Patient Understanding of the Resident Physician’s Role in Orthopaedics

Objectives Patients at teaching hospitals interact with resident physicians, yet their understanding of residents’ roles varies. Prior studies in other specialties have found gaps in patient knowledge of the medical training hierarchy. This study assessed patient understanding of the resident physician’s role in an academic orthopaedic setting and evaluated patient perceptions of resident involvement in care. Methods After obtaining Institutional Review Board (IRB) approval, we conducted a cross-sectional survey of adult patients at Missouri Orthopaedic Institute, an academic orthopaedic hospital. The anonymous questionnaire collected demographics and included True/False knowledge questions about resident physicians (e.g., “A resident has completed medical school”) and Likert-scale statements about patient preferences and comfort with resident involvement. No identifiable health information was collected, in compliance with the Health Insurance Portability and Accountability Act (HIPAA). Survey responses were analyzed with descriptive statistics, and results are presented with values rounded to two significant digits. Results A total of 168 patients completed the survey. The mean age was 44 (±17) years; 57% were female, and 85% were White. Overall knowledge of the resident’s role was high: 7 of 9 knowledge questions had over 80% of patients answering correctly. Nearly all patients (99%) knew that the Missouri Orthopaedic Institute is a teaching hospital, and 94% understood that residents work under supervision. However, only 68% knew that residents can prescribe medications, and 78% recognized that a resident is a medical doctor – indicating that roughly one-fifth of patients did not realize residents are licensed physicians who have completed medical school. About 11% of patients believed that resident physicians “do not get paid.” Patient attitudes toward resident involvement were largely positive. A vast majority (96%) agreed or strongly agreed that they were comfortable with residents participating in their care in the clinic, and 81% were comfortable with resident involvement in the operating room. Only 9% of patients expressed concern that having residents involved leads to higher complication rates. Most patients (77%) felt they understood the resident’s role in their own care, yet 43% indicated they would like more information about the training level of the providers caring for them. Conclusion Patients in this orthopaedic academic practice demonstrated generally good understanding of the resident physician’s role and were highly accepting of resident involvement in their care. Nonetheless, certain misconceptions persist (particularly regarding residents’ qualifications and authority to perform duties such as prescribing medications), and a significant subset of patients desire greater transparency about providers’ training levels. Targeted patient education efforts, for example, clarifying the credentials and supervision of resident physicians, could further improve patient understanding and comfort, thereby enhancing the clinical experience in teaching hospital settings.