Patient perspective on the participation of ophthalmology residents in their cataract surgery

To determine the proportion of patients consenting to resident participation in cataract surgery and to identify factors predictive of consent.

Prospective cross-sectional study.

The 330 consecutive patients referred for cataract evaluation from February-April 2021 to 3 surgeons at a tertiary care referral centre in London, Ontario.

Using a standardized disclosure script, individuals were asked about resident participation in their cataract surgery. A phone survey and medical record review were conducted to obtain clinical and demographic information. Predictors of consent were assessed using logistic regression modelling.

Responses were received from 279 individuals (85% response rate), with a mean age of 71.7 ± 8.6 years, and 113 were female. The consent rate was 71%. Prior negative experience with any medical trainee was an independent predictor for refusing resident participation (odds ratio [OR] = 3.10; 95% CI, 1.32-7.28; p = 0.009). Nonconsenters also had more prior negative experiences with other physicians (35% vs 23%; p = 0.031) and knew someone who had had a problem after eye surgery (36% vs 22%; p = 0.016). Individuals with an occupation involving apprenticeship (OR = 2.87; 95% CI, 1.08-7.67; p = 0.035) and those with a preoperative acuity of 20/200 or worse (OR = 2.78; 95% CI, 1.03-7.14; p = 0.043) were more likely to consent.

Patients should be explicitly asked about resident involvement. Negative experiences can make individuals reluctant to have learners involved in their future care. Patient education describing the apprenticeship model in medicine may increase consent.