title: Informed consent training improves surgery resident performance in simulated encounters with standardized patients.
abstract: BACKGROUND
  Although informed consent is vital to patient-physician communication, little training is provided to surgical trainees. We hypothesized that highlighting critical aspects of informed consent would improve resident performance.
  
  
  METHODS
  Eighty (out of 88) surgical postgraduate year 1 surgical residents were randomly assigned to one of the 2 cases (laparoscopic cholecystectomy or ventral herniorrhaphy) and instructed to obtain and document informed consent with a standardized patient (SP) followed by a didactic training session. The residents then obtained and documented informed consent with the other case with the other SP. SPs graded encounters ("Checklist"); trained raters graded notes. Repeated measures multivariate analysis of variance (MANOVA) was used to determine differences between pre- and post-training and Checklist versus "Note" scores.
  
  
  RESULTS
  Statistically significant pre- to post differences for Note (P < .01) and Checklist (P < .01) along with significant differences between Note and Checklist (P < .01) were noted.
  
  
  CONCLUSIONS
  Training improved surgery residents' ability to discuss and document informed consent. Despite this improvement, significant differences between discussion and documentation persisted. Documentation training is a future area for improvement.
authors.affiliation: University of Oklahoma College of Medicine, Office of Medical Education and Clinical Skills Education and Testing Center, 941 Stanton L. Young Boulevard, BSEB 115A, Oklahoma City, OK 73104, USA; PennState Hershey College of Medicine, Hershey, PA, USA. Electronic address: bthompson@hmc.psu.edu.
authors.forename: Britta M
authors.initials: BM
authors.lastname: Thompson
authors.affiliation: University of Oklahoma College of Medicine, Clinical Skills Education and Testing Center, Oklahoma City, OK, USA.
authors.forename: Rhonda A
authors.initials: RA
authors.lastname: Sparks
authors.affiliation: Department of Surgery, University of Oklahoma College of Medicine, Oklahoma City, OK, USA; National Naval Medical Center, Bethesda, MD, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Seavey
authors.affiliation: University of Oklahoma College of Medicine, Clinical Skills Education and Testing Center, Oklahoma City, OK, USA.
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Wallace
authors.affiliation: Department of Surgery, University of Oklahoma College of Medicine, Oklahoma City, OK, USA.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Irvan
authors.affiliation: Department of Surgery, University of Oklahoma College of Medicine, Oklahoma City, OK, USA.
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Raines
authors.affiliation: OU Physicians, Professional Liability, Patient Safety & Risk Management, Oklahoma City, OK, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: McClure
authors.affiliation: Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine, Oklahoma City, OK, USA.
authors.forename: Mikio A
authors.initials: MA
authors.lastname: Nihira
authors.affiliation: Department of Surgery, University of Oklahoma College of Medicine, Oklahoma City, OK, USA.
authors.forename: Jason S
authors.initials: JS
authors.lastname: Lees
mesh_terms: D017081:Cholecystectomy, Laparoscopic; D003142:Communication; D004282:Documentation; D013502:General Surgery / Q000193:education*; D059685:Herniorrhaphy; D006801:Humans; D007258:Informed Consent; D007396:Internship and Residency; D009825:Oklahoma; D016544:Patient Simulation
keywords: Communication; Informed consent; Resident education; Standardized patients