Wiseman O J, Wijewardena M, Calleary J, Masood J, Hill J T
Department of Urology, Harold Wood Hospital, Romford, Essex, UK. oliver@
Ann R Coll Surg Engl. 2004 Nov;86(6):462-4. doi: 10.1308/1478708041109.
As part of the consent process, it is part of a doctor's duty of care to reveal any material risk. Depending upon the level of supervision, whether the operating surgeon is a trainee may be such a risk, but in our experience this is not routinely discussed with patients pre-operatively. We set out to discover patients' attitudes to being operated on by trainee urological surgeons.
A total of 101 completed questionnaires were received from patients (90 male, 11 female, mean age 72 years) undergoing transurethral resection of the prostate (TURP), transurethral resection of a bladder tumour (TURBT) or cystodiathermy on various aspects of their attitudes to being operated on by junior doctors as part of training.
The response rate was 77%. Of the respondents, 94 patients (91%) thought that junior doctors should perform surgery as part of their training. Only 11 of 73 (15%) said they would be happy for a junior doctor, competent to perform the procedure, to operate unsupervised. Of 98 patients, 80 (82%) thought they should be told if the operation was going to be performed by a junior doctor, and 85 (87%) that they should be told their name and designation.
For consent to be 'informed', the experience and identity of the surgeon should be made known to patients. Most patients are happy to be operated on by a junior doctor under consultant supervision, but would want to be told and know their name and status.
作为同意过程的一部分，告知任何重大风险是医生护理职责的一部分。根据监督级别，主刀外科医生是否为实习生可能是这样一种风险，但根据我们的经验，术前通常不会与患者讨论这一问题。我们着手了解患者对于由泌尿外科实习医生进行手术的态度。
共收到101份来自接受经尿道前列腺切除术（TURP）、经尿道膀胱肿瘤切除术（TURBT）或膀胱透热疗法的患者（90名男性，11名女性，平均年龄72岁）填写的问卷，内容涉及他们对于作为培训一部分由初级医生进行手术的各方面态度。
回复率为77%。在受访者中，94名患者（91%）认为初级医生应将手术作为培训的一部分。在73名患者中，只有11名（15%）表示，他们愿意让一名能够胜任该手术的初级医生在无监督的情况下进行手术。在98名患者中，80名（82%）认为如果手术将由初级医生进行，他们应该被告知，85名（87%）认为应该告知他们初级医生的姓名和职位。
为了实现“知情”同意，应向患者告知外科医生的经验和身份。大多数患者乐于在顾问监督下由初级医生进行手术，但希望被告知且知道初级医生的姓名和身份。
