Informed consent training for medical oncology fellows: Checklist-based simulation exercise.

e20671 Background: Discussing informed consent (IC) is essential for quality cancer care. While essential elements of IC are clearly defined, there is little data to guide how best to teach IC to medical oncology fellows’ (MOF). A PI project was conducted using a simulation (SIM) exercise to assess the MOF skills in obtaining IC to enhance our teaching of the subject. Methods: Program directors from 2 training sites in San Antonio, TX created a 30-minute SIM lab using standardized patients (SP) and the use of checklists (CKL) for obtaining IC. MOF from both institutions were asked to obtain IC for chemotherapy in a patient with Stage III seminoma. Half the MOF were given an IC checklist prior to their SIM encounter that included 18 side effects (SE) for discussion recommended by ASCO along with 12 essential elements (EE) for IC. All encounters were videotaped and data recorded by 2 faculty. Results: 17 MOF (6 PGY-4s, 6 PGY-5s, and 5 PGY-6s) participated. Video review was available for 15 MOF, and 8/15 were given CKL prior to their encounter. The median number of SE (18 items) discussed was 11 (IQR=7-12) for the entire group. The median number of SE discussed in the CKL group was significantly higher than those without a CKL, 12 (11-14) vs. 9 (6-11); (p=0.04). The median number of EE (12 items) discussed for the entire group was 8 (5-11). The median number of EE discussed in CKL group trended higher than the group without CKL (8 vs 6.5, p=0.06). While 66% of MOF discussed alternatives, only 33% discussed the risks of those alternatives, and only 20% of MOF informed patients they could stop chemotherapy at any time. Fertility was discussed in 47% of all encounters (n=15). Among those with CKL, 71% discussed fertility compared 25% without CKL (p=0.07). Only 13% of MOF discussed risk of secondary malignancy. No MOF discussed sexual SE (0/15). At the conclusion of the encounter, 7% (1/15) of MOF offered the patient a copy of the IC. Conclusions: Using SP and CKL, we were able to objectively measure aspects of our MOF knowledge of the IC process. CKL led to improved SE and EE discussions. Our project suggests that we should focus our efforts on teaching MOF how to discuss alternative therapy, risks, as well SE regarding fertility, sexuality, and risk of secondary malignancy.