教導麻醉科住院醫生如何獲得知情同意
麻醉知情同意書是一項重要的具有法律效應的文件，如何在術前告訴患者麻醉相關事項，讓患者及其家屬瞭解麻醉、知曉風險，簽署知情同意書對臨床醫生是一項重要的技能。而這項技能如何獲得呢？這篇發表在J Educ Perioper Med的文章Teaching Anesthesiology Residents How to Obtain Informed Consent報道了他們的做法
摘要譯文
教導麻醉科住院醫生如何獲得知情同意
背景: 儘管獲得醫療同意是一項重要技能，但許多住院醫生在理解知情同意的關鍵概念方面可能存在知識空白，或者可能缺乏對嚴重程序風險的認識。
目的：這項研究的目的是看看正規教育是否對麻醉科住院醫生獲得知情同意的能力產生影響。
方法: 將34名一年級麻醉科住院醫生隨機分為對照組和研究組。 對照組按目前的方法，通過觀察高年資住院醫師或老師學習如何獲得全身麻醉的知情同意。 研究組接受了額外的正規教育，包括一個視頻，一個旁白講座和一個測驗。 隨後，觀察兩組醫生在全身麻醉患者中獲得知情同意的情況。 研究人員使用了一個由10個重要項目組成的清單，住院醫師必須完成適當的知情同意。 為了減少偏倚，無論是對照組還是研究組都沒有看過這個清單。
結果: 總體而言，研究組在完成清單上的10個項目方面明顯優於對照組（中位數為0.90 VS 0.70， P﹤0.001)。 在4個關鍵項目上有統計學上的差異: 識別麻醉小組的所有人員（76.5% VS 5.9%，P﹤0.001），解釋為什麼全身麻醉是必要的（82.4% VS 35.3%，P =0.0134），解釋全身麻醉的風險和好處（94.1% VS 47.1%， P=0.0066），討論輸血的風險和好處（70.59% VS 29.4%，P=0.0381）。
結論: 本研究表明，關於知情同意的正規教育提高了住院醫師獲得知情同意的能力。
原文摘要
Teaching Anesthesiology Residents How to Obtain Informed Consent
Background:
Although obtaining medical consent is an important skill, many residents may have knowledge gaps in understanding key concepts of informed consent or may lack awareness of serious procedural risks. The objective of this study was to see if formal education makes a difference in anesthesiology residents' ability to obtain an informed consent.
Methods:
Thirty-four first-year anesthesiology residents (CA1s) were randomized into either a control group or study group. The control group learned how to obtain consent for general anesthesia the current way, which is by observing senior residents or faculty. The study group received additional formal education, which included a video, a narrated lecture, and a quiz. Afterwards, both groups were observed obtaining informed consent on patients receiving general anesthesia. The investigators used a checklist consisting of 10 important items that the resident had to fulfill for a proper informed consent. To minimize bias, neither the control group nor the study group was shown the checklist.
Results:
Overall, the study group did significantly better than the control group in fulfilling the 10 items on the checklist (median 0.90 vs 0.70; P < .001). There were statistical differences on 4 key components: identifying all persons on the anesthesia team (76.5% vs 5.9%, P < .0001), explaining why general anesthesia is necessary (82.4% vs 35.3%, P < .0134), explaining the risks and benefits of general anesthesia (94.1% vs 47.1%, P < .0066), and discussing the risks and benefits of blood transfusion (70.59% vs 29.4%, P < .0381).
Conclusions:
This study shows that formal instruction on informed consent enhances residents' ability to obtain an informed consent.
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