Teaching pediatrics residents how to obtain informed consent.

BACKGROUND: Few physicians view informed consent as a critical component of the physician-patient relationship or as a way to improve individual and population health. We hypothesized that formal education about informed consent would affect first-year pediatrics residents' knowledge and attitudes. METHOD: Twenty-seven first-year pediatrics residents participated in a randomized controlled trial with a wait-list control group. The one-hour interactive intervention consisted of a lecture, video, and small-group discussion. Outcomes were measured after randomization at baseline and after the intervention group received the intervention. Data were analyzed using multivariate analysis and between and within group t tests. Qualitative data were obtained after the wait-list control group's exposure to the intervention. RESULTS: The quantitative analyses demonstrated that the intervention yielded statistically significant improvements in the measured outcomes. The qualitative analyses confirm the quantitative findings. CONCLUSION: A formal session on informed consent in the pediatrics residency educational program positively affects residents' knowledge and attitudes about informed consent.

Questioning skills: the effect of wait time on accuracy of medical student responses to oral and written questions.

BACKGROUND: Pauses (wait time) after asking questions in pre-college classes result in improved discussion and answer accuracy. The authors hypothesized that this would extend to medical students. METHOD: Third-year surgery clerks were randomized to three-second or six-second wait times after questions asked of them during a scripted lecture. Students were randomized within each session to answer 21 scripted questions. Students also completed a post-lecture written examination. RESULTS: Correct responses ranged from 17% to 100% for oral and 22% to 100% for written questions. Answer accuracy could not be distinguished between three- and six-second wait times for oral or written questions. CONCLUSIONS: The benefit of increasing wait times from three to six seconds appears not to extend to medical students. This may represent evolution of learning or different learning modes in medical students. Alternatively, maximum benefit may be achieved in medical students with shorter wait times.

A critical evaluation of the morbidity and mortality conference.

BACKGROUND: This study was designed to evaluate the impact of changes made to our morbidity and mortality (M&M) conference. METHODS: A 23-item survey using corresponding Likert-type scales was created. Faculty and residents were asked to anonymously complete the surveys in June 1999. Based on this information, specific modifications were made to the conference. The same survey was administered to faculty and residents in the Fall of 2000. Analysis was performed using Student t tests. RESULTS: Postsurvey findings showed residents felt eight components improved significantly (P <0.05). Faculty noted nonsignificant improvement in nine survey items and decline in nine items (five unchanged). CONCLUSIONS: Changes in content and structure made to enhance our M&M conference's educational value resulted in significant improvements as perceived by the surgical residents. Interestingly, these changes had only minimal impact on faculty perceptions.