title: From the patient's perspective: is there a need to improve the quality of informed consent for surgery in training hospitals?
abstract: OBJECTIVE
  This study was performed to evaluate the presurgical informed consent process at a training hospital in Jamaica.
  
  
  METHODS
  A postoperative survey was administered to all consecutive able and willing adult patients who underwent the presurgical informed consent process with surgical residents during a 5-week period. Information was collected on patient demographics and patients' perception and satisfaction with the informed consent process.
  
  
  RESULTS
  There were 210 surveys completed. Patients were unaware of the training status of the physician involved with their presurgical informed consent process in 48% of cases. Nineteen (9%) patients were instructed to sign a consent document without any discussion. An attempt was made to secure a signature after some discussion with the remaining 191 patients. Patients reported that details of the operation were discussed 74% of the time; potential benefits of the surgery, 72% of the time; potential morbidity, 84% of the time; potential mortality, 19% of the time; predicted postoperative course, 49% of the time; projected recovery, 26% of the time; and other treatment options, 33% of the time. Forty-five patients believed that they were instructed to sign the consent document with minimal discussion. At termination of the consent process, only 70% of the 210 patients reported that they signed the consent form voluntarily. Overall, 67% of patients thought the current informed consent process was unsatisfactory.
  
  
  CONCLUSIONS
  The current informed consent process in use in the surgical training program at the University Hospital of the West Indies requires improvement to meet expected ethical and legal standards.
authors.affiliation: Lecturer in the Department of Clinical Surgical Sciences at the University of West Indies in Port of Spain, Trinidad and Tobago. socawich@hotmail.com.
authors.forename: Shamir O
authors.initials: SO
authors.lastname: Cawich
authors.affiliation: Lecturer in the Department of Surgery at the University of West Indies in Kingston, Jamaica. alanbarnett@gmail.com.
authors.forename: Alan T
authors.initials: AT
authors.lastname: Barnett
authors.affiliation: Lecturer in the Department of Surgery at the University of West Indies in Kingston, Jamaica. ivorcrandon@gmail.com.
authors.forename: Ivor W
authors.initials: IW
authors.lastname: Crandon
authors.affiliation: House Officer in the Department of Surgery at the Southampton General Hospital, United Kingdom. sddrew@hotmail.com.
authors.forename: Samantha D
authors.initials: SD
authors.lastname: Drew
authors.affiliation: Lecturer in the Department of Surgery at the University of West Indies in Kingston, Jamaica. ggstrachan@gmail.com.
authors.forename: Georgiana
authors.initials: G
authors.lastname: Gordon-Strachan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001364:Awareness; D003142:Communication; D032962:Consent Forms; D030881:Disclosure; D004501:Education, Medical / Q000592:standards*; D004992:Ethics, Medical; D005260:Female; D013502:General Surgery / Q000193:education*; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D006785:Hospitals, University / Q000592:standards; D006801:Humans; D007258:Informed Consent / Q000941:ethics / Q000592:standards*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D058996:Quality Improvement; D011795:Surveys and Questionnaires; D014900:West Indies; D055815:Young Adult