# Patient Perspectives on Medical Trainee Involvement in the Anesthesia-Related Procedural Skill Attainment: A Cross-Sectional Study

## TL;DR

This study explores patient preferences for trainee involvement in anesthesia procedures and finds that most are accepting if trainees have some experience.

## Contribution

The study provides new insights into patient attitudes toward trainee participation in anesthesia care and highlights the need for clearer explanations of training levels.

## Key findings

- 87% of participants agreed to trainee involvement in their care if trainees had 5 to 10 repetitions.
- 30% of participants refused trainee involvement in epidural procedures.
- Most participants did not understand the differences between training levels of residents, fellows, and attendings.

## Abstract

Introduction

This qualitative study examines patient preferences in trainee involvement with various anesthesia-related procedures (endotracheal intubations, fiberoptic intubations, epidurals, arterial lines, and central lines) after they are educated on the details of these procedures. The goal of the study is to observe patients’ wishes regarding trainee involvement in care. This study predicted that most participants would express reluctance toward trainee procedural involvement and would prefer trainees to have at least 10 repetitions of a procedure before performing it on them.

Methods

The study was conducted between March and June of 2022 at Corewell Health William Beaumont University Hospital in Royal Oak, USA. As part of the study, 100 participants partook in a questionnaire that assessed their knowledge of training differences between medical students, residents, fellows, and attending physicians. The participants were educated on features of the aforementioned anesthesia-related procedures (endotracheal intubations, fiberoptic intubations, epidurals, arterial lines, and central lines), and were then administered a questionnaire that inquired about their preferences regarding trainee participation in these treatments.

Results

Of the participants surveyed (N = 100), 87% agreed to have trainees gain experience from their care. Before trainee procedural involvement, many participants preferred that trainees have completed 5 to 10 repetitions of a procedure. Regarding epidural procedures, 30% of participants stated that they never wanted trainees involved. When asked about levels of training, 47% of participants understood the difference between a resident and a fellow, and 51% understood the difference between fellows and attending physicians. Additionally, 76% of participants expressed a desire for the distinctions between medical students, residents, fellows, and attendings to be explained to them when these individuals are involved in their care.

Conclusion

Participants did not express reluctance toward trainee procedural involvement and were accepting when trainees had fewer than 10 repetitions of a procedure before performing it on them. When asked about their prior knowledge of the definitions of trainees, participants were unlikely to know the difference in the training level of a fellow compared to a resident or an attending. Therefore, explaining the title and training history of those involved in a procedure may help improve clarity for patients regarding who is involved in their care. The implications of these findings may open the door to studies regarding patient opinions on trainee involvement in treatments from medical specialties other than anesthesiology.