Survey of Informed Consent Procedures in Urology

Survey of Informed Consent Procedures in Urology
Juliana Kim, Arnav Srivastava, Alexandra Tabakin, Eric A Singer
Journal of the American College of Surgeons, November 2022; 235(5)
Abstract
Introduction
The American Urological Association and American College of Surgeons codes of professionalism require surgeons to disclose the specific roles and responsibilities of trainees to patients during the informed consent process. This study analyzes how these requirements are met by urology training programs.
Method
An anonymous electronic survey was distributed to the program directors (PDs) of the 143 ACGME urology residency programs in the US in 2021. Responses were procured during 3 months. Information was collected regarding program demographics, aspects of the program’s consent process, and the disclosure of the role and participation of residents to patients.
Result
Of 143 distributed surveys, 30.0% (n = 43) received a response. Of responding PDs, 67.4% reported that attending physicians lead the consent process. The topics covered during consent discussion include possible complications (25.1%), expected recovery time (22.8%), length of the surgery (22.2%), the people involved (18.0%), and their specific roles (7.2%). Of PDs, 48.8% and 87.8% of do not explicitly discuss trainee involvement or when a resident performs the majority of the case, respectively (Figure). Of PDs, 78.8% do not communicate medical student involvement. Of PDs, 73.2% reported having a patient decline participation of a trainee after describing their role.
Conclusion
Despite the American Urological Association and American College of Surgeons codes of professionalism, many urologists involved in the training of residents may not disclose resident participation in surgery to patients. Further discussions are needed to explore how to better balance resident education while strengthening the informed consent process.