Piloting a Nationwide Survey of General Surgery Residents Investigating Their Experience with Obtaining Procedural Consent

Abstract

Objective: There remains a lack of multi-center nationwide data that examine residents’ self-reported level of comfort with obtaining informed consent. Our study sought to acquire these data and discover relationships affecting the subjective experiences of general surgery residents during consent acquisition so that general surgery residency programs can better understand their trainees’ needs. Design: We internally developed a 22-item survey assessing the demographics of general surgery residents who commonly obtain consent, the amount of formal informed consent training provided in residency, and residents’ comfort level with the consent process. Setting: The study originated from the University of Iowa Health Care Department of Surgery. Our survey was distributed nationally via mass electronic-mailing to recruit participants. Participants: The survey was iteratively sent to 323 ACGME-accredited general surgery residency programs across the United States via program leadership. Eight weeks were allowed for response accumulation from May to June 2025. There were 140 total survey responses (1.4% response rate) with a likely unrepresentative national sample. Results: Across all respondent training levels, first-year residents (interns) were identified as the most frequent consenters. Only 14.3% of interns felt “very comfortable” obtaining surgical consent. Although most senior residents reported receiving consent training during their PGY1 year, 73.3% of interns reported not receiving any formal instruction during residency. Interns made up 60% of respondents who reported being “very dissatisfied” with their formal consent training. Furthermore, 64.3% of interns were either very dissatisfied (21.4%) or slightly dissatisfied (42.9%) with consent training. Nearly half of interns reported “usually” obtaining consent for procedures they felt would be more appropriate for senior residents, and 57.1% reported acquiring consent for unfamiliar procedures “about half the time.” Conclusions: These findings suggest a possible disconnect between expectations and preparation among surgical trainees who are expected to obtain informed consent. This self-reported lack of preparation may represent a lapse in patient safety standards and supports our continued research into the necessity of developing a standardized informed consent curriculum for all general surgery residents with a revamped participant recruitment strategy.