Pediatric Resident Preparedness and Educational Experiences with Informed Consent

Objective Informed consent is an essential component of optimal patient care. Scant data exist about pediatric residents' experiences, comfort level, and educational exposure to informed consent discussions. Methods Electronic survey of a random selection of members of the American Academy of Pediatrics Section for Medical Students, Residents, and Fellows regarding consent practices and processes for 5 commonly encountered pediatric procedures/situations: lumbar puncture, neonatal central line, pediatric sedation, intubation, and administration of blood products. Results Overall response rate was 34.7% (1071 participants of 3084 invited). Responses from 622 active categorical pediatric residents were analyzed. Almost all respondents (99%) endorsed the importance of informed consent for best patient care. Observation was the most frequently reported educational modality. Over 90% had obtained consent for lumbar puncture and blood products but only 27.6% for intubation. Between 9% and 31% of respondents reported obtaining consent for specific procedures in which they were not expected to actively participate. Depending on the procedure, a variable number of respondents reported not feeling prepared to discuss the benefits (1-23%) or risks (2-31%) of these procedures with patients and/or parents. Respondents felt significantly less prepared to discuss risks (P <.05 for each procedure). Conclusions A significant percentage of respondents reported not feeling comfortable with discussing key components of informed consent. A minority of respondents reported being engaged in obtaining consent for procedures in which they are not expected to actively participate. Best practices for resident involvement in informed consent discussions need to be defined and incorporated into resident education.