How Informed Is Your Informed Consent: Evaluating Differences Between Resident and Attending Obtained Consents for Cholecystectomy

OBJECTIVE: There is considerable variability in surgeons' approach to write and obtain informed con-sent for surgery, particularly among resident trainees. We analyzed differences in procedures and complica -tions described in documented surgical consents for cholecystectomy between residents and attendings. We hypothesized that attending consents would describe more comprehensive procedures and complications than those done by residents.DESIGN: This is a retrospective analysis of 334 patients who underwent cholecystectomy. Charts were queried for demographics, surgical approach, whether the con-sent was completed electronically, and which provider completed the consent. Specifically, consents were eval-uated for inclusion of possible conversion to open proce-dure, intraoperative cholangiogram, bile duct injury, injury to nearby structures, reoperation, bile leak, as well as if the consent matched the actual procedure performed.SETTING: This study was conducted at an accredited general surgery training program at an academic tertiary care center in the Midwest. PARTICIPANTS: This was a review of 334 patients who underwent cholecystectomy over a 1 year period.RESULTS: Of all documented consents analyzed, 153 (47%) specifically included possible intraoperative cholangiogram, 156 (47%) included bile duct injury, 76 (23%) included injury to nearby structures, 22(7%) included reoperation, and 62 (19%) included bile leak. In comparing residents and attendings, resi-dents were more likely to consent for bile duct injury (p = 0.002), possible intraoperative cholangiogram (p = 0.0007), injury to nearby structures (p < 0.0001), reoperation (p < 0.0001), and bile leak (p < 0.0001). CONCLUSIONS: Significant variation exists between documentation between resident and attending chole-cystectomy consents, with residents including more complications than attendings on their consent forms. These data suggest that experience alone does not pre-dict content of written consents, particularly for com -mon ambulatory procedures. Education regarding the purpose of informed consent and what should be included in one may lead to a reduction in variability between providers. ( J Surg Ed 79:1509-1515. (c) 2022 Published by Elsevier Inc. on behalf of Association of Program Directors in Surgery.)