Anesthesia Counseling, Consent, & Professionalism

Study Overview
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Brief Summary
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The anesthesia consent form has become a standard before surgery. However, verbal aspects of anesthesia consent and of the value of the preoperative anesthesia discussion has not been addressed. This study will use preoperative discussions and postoperative patient questionnaires to examine the degree of awareness that the patients and the patients families have regarding what general anesthesia is, the responsibilities of the anesthesiologist, and the specifics of what the participants are agreeing to by signing the consent form.

Detailed Description
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There is a substantial body of work regarding the written anesthesia consent form. As a result, the written anesthesia consent form has become a standard requirement throughout the United States of America. However, there has been little examination of verbal aspects of anesthesia consent and of the value of the preoperative anesthesia discussion that should take place prior to surgery. Non-anesthesia medical studies have indicated that inadequate patient-physician communication and an inadequate patient-physician relationship will result in misunderstanding and an increased malpractice risk. Lack of understanding of the duties and responsibilities of anesthesiologists is also damaging to the professional status of the field of anesthesiology. This study will utilize patient interviews and questionnaires to examine the degree of awareness that the patients and the patients families possess regarding what general anesthesia is, the duties and responsibilities of the anesthesiologist, the role of the anesthesiologist within the operating room and the specifics of what the participants are agreeing to by signing the consent form. If it is determined that a more structured and thorough pre-anesthesia discussion will help patients and the patients families understand what general anesthesia is, understand the specific responsibilities of anesthesiology providers, understand the professional status of anesthesiologists, give the participants a better feeling of autonomy and better understand what the participants are agreeing to by signing the consent form, then there will be substantial ramifications to the priority and importance given to pre-anesthesia discussions nationwide. Secondary benefits include influences on anesthesia residency training and improved patient satisfaction with the anesthesia experience.

Official Title
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Anesthesiology Counseling, Consent, & Professionalism

Conditions
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Communication, Preoperative, Ethics

Intervention / Treatment
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* Behavioral: Script guided conversation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 18 and up Elective Procedures English-speaking Consenting for general anesthesia Exclusion Criteria: Obstetric patients Prisoners Emergency cases Patients under age 18 Patients don't speak English Not consented for general anesthesia

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control<br>Group getting standard treatment without script guided intervention in the preoperative period | |
| Experimental: Script guided intervention<br>Group getting script guided intervention during the preoperative conversation | Behavioral: Script guided conversation<br>* Patients getting script guided intervention of 3 domains in the preoperative period<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative recall of conversation about the anesthesia as assessed by questionnaire by developed by study team | Recall of team members score 0-100 with higher score indicating better recall of anesthesia team members | up to 3 days after surgery | 
| Postoperative recall of anesthesia risks as assessed by questionnaire by developed by study team | anesthesia risks, (0) don't remember any risks - (3) remembered 3 or more correctly | up to 3 days after surgery | 
| Postoperative recall of anesthetic plan as assessed by questionnaire by developed by study team | Recall of anesthetic plan; one question correct signifies recall | up to 3 days after surgery | 
| Postoperative understanding of anesthetic plan as assessed by the questionnaire developed by the study team | Demonstrate understanding of anesthetic plan; score total 0-100 with a higher score more understanding. | up to 3 days after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient Satisfaction with anesthesia conversation as assessed by questionnaire developed by the study team | Rating of satisfaction with anesthetic conversation using likert scale rating; extremely satisfied (5) to extremely dissatisfied (1) | up to three days after surgery | 
| Quality of explanation of anesthesia plan as assessed by questionnaire developed by study team | Patients rate quality of anesthesia plan using likert scale very detailed (5) to very poor (1) | up to three days after surgery | 
| Preoperative anxiety as assessed by questionnaire developed by study team | Patients are asked about any change in anxiety after the preoperative conversation using likert scale extremely reduced (5) to extremely more anxious (1) | up to 3 days after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Communication, Medical ethics, Professionalism