegated to members of the clinical team not performing the procedure (eg, junior doctors). However, it is common for consent-taking delegates to lack sufficient time and clinical knowledge to adequately promote patient autonomy and informed decision-making. Such problems might be addressed in a number of ways. One possible solution to this clinical dilemma is through the use of conversational artificial intelligence using large language models (LLMs). There is considerable interest in the potential benefits of such models in medicine. For delegated procedural consent, LLM could improve patients’ access to the relevant procedural information and therefore enhance informed decision-making.In this paper, we first outline a hypothetical example of delegation of consent to LLMs prior to surgery. We then discuss existing clinical guidelines for consent delegation and some of the ways in which current practice may fail to meet the ethical purposes of informed consent. We outline and discuss the ethical implications of delegating consent to LLMs in medicine concluding that at least in certain clinical situations, the benefits of LLMs potentially far outweigh those of current practices.

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‘All by myself’: interns’ reports of their experiences taking consent in Irish hospitals

Abstract: The majority of interns reported that they had taken consent for a procedure without full knowledge of the procedure and its complications. Supervision or instruction from a senior colleague was reported by a minority.

Cited by 11 publications

References 18 publications

Exploring healthcare professionals' perspective of the process of obtaining consent for adult patient's having planned surgery: A scoping review

Exploring healthcare professionals' perspective of the process of obtaining consent for adult patient's having planned surgery: A scoping review

Benefits of Medical-Mediation in Informed Consent: Evaluating Clinicians’ Perspectives

Consent-GPT: is it ethical to delegate procedural consent to conversational AI?

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