Avanços em Ética Médica
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Patient willingness to allow hands-on training for post-graduate learning of new surgical techniques

Emily C. Rosenfeld, Jennifer M. Wimberly, Alana Christie, Philippe E. Zimmern

Background: This study assessed patient willingness to allow hands-on training from the surgeon of record to supplement the current ‘observership’ model when learning new techniques. Methods: A survey was administered to patients in two separate outpatient settings, comprising three components: Rapid Estimate of Adult Literacy in Medicine- Short Form (REALM-SF), State Trait Anxiety Inventory form X2 (STAI-X2), and a specifically designed Observer Questionnaire (OQ) with free space for comments. The OQ included two questions of interest. Exclusion criteria were: sub-sixth grade reading level, non-English speakers, and pregnancy. Demographic data collected were: age, gender, and ethnicity. Results: Ninety-nine patients (Location I) and 100 patients (Location II) met inclusion criteria with 91.9% of patients at Location I and 82% at Location II consenting to hands-on training. For current methods of training, responses were: 61% cadaver lab (A), 63% training video/reading material (B), 62% observation without direct contact (C), and 73% observation with direct trainee contact (D). Neither age (p=0.41), ethnicity (p=0.95), or gender (p=0.42) significantly affected responses, nor did an occupational background in health care (p=0.55, surveyed in Location II only). REALM-SF and STAI-X2 scores did not significantly affect responses at either location. The majority of explanations cited for declining hands-on contact were unease due to history of past surgical complications. Conclusions: Supplementing the current ‘observership’ model utilizing on the job training can be acceptable to the majority of patients given strict boundaries including informed patient consent, the surgeon of record remaining fully in charge, and the trainee surgeon having tested credentials.