Implicit Surgeon Perceptions of Patient Personas: a Framework for Surgical Informed Consent Design

Implicit Surgeon Perceptions of Patient Personas: a Framework for Surgical Informed Consent Design
Jasmine Panton, Jayson S. Marwaha, Gabriel Brat
Journal of the American College of Surgeons, 1 November 2021; 233(5)
Open Access
Abstract
Introduction
Surgeons communicate risk with patients in different ways based on patient and contextual factors. To optimize risk communication for surgeons, there has to be a detailed understanding of how surgeons think about using risk in preoperative conversations with patients. In this study, we sought to identify personas leveraged by surgeons to facilitate risk communication during informed consent.
Methods
We conducted interviews with 13 surgeons regarding strategies for discussing patient-specific risk, and completed a narrative review on risk communication across surgical contexts. With these data, we created a framework to characterize the implicit patient personas used by surgeons during informed consent to appropriately communicate risk.
Results
In our analysis, we identified 7 key elements implicitly evaluated by surgeons during preoperative consent. These included the patients’ health profile, acuity of illness, health literacy, perception of and receptiveness to risk, clinical and procedural context, and encounter scenario. By accounting for these, we found that additional outputs beyond perioperative complications, such as postoperative quality-of-life complications and pain, are needed to provide personalized risk to lower acuity patients.
Conclusion
Understanding the implicit heuristic used by surgeons during informed consent has the potential to significantly inform efforts to improve preoperative consent. Tools using risk data to facilitate shared decision-making may benefit from patient personas to improve generalizability across patient populations. Because surgeons’ communication strategies and priorities are driven by key components of the patient’s persona, next-generation shared decision-making tools should use personas to optimize surgeon risk communication in the context of patient needs.