Marriage of professional and technical tasks: a strategy to improve obtaining informed consent

Background Education in obtaining informed consent, combined with technical training using a stepwise approach, may improve resident knowledge of, confidence in, and frequency of obtaining consent for bedside procedures. Methods Surgical trainees were randomized to receive a lecture on obtaining informed consent. Knowledge of, confidence in, and frequency of obtaining consent were assessed. Subsequent first-year residents received combined technical and consent training using a stepwise approach. Residents listed key steps for procedures before and after training, were observed for consent and technical competency on patients, and were assessed on frequency of obtaining consent by follow-up chart review. Results Knowledge and confidence improved after lecture instruction, but consent rate (21%) did not. Stepwise training increased resident awareness of obtaining informed consent as a key step (19% to 77%) and increased frequency of obtaining consent (89% for proctored procedures and 79% in follow-up). Conclusions Education alone improves knowledge but not practice of obtaining consent. Teaching the consent process concomitantly with technical training may increase awareness and performance of obtaining informed consent for bedside procedures.