Persistence of inadequate consent training for interns.
Consent
Education
Ethics
Interns
Risk disclosure
Journal
Irish journal of medical science
ISSN: 1863-4362
Titre abrégé: Ir J Med Sci
Pays: Ireland
ID NLM: 7806864
Informations de publication
Date de publication:
07 Aug 2023
07 Aug 2023
Historique:
received:
27
10
2022
accepted:
23
06
2023
medline:
7
8
2023
pubmed:
7
8
2023
entrez:
7
8
2023
Statut:
aheadofprint
Résumé
Informed consent is a continuous process of communication with the patient and not merely the signing of a form. The Irish Medical Council's Guide to Good Practice and Ethics state that no part of the consent process should be delegated to an intern unless the procedure is a minor with which the intern is very familiar and all relevant information has first been explained to the intern. We aimed to evaluate whether practices regarding interns and consent had changed in the past five years. An anonymous Google Forms survey was distributed to interns from all intern networks between 24-August and 26-November 2021. Of 854 interns, there were 147(17.2%) survey responses. 129(87.8%) participants had consented for a procedure. 111(86%) responded that they had consented for procedures that they had not witnessed before. 92(71.3%) reported that their medical supervisor did not explain procedures to them prior to obtaining consent. 128(99.2%) of interns were not usually observed by a more senior doctor when obtaining consent. 116(89.9%) were expected to obtain consent from patients on a regular basis, with 78(60.5%) feeling pressured into doing so on at least one occasion. Results were largely unchanged compared to when the same survey was circulated in 2016. Interns remain routinely involved in the consent process without adequate training or supervision. This is unfair on our most junior doctors and on patients. Steps must be taken to ensure the IMC guidance is adhered to and this deficiency must be highlighted to Senior Clinicians.
Sections du résumé
BACKGROUND
BACKGROUND
Informed consent is a continuous process of communication with the patient and not merely the signing of a form. The Irish Medical Council's Guide to Good Practice and Ethics state that no part of the consent process should be delegated to an intern unless the procedure is a minor with which the intern is very familiar and all relevant information has first been explained to the intern.
AIMS
OBJECTIVE
We aimed to evaluate whether practices regarding interns and consent had changed in the past five years.
METHODS
METHODS
An anonymous Google Forms survey was distributed to interns from all intern networks between 24-August and 26-November 2021.
RESULTS
RESULTS
Of 854 interns, there were 147(17.2%) survey responses. 129(87.8%) participants had consented for a procedure. 111(86%) responded that they had consented for procedures that they had not witnessed before. 92(71.3%) reported that their medical supervisor did not explain procedures to them prior to obtaining consent. 128(99.2%) of interns were not usually observed by a more senior doctor when obtaining consent. 116(89.9%) were expected to obtain consent from patients on a regular basis, with 78(60.5%) feeling pressured into doing so on at least one occasion. Results were largely unchanged compared to when the same survey was circulated in 2016.
CONCLUSIONS
CONCLUSIONS
Interns remain routinely involved in the consent process without adequate training or supervision. This is unfair on our most junior doctors and on patients. Steps must be taken to ensure the IMC guidance is adhered to and this deficiency must be highlighted to Senior Clinicians.
Identifiants
pubmed: 37548839
doi: 10.1007/s11845-023-03444-0
pii: 10.1007/s11845-023-03444-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.
Références
HSE (2014) Consent: A guide for health and social care professionals
HSE (2019) National Consent Policy (Ireland)
Pomeroy E, Shaarani S, Kenyon R, Cashman J (2021) Patient Recall of Informed Consent at 4 Weeks After Total Hip Replacement With Standardized Versus Procedure-Specific Consent Forms. J Patient Saf 17:e575–e581. https://doi.org/10.1097/PTS.0000000000000412
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pubmed: 28858002
Medical Council (2019) Guide to Professional Conduct & Ethics 8th Edition. 64
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pubmed: 18315998
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Irish Medical Council (2009) Guide to Professional Conduct and Ethics for Registered Medical Practitioners 7th Edition
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doi: 10.1007/S11845-018-1782-5
pubmed: 29524100
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