Most Patients Want Experienced Surgeons, Not
FRIDAY, Sept. 23 (HealthDay News) -- Hospital patients want to
know whether medical trainees are participating in their surgery,
according to a new study.
Researchers found that although most patients would allow
residents and medical students to be involved in their operation,
rates of consent vary depending on the type of surgery and the
trainee's level of participation. The findings, they concluded,
could have a significant impact on teaching programs.
"Currently, no widely accepted guidelines or policies exist for providing information regarding the role of surgical trainees to the patient during the informed consent process," the authors wrote. "The accepted standard is to provide information that 'a reasonable patient' would want and would need to know to make an informed decision, but this counseling may vary widely by health care professional, setting, and type of surgical procedure."
In conducting the study, researchers from Madigan Army Health
System in Tacoma, Washington analyzed anonymous surveys from 316
patients to find out how they felt about surgical resident
education and training programs.
The study, published online Sept. 19 in the
Archives of Surgery, found most patients did not care if they were treated in a private hospital or a teaching one. The 91.2 percent of the patients who said they had a preference in where they were treated said they believed the care they would receive in a teaching hospital would be just as good or better than that in a private hospital.
Despite being supportive of teaching facilities, the vast
majority of patients said they wanted to be informed if a trainee
was going to participate in their operation, whether the procedure
was considered major (95.7 percent) or minor (87.5).
Although 94 percent of the patients questioned said they would
allow a surgical resident to be involved in their surgery, just 85
percent would agree to a surgical intern being included and only
about 80 percent would allow a medical student to participate in
When asked what role they would allow junior residents to have
in their care, 57.6 patients said they could act as the first
assistant. Only 25.6 percent said they would allow a junior
resident to perform the operation if there was direct staff
supervision, and a still smaller percentage -- 18.2 percent agreed
the resident could participate without direct staff
The study's authors concluded that informed consent is important
to surgical patients, and their unwillingness to allow trainee
participation in certain situations could have a significant impact
on teaching facilities.
"Although most patients express an overall willingness to participate in surgical education, wide variations can be observed in the actual consent rates for specific training situations. This decreased willingness to consent and the potential effect on training programs must be considered when discussing policy initiatives aimed at improving informed consent," the authors wrote.
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