Nikta Projects, Sydney, New South Wales, Australia.
Faculty of Health and Medicine, The University of Newcastle, Newcastle, New South Wales, Australia.
ANZ J Surg. 2022 Apr;92(4):819-824. doi: 10.1111/ans.17517. Epub 2022 Feb 4.
The purpose of informed consent is to provide patients with adequate information about a proposed plan or intervention, including the benefits and risks, so that they can make an informed decision about their medical treatment. The literature suggests that trainees are often delegated the task of obtaining consent with inadequate knowledge, skill or experience. The aim of this study is to determine the extent orthopaedic surgical trainees have been exposed to education about the informed consent, their perceived ability to obtain consent effectively and the frequency with which they routinely address elements of the process when consenting patients.
An eight-item questionnaire assessing trainees' experience with informed consent was distributed to trainees undertaking Australian orthopaedic surgery training in 2019.
Of the 239 trainees, 102 completed the questionnaire. Although 99% of trainees were confident that they can obtain valid consent from patients, when asked about aspects of the process, many trainees do not address them. Only 29% of trainees always ask patients about goals of care and 21% always advise the patient of who will be performing the procedure. Trainees who indicated that they had received education on informed consent during surgical training are significantly more likely to address key elements.
Trainees' perceptions of their knowledge and skill in relation to informed consent does not align with their reported practice. Although the majority of trainees had received some education on informed consent, greater emphasis on explicit teaching and formal assessment should be undertaken during surgical training, prior to trainees completing this activity independently.
知情同意的目的是向患者提供有关拟议计划或干预措施的充分信息，包括获益和风险，以便他们能够就其医疗做出明智的决定。文献表明，受训者通常在知识、技能或经验不足的情况下被委托完成获取同意的任务。本研究旨在确定骨科手术受训者在多大程度上接受过有关知情同意的教育，他们对有效获取同意的能力的看法，以及他们在同意患者时常规处理该过程各个要素的频率。
2019 年，向澳大利亚骨科培训中的受训者分发了一份评估其对知情同意的经验的八项问题的调查问卷。
在 239 名受训者中，有 102 名完成了问卷。尽管 99%的受训者有信心能够从患者那里获得有效的同意，但在问及过程的各个方面时，许多受训者并未涉及这些方面。只有 29%的受训者总是询问患者关于治疗目标的问题，21%的受训者总是告知患者谁将进行手术。表示在外科培训中接受过知情同意教育的受训者更有可能涉及关键要素。
受训者对其在知情同意方面的知识和技能的看法与其报告的做法不一致。尽管大多数受训者已经接受过一些有关知情同意的教育，但在外科培训期间，应更加强调明确的教学和正式评估，然后再让受训者独立完成此项活动。
