Abstract: Training Surgeons and the Informed Consent Process: Routine Disclosure of Trainee Participation and Its Effect on Patient Willingness and Consent Rates

Patients  
Three hundred sixteen individuals scheduled for elective surgery.

Conclusions
Most patients expressed approval of teaching facilities and resident education. However, consent rates were significantly altered when more detailed information was provided and they declined with increasing levels of resident participation. Providing detailed informed consent is preferred by patients but it could adversely affect resident participation and training.

abstract: Resident Participation Does Not Affect Surgical Outcomes, Despite Introduction of New Techniques

Abstract

BACKGROUND: Surgical operations at academic medical centers typically involve a resident physician performing cases together with, and/or under the supervision of, an attending physician. Although this is a widely accepted practice, recent emphasis on patient safety has led to scrutiny about this educational model. There are few studies evaluating whether complication rates, independent of patient risk factors, are affected by resident participation in operations.
STUDY DESIGN: We identified 295 patients (590 breasts) who had undergone bilateral reduction mammoplasty led by a single attending surgeon between October 1, 1997 and September 30, 2008 at the University of Michigan Health System. In all cases, the attending operated on the right breast and the resident operated on the left breast under the supervision of the attending, allowing each patient to act as their own control. Their charts were retrospectively reviewed and major complications were defined as those requiring either an operation or hospitalization to treat.
RESULTS: Twenty-three patients (7.8%) had a major complication after their breast reduction. Ten of these complications occurred in the left breast, 9 in the right breast, and 4 in both breasts. Statistical analysis revealed no differences in major complication rates between the side operated on with the primary surgeon being the resident versus the attending (4.7% versus 4.4%; p = 1.00).
CONCLUSIONS: In the context of this single surgical operation, resident participation does not substantially affect major complication rates. The common residency training paradigm provides clinical experience and supervision without necessarily impacting patient safety. Analysis of additional operations in different settings will be necessary.

Evaluation of laparoscopic management of gynecologic emergencies by residents

Oncology Residents' Perspectives on Communication Skills and Shared Decision Making

Obstetrics/Gynecology Residents' Knowledge of Hereditary Breast and Ovarian Cancer and Lynch Syndrome.

"Although there have been many studies regarding physicians' knowledge of hereditary cancer syndromes, very little information exists regarding medical residents' knowledge of hereditary cancer syndromes. Obstetrics/gynecology residents completed a test which evaluated their knowledge of hereditary breast and ovarian cancer and Lynch syndrome.