Development and Testing of a Curriculum for Teaching Informed Consent for Spinal Anesthesia to Anesthesiology Residents

Tanaka, Pedro Paulo; Park, Leeanne; Udani, Ankeet D.; Macario, Alex

doi:10.4172/2167-0846.1000259

Cited by 3 publications

(4 citation statements)

References 27 publications

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“…"Teach back", which is asking the patient to describe what has just been discussed in their own words, was the most poorly performed element in baseline assessment amongst the participants of the current study (0 out of 16 participants at pre-assessment). This was also the case in the study performed by Tanaka et al [10]. However, post-simulation significant improvement (p = 0.02) was observed at the final assessment.…”

Section: Discussionsupporting

confidence: 76%

“…The checklist comprising of 11 essential elements of the informed consent obtaining process used for assessing informed consent was adapted from a study done earlier at the University of Stanford in 2016 [ 10 ].…”

Section: Methodsmentioning

confidence: 99%

“…The purpose of this phase was to assess the degree of retention of skills by the trainees after having undergone simulated training. The checklist comprising of 11 essential elements of the informed consent obtaining process used for assessing informed consent was adapted from a study done earlier at the University of Stanford in 2016 [10].…”

Section: Phase Three (Post Intervention)mentioning

confidence: 99%

“…Studies have shown that consent discussions are usually incomplete. These shortcomings of insufficient consent discussion are often responsible for increased litigation [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Assessment of Informed Consent and the Impact of Simulation on Anesthesia Trainees

Bashir¹,

Khan²,

Khan³

2021

Cureus

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Introduction Over the years, the process of obtaining informed consent has evolved and now places an emphasis on the concept that patients should play a major role in medical decision making. Failure to adequately involve patients in making decisions regarding their health can lead to medicolegal consequences. Therefore, taking informed consent is a fundamental component of anaesthesia training. Simulation, for training, is an excellent tool that is being utilised widely in the training of medical professionals. The use of simulated training for teaching the process of informed consent is an innovative initiative that can provide improved results. Material and methods After approval from the institutional review board, a prospective clinical study was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, from August 2019 to September 2020. Sixteen anaesthesia trainees were randomly selected for the study. The study was divided into pre-interventional, interventional and post interventional phases. For data collection, a predesigned checklist was used. Data collected was analysed using SPSS version 23 (IBM Inc., Armonk, New York). The McNemar test was deployed to assess the difference between the baseline assessment and post-simulated training assessment; p-value < 0.05 was taken to be significant. Results Of the 16 participants, the majority were males (n= 13). A positive impact was observed in terms of improvement of the outcome of the following study components i.e., description of benefits of the procedure (p=0.01), disclosure of associated minor risks (p=0.005), disclosure of major risks (p=0.01), discussion of alternatives (p=0.001), teach back (p=0.001), documentation of patients’ verbal agreement (p=0.01), and communication skills involving utilising the process of connecting, introduction, communication, permission, response, and exit (p = 0.01). Conclusion Simulated training had a positive impact in improving outcomes in the following study components: description of benefits of the procedure, disclosure of associated risks, discussion of alternatives, teach back, documentation of patients’ verbal agreement, and utilisation of the process of connecting, introduction, communication, permission, responding, and exiting.

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Section: Discussionsupporting

confidence: 76%

Section: Methodsmentioning

confidence: 99%

Section: Phase Three (Post Intervention)mentioning

confidence: 99%

“…Studies have shown that consent discussions are usually incomplete. These shortcomings of insufficient consent discussion are often responsible for increased litigation [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Assessment of Informed Consent and the Impact of Simulation on Anesthesia Trainees

Bashir¹,

Khan²,

Khan³

2021

Cureus

View full text Add to dashboard Cite

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Assessment Scores of a Mock Objective Structured Clinical Examination Administered to 99 Anesthesiology Residents at 8 Institutions

Tanaka

Park

Liu

et al. 2020

Anesthesia &Amp; Analgesia

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BACKGROUND: Objective Structured Clinical Examinations (OSCEs) are used in a variety of high-stakes examinations. The primary goal of this study was to examine factors influencing the variability of assessment scores for mock OSCEs administered to senior anesthesiology residents. METHODS: Using the American Board of Anesthesiology (ABA) OSCE Content Outline as a blueprint, scenarios were developed for 4 of the ABA skill types: (1) informed consent, (2) treatment options, (3) interpretation of echocardiograms, and (4) application of ultrasonography. Eight residency programs administered these 4 OSCEs to CA3 residents during a 1-day formative session. A global score and checklist items were used for scoring by faculty raters. We used a statistical framework called generalizability theory, or G-theory, to estimate the sources of variation (or facets), and to estimate the reliability (ie, reproducibility) of the OSCE performance scores. Reliability provides a metric on the consistency or reproducibility of learner performance as measured through the assessment. RESULTS: Of the 115 total eligible senior residents, 99 participated in the OSCE because the other residents were unavailable. Overall, residents correctly performed 84% (standard deviation [SD] 16%, range 38%–100%) of the 36 total checklist items for the 4 OSCEs. On global scoring, the pass rate for the informed consent station was 71%, for treatment options was 97%, for interpretation of echocardiograms was 66%, and for application of ultrasound was 72%. The estimate of reliability expressing the reproducibility of examinee rankings equaled 0.56 (95% confidence interval [CI], 0.49–0.63), which is reasonable for normative assessments that aim to compare a resident’s performance relative to other residents because over half of the observed variation in total scores is due to variation in examinee ability. Phi coefficient reliability of 0.42 (95% CI, 0.35–0.50) indicates that criterion-based judgments (eg, pass-fail status) cannot be made. Phi expresses the absolute consistency of a score and reflects how closely the assessment is likely to reproduce an examinee’s final score. Overall, the greatest (14.6%) variance was due to the person by item by station interaction (3-way interaction) indicating that specific residents did well on some items but poorly on other items. The variance (11.2%) due to residency programs across case items was high suggesting moderate variability in performance from residents during the OSCEs among residency programs. CONCLUSIONS: Since many residency programs aim to develop their own mock OSCEs, this study provides evidence that it is possible for programs to create a meaningful mock OSCE experience that is statistically reliable for separating resident performance.

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Development of an Objective Structured Clinical Examination Using the American Board of Anesthesiology Content Outline for the Objective Structured Clinical Examination Component of the APPLIED Certification Examination

et al. 2018

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The goal of this study was to use the American Board of Anesthesiology Objective Structured Clinical Examination (OSCE) content outline as a blueprint to develop and administer a 9-station mock OSCE with station-specific checklists to senior residents (n = 14). The G- and Ф-coefficient reliability estimates were 0.76 and 0.61, respectively. Residents judged the scenarios as either extremely or somewhat realistic (88%). It is feasible to develop and administer a mock OSCE with rigorous psychometric characteristics.

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Development and Testing of a Curriculum for Teaching Informed Consent for Spinal Anesthesia to Anesthesiology Residents

Cited by 3 publications

References 27 publications

Assessment of Informed Consent and the Impact of Simulation on Anesthesia Trainees

Assessment of Informed Consent and the Impact of Simulation on Anesthesia Trainees

Assessment Scores of a Mock Objective Structured Clinical Examination Administered to 99 Anesthesiology Residents at 8 Institutions

Development of an Objective Structured Clinical Examination Using the American Board of Anesthesiology Content Outline for the Objective Structured Clinical Examination Component of the APPLIED Certification Examination

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