Enhancing Resident Education in Informed Consent Through Digital Checklists

Abstract

Background

In many teaching hospitals, surgical residents frequently lead consent discussions despite limited procedural experience, which may hinder accurate risk disclosure. We hypothesized that a structured digital risk checklist, created by experienced attending surgeons and embedded within a video-based consent platform, would improve consent quality and serve as an educational tool for residents.

Methods

General surgery residents (R1-R5) completed informed consent for common procedures using two formats: traditional written consent followed by a digital checklist-based platform. The checklists included both relevant and irrelevant risk options to encompass risks associated with multiple procedures within a specific surgical field. Residents selected applicable risks for each operation, which were compared to the “gold standard” risk profiles generated by four core faculty attending surgeons that were not shared with residents beforehand. Accuracy, risk counts, and performance by training level were compared between the two consent formats.

Results

Consent practices among 23 surgical residents (R1-R5) across 8 surgical procedures were analyzed. Digital checklists use significantly improved accuracy compared with written consent, with a higher proportion of correctly identified risks (70.4% vs 50.7%, P < 0.001). Checklist performance exceeded written performance across all postgraduate year levels and surgical procedures. However, checklist use was associated with increased selection of irrelevant risks, particularly among junior residents compared with seniors (32% vs 15%, P < 0.01).

Conclusion

Digital risk checklists improved the completeness and accuracy of resident-led informed consent but may encourage over-selection of irrelevant risks. With refinement, digital consent aids show promise as effective educational tools in surgical training.