Informed Consent for Academic Surgeons: A Curriculum-Based Update.

Introduction: The principles of consent are evolving but remain an important part of the surgeon-patient relationship. The goal of this course was a concise, contemporary review of the principles of informed consent that would be favorably received by academic surgeons. Methods: The curriculum consisted of ethicohistorical and legal principles, current requirements, and new consent developments. An anonymous, voluntary evaluation tool was used to assess strengths and opportunities for improvement. A short postcourse quiz was developed to assess understanding. Results: Eighty-five percent of the surgery department faculty participated. Evaluations were overwhelmingly positive, all elements having weighted averages of greater than 4.5 on a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree). Furthermore, a majority of respondents for the posttest got the answers correct for all five questions asked on the postcourse quiz. Discussion: A proper understanding of informed consent remains critically important in the practice of surgery. This short course updating surgeons on informed consent quantitatively confirms the favorable reception of this approach in terms of attendance and satisfaction, as well as understanding of the material.

Communication Skills Training for Surgical Inpatient Advanced Practice Providers in an Academic Health-Care System.

BACKGROUND: Good communication skills enhance the patient experience, clinical outcomes, and patient satisfaction. OBJECTIVE: A course was developed by an interdisciplinary team (surgeon, nurse practitioner, and nurse MBA) for advanced practice providers (APPs) working for the department of surgery-a mix of practice and hospital-employed professionals-to enhance communications skills in an inpatient setting. METHODS: Current concepts on provider-patient communication were discussed. Participants also asked to view and critique a video "provider-patient communication gone wrong" scenario. Lastly, participants were provided with techniques for improving provider-patient communication. The participants assessed the course. Provider communication scores were tracked from quarter 1, Fiscal Year 2014 to quarter 4 Fiscal Year 2017. RESULTS: Of 110 eligible APPs, 95 (86%) attended the course. The anonymous survey response rate was 90% (86/95). Participants expressed satisfaction with the course content confirmed by Likert score weighted averages of >4.6/5 in all 8 domains. Communication scores increased with time. CONCLUSION: An interdisciplinary course aimed at enhancing provider-patient communication skills was well-received by the APP participants. The course was part of ongoing system-wide efforts to improve patient experiences, satisfaction, and outcomes. Continuing education in communication continues to play a key role in improving clinical outcomes and patient satisfaction.

Tipping the scales: educating surgeons about medical malpractice.

BACKGROUND: In Pennsylvania, medical malpractice premiums are a major cost to surgeons. Yet surgeons often have little if any education in the basics of tort litigation or how to manage their risk. This work describes one approach for educating academic faculty surgeons on current concepts of medical malpractice and provide some guidance on how to "tip the scales of justice"; or minimize the risks of being named in a malpractice claim. MATERIALS AND METHODS: The course had five parts: the basics of medical malpractice, the cost of malpractice insurance, current departmental claims experience, strategies for decreasing the risk of being named in a claim, and an overview of malpractice reforms. An anonymous seven question survey was cast in a five-point Likert scale format. A weighted average of 4.5 or above was considered satisfactory. Two free text questions asked about positive and negative aspects of the course. RESULTS: Eighty of 95 (84%) faculty attended either in person or by reviewing a web-based video. Quantitatively, five of seven questions had a weighted average of more than 4.5 (n = 48, response rate = 60%). Qualitatively, the course was reviewed very favorably. CONCLUSIONS: The high percentage of participation and overall survey results suggest that the course was successful. This course was one facet of an approach to decrease the risk of malpractice claims. Unique aspects of this course include an emphasis on state law, department-specific data, and strategies to minimize risk of future claims. Given the state-specific nature of malpractice claims and litigation, individual departments must particularize similar presentations.