(O-16) Ethical Dilemmas in Urological Surgical Training: Consent for Procedures Performed by Residents

Abstract Background Surgical education often creates tension between the training needs and the physician–patient relationship. Practical training requires integrating residents into operative and perioperative care. This last has been raising ethical concerns about informed consent. The aim of the study was to assess urologists’ attitudes, experiences, and knowledge regarding ethical principles in urological surgical training in Tunisia. Methods A cross-sectional anonymous self-administered questionnaire was distributed to 70 residents. It explored their familiarity with informed consent in the context of resident involvement, attitudes toward residents performing procedures, and the impact of patient information on the acceptance of trainee-performed care. Results The response rate was 85%. Most respondents (85%) believed patients had an unclear understanding of residents’ roles. Only 26.7% reported providing clear information about all aspects of care, and just 50% of trainees routinely obtained informed consent prior to surgery. About 51.7% believed patients were aware of their right to refuse examination or surgery by a resident. Learning directly on patients was considered ethically correct by 16.7% and acceptable by 45% of respondents. Less than half of patients refused surgery performed solely by a resident. Most respondents (80%) agreed that residents bear legal and ethical responsibility during surgical procedures. Conclusions Although ethical principles are partially integrated into clinical practice, further efforts are required to ensure that urology residents receive adequate training in ethical conduct and informed consent.