Bariatric surgery patient perceptions and willingness to consent to resident participation

Abstract

Background: Many bariatric surgery programs are located at teaching hospitals, where they are integral to the training of surgical residents.

Objectives: The purpose of this study was to examine preexisting bariatric patient perceptions and willingness to allow resident participation in their surgery.

Setting: Madigan Army Medical Center, Tacoma, Washington, USA.

Methods: Anonymous questionnaire was given to bariatric patients at their preoperative appointment at an academic teaching hospital. The survey captured demographic characteristics, overall opinions of teaching programs, and willingness to consent to various scenarios of trainee participation. Univariate and multivariate analyses were performed.

Results: One hundred eight patients (93% female) completed the questionnaire. Most patients (92.4%) expressed overall support for their procedure being performed at a teaching hospital. When presented with several realistic scenarios, most patients would consent to having a staff surgeon operate and residents/students observe (86%). However, only 56% of patients would consent to a resident assisting staff during a procedure and barely 14% of patients would consent to staff surgeon observing. An independent factor associated with increased willingness to consent to resident participation included patients whose first choice would be to undergo surgery at a teaching hospital (P< .05).

Conclusion: Overall, patients expressed support for the teaching hospital model and resident education and participation. However, their willingness to consent to specific realistic scenarios involving various levels of resident participation in their surgery ranged widely. Although patients prefer detailed informed consent, it has the potential to negatively affect resident participation and training.

Keywords: Anonymous survey; Attitudes toward teaching hospital; Bariatric patient; Informed consent; Patient perceptions; Private versus teaching hospital; Resident participation; Resident training; Teaching hospital; Willingness to consent.