title: Marriage of professional and technical tasks: a strategy to improve obtaining informed consent.
abstract: BACKGROUND
  Education in obtaining informed consent, combined with technical training using a stepwise approach, may improve resident knowledge of, confidence in, and frequency of obtaining consent for bedside procedures.
  
  
  METHODS
  Surgical trainees were randomized to receive a lecture on obtaining informed consent. Knowledge of, confidence in, and frequency of obtaining consent were assessed. Subsequent first-year residents received combined technical and consent training using a stepwise approach. Residents listed key steps for procedures before and after training, were observed for consent and technical competency on patients, and were assessed on frequency of obtaining consent by follow-up chart review.
  
  
  RESULTS
  Knowledge and confidence improved after lecture instruction, but consent rate (21%) did not. Stepwise training increased resident awareness of obtaining informed consent as a key step (19% to 77%) and increased frequency of obtaining consent (89% for proctored procedures and 79% in follow-up).
  
  
  CONCLUSIONS
  Education alone improves knowledge but not practice of obtaining consent. Teaching the consent process concomitantly with technical training may increase awareness and performance of obtaining informed consent for bedside procedures.
authors.affiliation: Department of Surgery, John A. Burns School of Medicine, University of Hawaii, 1356 Lusitana St., Sixth Floor; Honolulu, HI 96813, USA. steine@hawii.edu
authors.forename: Susan
authors.initials: S
authors.lastname: Steinemann
authors.forename: Daniel
authors.initials: D
authors.lastname: Furoy
authors.forename: Fredrick
authors.initials: F
authors.lastname: Yost
authors.forename: Nancy
authors.initials: N
authors.lastname: Furumoto
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Lam
authors.forename: Kenric
authors.initials: K
authors.lastname: Murayama
mesh_terms: D018592:Cross-Over Studies; D004503:Education, Medical, Graduate / Q000458:organization & administration*; D005500:Follow-Up Studies; D013502:General Surgery / Q000193:education*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007258:Informed Consent; D007396:Internship and Residency; D012189:Retrospective Studies