Attitudes and Perspectives on Ophthalmology Resident Training:The APORT Study Series

Matthew J. Welch, M.D. and James F. McDonnell, M.D.Department of Ophthalmology, Loyola University Health System, Maywood, IL

While the majority of patients feel that in teaching institutions residents should be involved in the medical and surgical care of all patients, many patients do not clearly understand the definition of a resident physician.

This lack of understanding may create boundaries limiting the effectiveness of resident physician patient care.

A majority of patients also feel that there is no net negative impact in their care or the amount of attention they receive from their attending when residents are involved in their care.

A fundamental understanding between physicians and patients is key to being able to provide optimal patient care. This principle holds true to resident physicians and the patients they care for as well.

Results Highlighted Results

ConclusionsMethods

Introduction

Little attitudinal research has been conducted in the field of Ophthalmology or resident training in general. It is the hope that this study will produce data that can be readily applied to the clinic and surgical setting in order to better patient care, resident physician training, and the overall experiences of patients, resident, and attending physicians in a tertiary care medical center setting.

The purpose of the study is to assess patient understanding and attitudes towards resident participation in ophthalmic medical care and ophthalmic surgical care.

We hypothesize that there is high variability in patient understanding of the role of resident physicians as well as patient attitudes towards resident involvement in their ophthalmic care.

An anonymous, 13-question multiple choice survey

121 adult patients at the Loyola University Medical Center Ophthalmology clinic, Maywood, IL.

Survey topics included: the definition of a resident physician, the informed consent procedure, resident participation in medical and surgical ophthalmic care, the role of teaching hospitals, patient comfort with resident physician physical examinations, patient’s perspective on their level of participation in resident physician development, and resident impact on patient care quality.

49% of patients selected the correct definition of a resident physician from four definition choices

74% felt that using the term “assist” as a way to describe resident involvement in a surgical procedure indicated that the resident would be performing parts of their surgery, but not the entire procedure

64% prefer the consent process to be conducted by their attending physician as opposed to a resident physician, nurse, or other medical staff member; while 31% responded having neutral feelings as to who conducts the informed consent procedure

The majority indicated that residents should be involved in general ophthalmic care (84%) and surgical care (64%) in a “teaching hospital”

85% reported feeling comfortable having a resident physician physical examination prior to an attending, though 48% prefer having the option to choose whether they be subjected to a resident examination prior to their attending

Only 35% of patients reported being comfortable having resident physicians perform a portion of their surgical procedure; while 11% were comfortable having residents perform their entire surgical procedure

83% responded that by having a resident physician involved in their care and/or surgery that they (the patient) felt they were helping the resident become a better physician

79% felt they were helping future patients that would be cared for by the resident physician caring for them

Most patients (60%) felt there is no difference in patient care, and they receive the same amount of attention from their attending physician, when residents were involved in their care (63%)

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This study was conducted with a financial grant awarded by the Illinois Society for the Prevention of Blindness

Correspondence: Matthew J. Welch, M.D. (mawelch@lumc.edu)