The Effect of Patient Education on the Perceptions of Resident Participation in Surgical Care

OBJECTIVE

To decipher if patient attitudes toward resident participation in their surgical care can be improved with patient education regarding resident roles, education, and responsibilities.

DESIGN

An anonymous questionnaire was created and distributed in outpatient surgery clinics that had residents involved with patient care. In total, 3 groups of patients were surveyed, a control group and 2 intervention groups. Each intervention group was given an informational pamphlet explaining the role, education, and responsibilities of residents. The first pamphlet used an analogy-based explanation. The second pamphlet used literature citations and statistics.

SETTING

Keesler Medical Center, Keesler AFB, MS. University of Texas Health Science Center at San Antonio, San Antonio, TX.

PARTICIPANTS

A total of 454 responses were collected and analyzed-211 in the control group, 118 in the analogy pamphlet group, and 125 in the statistics pamphlet group.

RESULTS

Patients had favorable views of residents assisting with their surgical procedures, and the majority felt that outcomes were the same or better regardless of whether they read an informational pamphlet. Of all the patients surveyed, 80% agreed or strongly agreed that they expect to be asked permission for residents to be involved in their care. Further, 52% of patients in the control group agreed or strongly agreed to a fifth-year surgery resident operating on them independently for routine procedures compared to 62% and 65% of the patients who read the analogy pamphlet and statistics pamphlet, respectively (p = 0.05). When we combined the 2 intervention groups compared to the control group, this significant difference persisted (p = 0.02).

CONCLUSION

Most patients welcome resident participation in their surgical care, but they expect to be asked permission for resident involvement. Patient education using an information pamphlet describing resident roles, education, and responsibilities improved patient willingness to allow a chief resident to operate independently.

Incorporating a Mandatory Osteopathic Manipulative Medicine (OMM) curriculum in clinical clerkships: impact on student attitudes toward using OMM

CONTEXT

As the osteopathic medical profession grows and enrollment in osteopathic graduate medical education falls, it is important to ensure that all osteopathic medical students receive adequate training in osteopathic manipulative medicine (OMM).

OBJECTIVE

To determine if incorporating mandatory exposure to OMM into third- and fourth-year clinical clerkships favorably influences osteopathic medical students' comfort with the use of OMM.

METHODS

All participants attended a 1-hour mandatory didactic lecture and a 3-hour practical clinic every week as part of their rotations at Wilson Memorial Medical Center. The authors distributed 2 hardcopy questionnaires to each subject: the first survey before rotations began and the second at the end of rotations. The survey comprised 7 clinical situations to which students used a visual analog scale ranging from "comfortable" to "uncomfortable" to describe their personal comfort with using OMM in each situation. Students' responses before and after rotations were compared using the paired t test.

RESULTS

Sixty-eight students had rotations at the clinic; 50 students completed both questionnaires. The study demonstrated a statistically significant increase in comfort level of 17.9% (P<.001) after the rotations.

CONCLUSIONS

Students' reported levels of comfort with OMM increased after they underwent formal OMM education. Incorporating exposure to an OMM curriculum may help instill a greater sense of identity as a future osteopathic physician and may influence participation in an osteopathic residency.