Patients’ perspectives on the extent of resident participation in the operating room for total hip or knee arthroplasty

Abstract

Introduction: Previous work suggests that patients do not understand the extent of trainee involvement in their care and are uncomfortable with trainee involvement.
 Methods: We recruited 202 English speaking patients with previous or planned total joint arthroplasty of the lower limb for a prospective survey trial. We assessed participant’s knowledge of trainee level of education and confidence of trainee involvement in their surgery as a function of supervision.
 Results: Participants’ mean level of confidence in the consultant surgeon was 4.30 (SD±1.13) on a 5-point Likert scale. Confidence in residents was significantly less, regardless of resident experience (p < 0.05). 11.1% of participants did not want trainees involved in their treatment. 60.6% would like to know more about the education level of the trainee. Less than half of participants correctly identified the education level of residents and fellows.
 Conclusion: Patient confidence in trainees performing part or all of their surgery increases with resident experience and supervision. Most patients do not understand the hierarchy in education of medical trainees and would like to know more about the education level of the trainee involved in their care. Further work should explore how we can help patients better understand trainee involvement in their surgical care.

Hospital teaching status and patient outcomes in intestinal obstruction surgery: A comparative analysis

“…Despite evidence suggesting superior outcomes among patients admitted to large teaching hospitals (LTHs) (4), patients often worry about having a resident, intern, or medical student involved in their care, fearing that this might jeopardize their safety or compromise positive surgical outcomes. Previous reports have indicated that up to 60% of surgical patients lack confidence in the level of training of surgical residents, and up to 11% of surgical patients do not want residents involved in their care (5). Additionally, teaching hospitals (THs) are often considered more expensive than community hospitals (6,7), and intestinal obstruction care is already a significant financial burden to patients and payers (8,9).…”