کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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2913835 | 1575522 | 2009 | 6 صفحه PDF | دانلود رایگان |
AimDespite no formal training in consenting patients, surgeons are assumed to be competent if they are able to perform an operation. We tested this assumption for carotid endarterectomy (CEA).MethodsThirty-two surgeons [Group 1: junior surgical trainees – performed 0 CEA's (n = 11); 2: senior vascular trainees – 1–50 CEA's (n = 11); 3: consultant vascular surgeons – > 50 CEA's (n = 10)] consented two patients (trained actors) for a local anaesthetic CEA. The performance was assessed at post hoc video review by two independent assessors using a validated rating scale and checklist of risk factors.ResultsThere was no difference in performance between the junior and senior trainees (1: median 91 range 64–121; 2: median 100.5 range 66–125; p = 0.118 1 vs. 2 Mann–Whitney). There was a significant improvement between senior trainees and consultant surgeons (3: median 120 range 89–1 142; p = 0.001 2 vs. 3). Few junior (1/11) and senior (2/11) trainees, and most (8/11) consultants, were competent. Inter-rater reliability was high (α = 0.832).Consultant surgeons were significantly more likely to discuss cranial nerve injuries (p < 0.0001 Chi-square test) as well as personal or hospital specific stroke risk (p < 0.0001) than their junior counterparts. They were less likely to discuss infection (p < 0.0001).ConclusionSenior trainees, despite being able to perform a CEA, were not competent in consent. The majority of consultant surgeons had developed competence in consenting even though they had no formal training.
Journal: European Journal of Vascular and Endovascular Surgery - Volume 37, Issue 2, February 2009, Pages 134–139