Simulation study reveals persistent informed consent gaps in orthopaedic trainees regardless of seniority, indicating the need for formal communication curricula.
Key Points
To evaluate orthopaedic surgery trainees' confidence and objective performance when obtaining informed consent, comparing outcomes across training years and prior consent education.
Conducted an objective structured clinical examination (OSCE) simulating a primary total knee arthroplasty consent discussion with standardized patients.
Evaluated 23 orthopaedic trainees (N=18 residents across PGY-1, PGY-3, and PGY-5; N=5 adult reconstruction fellows in PGY-6) using a 20-point objective rubric and post-examination survey.
Average OSCE performance was 16.2/20 (range: 11–19) with no significant differences across training years, while only 13% of trainees completed assessments of patient comprehension and 39% facilitated shared decision-making.
Prior formal consent education significantly increased procedure explanation scores (1.7/2.0 vs. 1.2/2.0; P = 0.013), despite 39% of trainees never having received clinical feedback on consent and only 30% recalling prior formal training.