Structured Feedback within the Framework of Communication Training in Informed Consent Prior to Surgery

Abstract

In many locations, communication between patients and doctors is already actively taught as part of undergraduate medicine at many. Informed consent prior to surgery is a particular reason for communication that calls for differentiated feedback to students. Within the framework of communication training, the aim was to compare the feedback given from 5 different sources (by a medical expert, by tutors, by student peers, by the student obtaining informed consent and by the simulated patients) using evaluation checklists. 171 medical students in their eighth semester at the University of Würzburg participated in a training module in obtaining informed consent prior to surgery. 50 students out of this group conducted a conversation. The emphasis laid on "communication" and "risks". Students were able to prepare using teaching materials from the University's own e-learning platform. The statistical evaluation focussed on assessing the test quality of the checklists, the scores in the scales, and interrater agreement based on the intraclass correlation coefficient. The checklists delivered satisfactory test values with respect to internal consistency, item difficulty and discriminatory index. The average scores from the five raters only differed significantly with respect to communicative skills, whereby the students seeking informed consent were strict in their self-assessment. The student raters where highly consistent with the expert rater. With respect to "risks and complications", there was high agreement between all raters. We were able to demonstrate that, within the highly specific setting of a simulation and after subtile preparation, a trained student tutor can provide just as effective feedback as a medical expert. Feedback from tutors or peers may be furnished with greater prominence in future, given the overall high agreement in the 360-degree feedback.