Disclosure of the Resident Role in the Interventional Radiology Suite: How Do Interventional Radiologists Balance Patient Care and Resident Education?

Purpose: The study sought to assess how academic interventional radiologists determine and disclose to patients the intraprocedural role of radiology residents in the interventional radiology (IR) suite.
Methods: A qualitative study consisting of in-person interviews with 9 academic interventional radiologists from 3 hospitals was conducted. Interviews were transcribed, and underwent modified thematic analysis.
Results: Seven themes emerged. 1) Interventional radiologists permit residents to perform increasingly complex procedures with graded responsibility. While observed technical ability is important in determining the extent of resident participation, possessing good judgement and knowing personal limitations are paramount. 2) Interventional radiologists do not explicitly inform patients in detail about residents' intraprocedural role, as trainee involvement is viewed as implicit at academic institutions. 3) While patients are advised of resident participation in IR procedures, detailed disclosure of their role is viewed as potentially detrimental to both patient well-being and trainee education. 4) Interventional radiologists believe that patients might be less likely to refuse resident involvement if they meet them prior to procedures. 5) While it is rare that patients refuse resident participation in their care, interventional radiologists' duty to respect patient autonomy supersedes their obligation to resident education. 6) Interventional radiologists are responsible for any intraprocedural, trainee-related complication. 7) Trainees should be present when complications are disclosed to patients.
Conclusion: Interventional radiologists recognize the confidence placed in them, and they do not inform patients in detail about residents' role in IR procedures. Respecting patient autonomy is paramount, and while rare, obeying patients' wishes can potentially be at the expense of resident education.
(Copyright © 2016 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.)