Patients' Attitudes Towards Trainee Involvement in Cardiac Surgery

Edward J. Caruana, Samer Mahran, Selveraj Shanmuganathan, Adam Szafranek

Nottingham University Hospitals, Nottingham, United Kingdom

Date, time and location: 2018.05.25 13:30, Exhibition area, 1st Floor. Zone – D

Abstract

Trainee contribution is essential for safe and effective care. Training and service provision are fundamentally coupled.We sought to evaluate cardiac surgical patients’ attitudes to varying extents of trainee-involvement in their care.

Methodology

Convenience sampling of thirty post-operative cardiac surgical patients at a single UK centre recruited voluntarily to a structured telephone interview. Quantitative ratings are on a 10-point scale. Statistical analysis was performed in Microsoft Excel 365 with the Anlalyse-it® add-on.

Results

24 patients (age 69±12years, 63% male) completed the survey.

63% of patients felt that basic operative competency should be first achieved in simulated settings.

Patients’ confidence in registrars performing their operation under direct supervision was 10(2) [median(IQR)]; falling to 8(4) with the consultant unscrubbed but in theatre, and to 6(3) with a consultant available nearby. Confidence in having senior house officers as the leading on-site clinicians out of hours was rated at 8(1). Higher confidence in trainee participation was noted in male patients (p = 0.02), and with increasing socioeconomic deprivation (p = 0.04); with a non-significant trend in younger patients (p = 0.06).

Patients wish to be informed beforehand that trainees may participate in their operation (54%), and to meet them pre-operatively (67%). 92% of patients felt reassured when shown matched cardiac surgical outcome data demonstrating equivalence of trainee- to consultant-performed procedures; with 83% articulating that such objective information should be shared pre-operatively.

Conclusions

Patient confidence in supervised trainee-participation is high. Explicitly educating patients about the role of surgical trainees and the implications of training on outcomes may provide reassurance. It should also be considered an integral part of the informed consent process.