Available online 16 October 2023

Author links open overlay panel, , , Objective

Identify what topics are of most interest to patients regarding surgical residents.

Design

Survey of general public describing a hypothetical surgery and then assessing comfort level with resident involvement in surgery, reactions to disclosure statements regarding resident involvement, and desires for additional information. This data was used to produce an amended statement about surgical residents and their involvement in a hypothetical surgery to determine the impact of increased information on participant comfort.

Setting

: Online survey via Mechanical Turk.

Participants

Our sample was broadly representative of the United States based on race and age, but with higher education level than United States census data.

Results

Using a combination of hierarchical clustering, weighted averages, and VAS scoring, questions that were most highly valued by participants were related to what the resident will be doing in the operation and the impact of resident involvement. Participants who had a past negative experience with residents assigned higher importance to all questions, even those that may be seen as not clinically relevant. Increasing the amount of proactively provided information did not have a significant effect on comfort (p = 0.219) when compared to our baseline statement, except with those who reported past negative experience with residents (p = 0.039).

Conclusions

These results demonstrate that the majority of potential patients want to know specific details about the residents’ skills, what they will be doing in their surgery, and the impact of their participation. Surgeons should be attuned to patients with past negative experiences, who may desire more information. Additional information alone may not be sufficient to comfort some patients, and future research should consider information delivery styles and interpersonal effects on patient comfort level.

Section snippetsINTRODUCTION

Residents are an integral part of the surgical team at academic medical centers, and necessarily take on greater responsibility for performing operations as they advance through training.1 However, despite residents’ substantial involvement in surgical procedures, evidence suggests that patients may be unaware of the extent of resident involvement, and express reluctance with having residents perform portions of their procedures when presented with realistic scenarios of resident involvement.2

METHODS

To develop the foundation of this research protocol, we re-analyzed qualitative transcripts from previously published studies from our research group involving interviews with patients10,11 and attending surgeons to identify thematic elements of discussions regarding resident involvement. Briefly, we accumulated quotes that were given by participants to answer questions related to resident involvement in surgeries, as well as what they believe patients should know about resident involvement.

First Survey

The first survey was completed by 673 MTurk users. Of these, 117 were rejected for being incomplete, duplicate, failing an attention check, or having the incorrect survey code. There were 466 usable surveys. Of the 466 respondents, 43.1% were female, 84.3% white, 23% were Hispanic, and 85.2% held a bachelor's degree or higher (Table 1). The mean age was 36.5 years old. The study population was broadly similar to the US adult population in terms of age and race, but had achieved a higher level

Discussion

Informed consent is a cornerstone of medicine. During the initial consultation before a surgery, patients are often provided a large amount of information about their disease and proposed procedure (e.g., complications, risks, benefits, and other options). Informed consent concerning the participation of residents in their operation might therefore be limited to a short disclosure within the informed consent document or briefly mentioned by the attending physician. Providing the “right” amount

Ethics Statements

This project was reviewed by the Vanderbilt University IRB and was deemed exempt under 45 CFR 46.104 (d) category (2).

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What Is a Surgical Resident? American College of...View full text

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