Neurosurgery patients' feelings about the role of residents in their care: a qualitative case study

Knifed, Eva; July, Julius; Bernstein, Mark

doi:10.3171/jns/2008/108/2/0287

Cited by 45 publications

(32 citation statements)

References 20 publications

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“…In our study, these 2 common situations of minimal resident supervision were associated with the lowest consent rates, with only 25.6% and 18.2% of patients indicating a willingness to consent to these respective scenarios. Many previous studies 5,6,9,15,16 of this issue have concluded with arguments for routine and detailed disclosure of information regarding trainee participation during the informed consent process but they provide no data estimating the potential effect of such a policy on consent rates. Our results raise significant concerns regarding the effect of such a policy on resident education and, in particular, the effect on allowing increased levels of autonomy to trainees.…”

Section: Commentmentioning

confidence: 99%

“…Several recent studies [5][6][7] have pointed out the paucity of information typically provided to the patient regarding trainee participation; those studies call for this information to become a standard and universal component of informed consent. However, the specifics of such a policy and their potential effect on the patient and the trainee remain unknown.…”

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confidence: 99%

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Training Surgeons and the Informed Consent Process

Porta¹

2012

Arch Surg

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Objectives: To examine patient perceptions and willingness to participate in resident education and to assess the effect on patient willingness and consent rates.Design: Anonymous questionnaire designed to capture demographics, overall opinions of teaching programs, and willingness to consent to various scenarios of trainee participation. Descriptive and univariate analyses were performed.Setting: Tertiary-level referral center.Patients: Three hundred sixteen individuals scheduled for elective surgery. Main Outcome Measures: Consent rates for various scenarios.Results: Of the 316 patients who completed the questionnaire, most expressed overall support of resident training: 91.2% opined that their care would be equivalent to or better than that of a private hospital, 68.3% believed they derived benefit from participation, and most con-sented to having an intern (85.0%) or a resident (94.0%) participate in their surgical procedure. However, when given specific, realistic scenarios involving trainee participation, major variations in the consent rate were observed. Affirmative consent rates decreased from 94.0% to 18.2% as the level of resident participation increased. Patients also were more willing to consent to the participation of a senior resident (83.1%) vs a junior resident (57.6%) or an intern (54.5%). Patients overwhelmingly opined that they should be informed of the level of resident participation and that this information could change their decision of whether to consent.Conclusions: Most patients expressed approval of teaching facilities and resident education. However, consent rates were significantly altered when more detailed information was provided and they declined with increasing levels of resident participation. Providing detailed informed consent is preferred by patients but it could adversely affect resident participation and training.

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Section: Commentmentioning

confidence: 99%

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confidence: 99%

Training Surgeons and the Informed Consent Process

Porta¹

2012

Arch Surg

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“…The importance of trust has not surprisingly been reported to be very important for patients participating in many other qualitative studies [3, 11]. Because this surgery would be a second or third surgery, presumably the patient would have earned trust in his/her surgeon, since they got the patient through it the first time.…”

Section: Discussionmentioning

confidence: 99%

Are patients open to elective re-sampling of their glioblastoma? A new way of assessing treatment innovations

et al. 2014

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BackgroundThis is a qualitative study designed to examine patient acceptability of re-sampling surgery for glioblastoma multiforme (GBM) electively post-therapy or at asymptomatic relapse.MethodsThirty patients were selected using the convenience sampling method and interviewed. Patients were presented with hypothetical scenarios including a scenario in which the surgery was offered to them routinely and a scenario in which the surgery was in a clinical trial.ResultsThe results of the study suggest that about two thirds of the patients offered the surgery on a routine basis would be interested, and half of the patients would agree to the surgery as part of a clinical trial. Several overarching themes emerged, some of which include: patients expressed ethical concerns about offering financial incentives or compensation to the patients or surgeons involved in the study; patients were concerned about appropriate communication and full disclosure about the procedures involved, the legalities of tumor ownership and the use of the tumor post-surgery; patients may feel alone or vulnerable when they are approached about the surgery; patients and their families expressed immense trust in their surgeon and indicated that this trust is a major determinant of their agreeing to surgery.ConclusionThe overall positive response to re-sampling surgery suggests that this procedure, if designed with all the ethical concerns attended to, would be welcomed by most patients. This approach of asking patients beforehand if a treatment innovation is acceptable would appear to be more practical and ethically desirable than previous practice.

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“…reduces the anxiety of patients 8,9 , improves decision making [10][11][12] , and increases adherence to the oncologist's recommendations [13][14][15] .…”

Section: Introductionmentioning

confidence: 99%

Trust in Physicians, Continuity and Coordination of Care, and Quality of Death in Patients with Advanced Cancer

Hamano

Morita

Fukui

et al. 2017

Journal of Palliative Medicine

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Neurosurgery patients' feelings about the role of residents in their care: a qualitative case study

Abstract: Patients appear to be unaware of the role of residents in their surgical care but do not seem anxious about it. Trust in the medical system helps patients proceed with risky operations. Surgeons could be more forthcoming with patients about the role of residents.

Cited by 45 publications

References 20 publications

Training Surgeons and the Informed Consent Process

Training Surgeons and the Informed Consent Process

Are patients open to elective re-sampling of their glioblastoma? A new way of assessing treatment innovations

Trust in Physicians, Continuity and Coordination of Care, and Quality of Death in Patients with Advanced Cancer

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