American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Teaching trainees can be touchy when the patient is awake

OCTOBER 24, 2017
Clinical Congress Daily Highlights, Tuesday First Edition

Surgical procedures on awake patients cut costs and recovery times, but how do patients react when they can hear residents being taught during their surgery?

Researchers led by Claire S. Smith of the University of Chicago asked 23 surgeons and 40 patients how they felt about the experience. Surgeons thought teaching during an awake surgery increased patients’ anxiety, and described approaches to mitigate patient stress, such as excluding them from the teaching conversation, limiting trainee involvement, and reduced transparency on the extent of trainee involvement.

Most patients said they recognized teaching was going on and did not perceive it as positive or negative. However, seven of 40 patients had a negative experience during their awake procedure. These included perception of error, perception of trainee inexperience, and unwanted exclusion from the teaching conversation.

Researchers concluded that patients’ dislike of being excluded from conversation during awake procedures means surgeons must learn new ways of incorporating teaching conversations during the procedures. Further research is needed to determine how best to do that while optimizing patient experience.

Additional Information:
This Scientific Forum study was presented October 24 at the 2017 Clinical Congress of the American College of Surgeons in San Diego, CA.  Program, webcast and audio information is available online at View the full abstract here

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