PTH-147 Improving junior doctors confidence and competence in consenting patients for ERCP – an educational intervention

Abstract

Introduction Obtaining high quality informed consent for endoscopic procedures is frequently devolved to Junior Doctors, within NHS Tayside there was previously no standardised induction or education for Junior Doctors regarding consent for endoscopic procedures. We wished to assess Junior Doctors’ confidence with regard to the consent process for endoscopy and then develop an educational tool to improve this process as part of a quality improvement project. Methods An online questionnaire was distributed to Junior Doctors (FY1-CMT2) working within Medical Specialities in Ninewells Hospital, Dundee in August 2017. Information was gathered both regarding frequency and the nature of procedures consented for. Alongside this self-assessment of confidence and competency in gaining consent for individual procedures as well as any barriers to gaining patient consent and ideas to improve the process was sought. This data was analysed and a simulated consent video (focussing on ERCP) was produced and delivered as a short educational intervention to Junior Doctors. Further questionnaires were used pre and post educational intervention to assess Junior Doctors confidence and competency. Results 24 Junior Doctors completed the initial questionnaire; 8 CT1s/GPSTs, 7 FY2s, 6 FY1s, 2 CT2s and 1 PA (physician associate). 54.17% of respondents were asked to gain patient consent for procedures at least weekly and 8.33% daily. The most common procedures Junior Doctors were asked to consent for were OGD (95.83%), colonoscopy (70.83%) and ERCP (50%). 75% felt comfortable and competent to gain consent for OGD, 79.17% for colonoscopy, but only 54.17% for ERCP. 10 Junior Doctors received a short educational session focused around the simulated ERCP consent recording. Prior to the education 70% did not feel confident and competent to gain consent for ERCP. Following the intervention 100% feel confident and competent to gain consent for ERCP. Conclusions A short educational intervention has been shown to be successful in improving Junior Doctors confidence and competence consenting patients for ERCP, with self-rated confidence and competence improving from 30% to 100% following the intervention. A wider number of junior doctors will be shown the video in the future and there are plans to expand this to all endoscopic procedures and embed this process as part of the Junior Doctor induction in the Gastroenterology Department.