'Sorry, it's my first time!' Will patients consent to medical students learning procedures?

摘要

CONTEXT: The clinical teaching of medical students is essential to medicine; however, medical students often may not inform patients of their inexperience. Hence patients do not have the opportunity to consent specifically to the procedures being performed by medical students. OBJECTIVES: The purpose of this study was to determine whether patients, when informed of the inexperience of a medical student, would still consent to the procedure. METHODS: Adult emergency department patients (114) were enrolled if they required one of the following procedures: sutures, intravenous (i.v.) access or splinting. Patients were first surveyed about his or her perceptions of medical student performing procedures. The first-year medical student then informed the patient of their inexperience (the number of procedures they had performed successfully). Finally, the patient was asked to consent to the student performing the procedure (i.e. "this is my first/third time suturing, may I suture you?") The main outcome measure was patient consent to the student performing the procedure. RESULTS: Only 48% of participants knew they could be the first patient on whom a medical student might perform a procedure. A total of 66% thought they should be told if a student was performing his or her first procedure on them. The majority of patients (90%) consented (69/80 i.v., 20/20 splints, 13/14 sutures). For 7 of the 12 refusals, it was the student's first time performing the procedure. CONCLUSION: Most patients will allow medical students to perform minor procedures, even when informed of the student's inexperience.