Assessing Qualitative and Quantitative Competence of Resident Knowledge in Communication of Procedure-Specific Risk for Suction Dilatation and Curettage and Vaginal Hysterectomy

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Abstract

PURPOSE:

Perform a knowledge assessment of OBGYN residents' communication of procedure-specific risk for two common gynecologic procedures.

BACKGROUND:

Informed consent is integral to patient autonomy. For surgical patients, satisfaction improves with understanding of the procedure performed. Standardized curriculum for the informed consent process has not been utilized to date. An assessment of resident knowledge in the communication of accurate and adequate information is essential to ensuring adequate disclosure.

METHODS:

Two medical students, 19 residents and 22 faculty were surveyed on understanding of informed consent process and knowledge source on the topic. Respondents identified procedure specific risks for dilation and curettage and vaginal hysterectomy as required by the Texas Medical Disclosure Panel. Statistical analysis was performed to determine knowledge adequacy (unsatisfactory, satisfactory, superior). Interest in formal curriculum was assessed.

RESULTS:

Overall response rate was 74%. Learners were predominantly female (89%) aged 25–29, and evenly distributed across training year. Interval from last surgical rotation was <1 month at all levels. R4/Faculty identified textbooks and American College of Obstetricians and Gynecologists bulletins as their source of knowledge more frequently than other learners (P<.05). Qualitative competence improved with training year (P=.04). Quantitative competence was unsatisfactory at all levels for suction D&C with no difference by PG year (P=.94). Quantitative competence was satisfactory at all levels for vaginal hysterectomy, with no difference by PG year (P=.762). Learners identified formal teaching and direct observation as desired instructional methods.

DISCUSSION:

Though qualitative competence improves with PG training year, the communication of adequate and accurate information remains a challenge at all levels, specifically for suction dilation and curettage. Standardized curriculum should be implemented to achieve competency.

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