Improving patient understanding of surgical bedside teaching: a quality improvement initiative to improve consent and awareness through patient education.

Abstract

Bedside teaching (BST) is a cornerstone of medical education, yet its ethical delivery depends on patients' informed and voluntary participation. This project aimed to improve patient understanding of BST and strengthen consent processes through a targeted educational intervention grounded in health literacy principles. A two-cycle quality improvement project was conducted in a surgical department at a UK District General Hospital using a pre- and post- intervention design with independent patient samples (n = 53 and n = 47). Following an initial assessment of patient awareness, a patient information leaflet was developed using adult learning theory and plain language (Flesch-Kincaid Grade Level 6.9). Primary outcomes included knowledge of BST purpose, voluntary nature, and rights to withdraw. Following the intervention, significant improvements (p < 0.05) were observed across all individual questionnaire items, including awareness that participation is voluntary (83.02-97.97% p = 0.0066), and knowledge of how to raise concerns (21.28-78.72% p < 0.0001). The mean knowledge score increased from 60.8% to 90.8%, with a large effect size (Cohen's d = 1.47). A structured, health-literacy-informed patient information leaflet effectively bridges the gap between clinical teaching requirements and patient autonomy. While written materials significantly enhance comprehension, persisting misconceptions suggest a need for ongoing verbal reinforcement. Implementing low-cost, patient-centred educational materials can align medical education with ethical guidance and shift patient participation from passive acquiescence to informed partnership. This model is transferable across various clinical specialties to support transparent consent processes.