Training program bolsters radiology residents’ skills at gaining informed consent, disclosing complications

A training program at one East Coast hospital is bolstering radiology residents’ skills at gaining informed consent and disclosing potential complications, according to new research.

Physicians are often tasked with this important duty, discussing the potential benefits, risks and possible complications of a medical intervention to earn the patient’s approval. However, many residents lack familiarity with this process due to minimal training, experts wrote Jan. 6 in the Journal of Surgical Education.

To close this knowledge gap, Temple University Hospital implemented a formal training process in radiology and six other procedural-based specialties. Surveying residents about their experiences unearthed marked improvements among the Philadelphia-based institution’s providers.

“Our study demonstrated that residents from seven different procedural-based specialties felt significantly more confident and comfortable disclosing complications after practicing in a structured environment,” Valeda Yong, MD, with the hospital’s department of surgery, and co-authors wrote.

Temple’s program consists of an hour-long didactic lecture given by its risk management department. The talk covers key elements of informed consent discussions, such as confirming understanding and identifying potential challenges. Residents also must undergo a two-part simulation including debriefing, a standardized patient scenario, and faculty feedback. Each specialty had a different procedure in the training, with radiologists tackling CT-guided needle biopsy of a lung mass.

The institution kicked off the initiative in 2014 and added the element of disclosing potential complications in 2016. With this, residents were also assessed on whether they verbalized the mistake, apologized afterward, and took responsibility for the complication when explaining what happened.

Progress was gauged based on surveys administered before and after the training. All told, 193 first-year residents completed the program, including 31 in radiology. Those in imaging, general surgery, OBGYN, and emergency medicine showed significant increases in confidence and comfort in filling out forms, obtaining informed consent and disclosing a complication. Meanwhile, otolaryngology residents did not show noteworthy gains.

Future work may explore how the program benefits physicians years after the exercise.

“Given that our study only assesses resident confidence and comfort immediately after participating in the formal training program, investigating the long-term benefits of the training in a clinical setting and surveying patients for their response to this training would be beneficial,” Yong and co-authors wrote.

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