Assessing medical students’ competence in obtaining informed consent

Roberts, Laura Weiss; Mines, Jan; Voss, Carolyn; Koinis, Cheri; Mitchell, Stephen Α.; Obenshain, S. Scott; McCarty, Teresita

doi:10.1016/s0002-9610(99)00178-6

Cited by 14 publications

(4 citation statements)

References 14 publications

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“…The items were generated from the literature on informed consent and confidentiality in the context of HIV, and had been refined on the basis of the authors' experience with a previous informed consent station on obtaining consent for cardiac catheterization (see Table 1). 15 Items related to respectfulness, relatedness, and quality of communication during the encounter (Items 1–3, 9–11), the reasons for and procedure of the HIV test (Items 4–5), the risks and benefits of and alternatives to the test (Items 6–8), the confidentiality issues (including documentation and access) related to the HIV test (Items 12–14), and the absence of coercion in consenting to or refusing the test (Item 15) were included in the checklist. The first 15 of the 16 items were encoded as “yes,”“sort of,” and “no” (2 points, 1 point, and 0 points, respectively) for the statistical analyses.…”

Section: Methodsmentioning

confidence: 99%

Evaluating medical students’ skills in obtaining informed consent for HIV testing

et al. 2003

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OBJECTIVE: To evaluate fourth-year medical students' abilities to obtain informed consent or refusal for HIV testing through a performance-based evaluation method. DESIGN: Student competence was assessed in a standardized patient interaction in which the student obtained informed consent or refusal for HIV testing. A previously validated 16-item checklist was completed by the standardized patient. A subset was independently reviewed and scored by a faculty member to calculate interrater reliability for this report. Student feedback on the assessment was elicited.SETTING: School of Medicine at the University of New Mexico. PATIENTS/PARTICIPANTS:All senior medical students in the class of 2000 were included.INTERVENTIONS: A 10-minute standardized patient interaction was administered within the context of a formal comprehensive performance assessment. MEASUREMENTS and MAIN RESULTS:Seventy-nine students participated, and most (96%) demonstrated competence on the station. For the 15 specific items, the mean score was 25.5 out of 30 possible points (range, 13 to 30; SD, 3.5) on the checklist. A strong positive correlation (r s = .79) was found between the total score on the 15 Likert-scaled items and the score in response to the global item,``I would return to this clinician'' (mean, 3.5; SD, 1.0). Scores given by the standardized patients and the faculty rater were well correlated. The station was generally well received by students, many of whom were stimulated to pursue further learning.CONCLUSIONS: This method of assessing medical students' abilities to obtain informed consent or refusal for HIV testing can be translated to a variety of clinical settings. Such efforts may help in demonstrating competence in performing key ethics skills and may help ensure ethically sound clinical care for people at risk for HIV infection.

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Section: Methodsmentioning

confidence: 99%

Evaluating medical students’ skills in obtaining informed consent for HIV testing

et al. 2003

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“…Many medical and osteopathic colleges incorporate standardized patients into ethics education as part of general professionalism, informed consent, and communication skills training. [12][13][14] Others add further specialized educational opportunities in the areas of genetics, neuroethics, pediatrics, and palliative care, for example. 15 Although some medical schools use standardized patients to teach about deceased organ donation, 4,5 we identified a gap in the use of standardized patients to teach about living organ donation.…”

Section: Discussionmentioning

confidence: 99%

Use of Standardized Patients to Teach Medical Students about Living Organ Donation

2012

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Educators routinely use standardized patients to teach medical students a variety of clinical concepts. Standardized patients have also been used to teach students about medical ethics and deceased organ donation. Not reported before, however, is the use of standardized patients to educate medical students about the ethical issues in living organ donation. It seems important to fill this gap because in the United States, roughly 45% of organ donors are living donors, and these patients will visit physicians throughout their lifespan, not just with the occurrence of donation. This article reports an experience teaching concepts in living donation and transplant ethics to second-year osteopathic medicine students using a standardized patient and supplementary instructional materials (eg, film, panel discussion, reading list). Specifically, a transplant ethics module was created that included an actor portraying a living donor candidate who had a number of case variables pertaining to medical and psychosocial matters. Instructional themes included informed consent, altruism, patient selection criteria, organ vending, and post-donation support systems.

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“…19,20 Opinions vary regarding what is 'sufficient' informed consent, emphasizing the importance of ongoing evaluation of consent procedures, particularly when working with patients lacking competence. 21 Informed consent is often viewed as a formality and obtained by presenting the patient with a written document, but this approach is ineffective. 22 Informed consent should be an interactive process between providers and those giving consent and not just a one-time event.…”

Section: Ethics Of Informed Consentmentioning

confidence: 99%

Informed consent procedures with cognitively impaired patients: A review of ethics and best practices

Fields

Calvert

2015

Psychiatry Clin Neurosci

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Aims:The objectives of this article are to discuss ethical issues of informed consent in cognitively impaired patients and review considerations for capacity determination. We will also discuss how to evaluate capacity, determine competence, and obtain informed consent when a patient is deemed incompetent. This review emphasizes how to carry out informed consent procedures when capacity is questionable and discusses measures supported for use when determining cognitively impaired patients' ability to consent.Methods: Information was gathered from medical and psychological codes of ethics, peer-reviewed journals, published guidelines from health-care organizations (e.g., American Medical Association), and scholarly books. Google Scholar and PsycINFO were searched for articles related to 'informed consent' and 'cognitive impairment' published in English between 1975 and 2014. Relevant sources referenced in retrieved publications were subsequently searched and reviewed. Results:We selected 49 sources generated by our search. Sources were included in our review if they presented information related to at least one of our focus areas. These areas included: review of informed consent ethics and procedures, review of cognitive impairment evaluations, recommendations for measuring cognitive capacity, and alternative forms of informed consent.Conclusions: Patients' cognitive impairments can hinder the ability of patients to understand treatment options. Evaluating the capacity of patients with cognitive impairment to understand treatment options is vital for valid informed consent and should be guided by best practices. Thus, proper identification of patients with questionable capacity, capacity evaluation, and determination of competence, as well as reliance upon appropriate alternative consent procedures, are paramount.

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Assessing medical students’ competence in obtaining informed consent

Abstract: This method of examining medical students' abilities to obtain informed consent has several positive features and holds promise as an ethics competence assessment tool.

Cited by 14 publications

References 14 publications

Evaluating medical students’ skills in obtaining informed consent for HIV testing

Evaluating medical students’ skills in obtaining informed consent for HIV testing

Use of Standardized Patients to Teach Medical Students about Living Organ Donation

Informed consent procedures with cognitively impaired patients: A review of ethics and best practices

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