Informed Consent Education in Obstetrics and Gynecology: A Survey Study

Propst, Katie; O’Sullivan, David; Ulrich, Amanda; Tunitsky-Bitton, Elena

doi:10.1016/j.jsurg.2018.12.005

Cited by 15 publications

(13 citation statements)

References 8 publications

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“…Our results were lower than similar studies such as from Kempner et al 22 because of a difference in design as all procedural information was provided up front to the students immediately before the standardized patient encounter. A survey of obstetrics and gynecology residents revealed that as many as 90% of trainees obtained IC for a procedure for which they were unsure of all the risks 23 . Instead of formal training in obtaining IC, most trainees are learning through an observation‐based model of watching other residents and attendings 23 .…”

Section: Discussionmentioning

confidence: 99%

“…A survey of obstetrics and gynecology residents revealed that as many as 90% of trainees obtained IC for a procedure for which they were unsure of all the risks 23 . Instead of formal training in obtaining IC, most trainees are learning through an observation‐based model of watching other residents and attendings 23 . Exposure and practice of these skills during earlier clinical phases and emphasis on the more challenging components of risks and alternatives during training are required.…”

Section: Discussionmentioning

confidence: 99%

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Minimum standard assessment of informed consent for internal medicine transition to residency program: A cohort study

Marwaha,

Bhalla,

Rao

et al. 2023

Health Science Reports

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Background and AimsInterns must be proficient in obtaining informed consent (IC), which is the Association of American Medical College's 11th of 13 Entrustable Professional Activities (EPAs). Medical students have limited opportunity to practice IC during clerkships, resulting in inconsistent proficiency. We aimed to create a tool to assess whether our transition to residency (TTR) workshop enables fourth‐year medical students to meet a minimum standard of obtaining IC.MethodsSixty fourth‐year medical students were enrolled in the internal medicine virtual TTR course during AY2021. The curriculum prioritizes deliberate practice activities. Pre‐ and postworkshop assignments involved students typing verbatim what they would say during IC encounters. We modified an IC abstraction tool created by Spatz et al. to assess a minimum standard for students' IC assignments. Our final 7‐item tool consisted of the following domains: “What,” “Why,” “How,” “Benefits,” “Quantitative Risks,” “Qualitative Risks,” and “Alternatives,” weighing 1 point each. A minimum standard was obtained with a score of 6 or more points by appropriately discussing at least one domain involving risk and all other domains.ResultsStudents scored highly on the prework domains pertaining to “What,” “Why,” and “How” of the procedure with no significant difference on postwork. Significant improvement was achieved on postwork domains covering “Benefits” (p = 0.039) and “Alternatives” (p = 0.031). For domains involving “Qualitative” and “Quantitative Risks,” there were no statistically significant improvements from pre‐ to postwork scores. Fifteen and 22 students met the minimum standard for IC on pre‐ and postwork, respectively.ConclusionOur students demonstrated a good a priori understanding of the “What,” “Why,” and “How” domains. After the workshop, they more reliably discussed “Benefits” and “Alternatives.” Our abstraction tool helped assess the strengths and weaknesses in our students' IC skillset and helped recognize areas of our curriculum that will benefit from improvements to bring students to meet the minimum standard.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Minimum standard assessment of informed consent for internal medicine transition to residency program: A cohort study

Marwaha,

Bhalla,

Rao

et al. 2023

Health Science Reports

View full text Add to dashboard Cite

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“…This has been reported elsewhere. In Otolaryngology, junior doctors have reported obtaining consent for procedures for which they were unsure of Reference 9 and a study of 281 obstetric trainees showed that nearly 90% had taken informed consent for a procedure for which they were unsure of all the risks 10 . Consent discussions with patients should only be delegated to trainees who can provide the necessary information to patients and answer any queries they may have.…”

Section: Discussionmentioning

confidence: 99%

“…However, in many jurisdictions, research suggests that trainees do not receive formal instruction on the informed consent process and rely on the observation of peers for learning 7 . In addition, studies demonstrate that those in training are less than competent in obtaining informed consent 8–10 …”

Section: Introductionmentioning

confidence: 99%

“…7 In addition, studies demonstrate that those in training are less than competent in obtaining informed consent. [8][9][10] Given the importance informed consent has for quality patient care and the consequences for failing to adequately perform this task, 11 it is surprising that the competency of Australian surgical trainees in relation to informed consent and their practise has not been studied or published. We designed a survey to examine the extent to which orthopaedic surgical trainees have been exposed to education about the informed consent process, their perceived ability to obtain it effectively and the frequency with which they include its essential elements.…”

Section: Introductionmentioning

confidence: 99%

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Informed consent: perceptions and practice of orthopaedic trainees

Atkin¹,

Incoll

Owen

et al. 2022

ANZ Journal of Surgery

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Background The purpose of informed consent is to provide patients with adequate information about a proposed plan or intervention, including the benefits and risks, so that they can make an informed decision about their medical treatment. The literature suggests that trainees are often delegated the task of obtaining consent with inadequate knowledge, skill or experience. The aim of this study is to determine the extent orthopaedic surgical trainees have been exposed to education about the informed consent, their perceived ability to obtain consent effectively and the frequency with which they routinely address elements of the process when consenting patients. Methods An eight‐item questionnaire assessing trainees' experience with informed consent was distributed to trainees undertaking Australian orthopaedic surgery training in 2019. Results Of the 239 trainees, 102 completed the questionnaire. Although 99% of trainees were confident that they can obtain valid consent from patients, when asked about aspects of the process, many trainees do not address them. Only 29% of trainees always ask patients about goals of care and 21% always advise the patient of who will be performing the procedure. Trainees who indicated that they had received education on informed consent during surgical training are significantly more likely to address key elements. Conclusion Trainees' perceptions of their knowledge and skill in relation to informed consent does not align with their reported practice. Although the majority of trainees had received some education on informed consent, greater emphasis on explicit teaching and formal assessment should be undertaken during surgical training, prior to trainees completing this activity independently.

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