ArticleCureus2026
Resident Proficiency in Assessing Medical Decision-Making Capacity: A Needs Assessment and Educational Intervention.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background Medical decision-making capacity is fundamental to informed consent, patient autonomy, and ethical care, yet incapacity is frequently underrecognized. Despite encountering patients requiring capacity assessments, residents often receive limited formal training. Objective The objectives of this study are to identify gaps in resident knowledge, confidence, and perceived barriers to capacity assessment and evaluate the impact of a targeted educational intervention. Methods This IRB-approved quality improvement study (2025-2026) included residents from two family medicine and one internal medicine residency program (83 eligible participants). A voluntary pre-survey assessed resident experience and educational needs. Primary measures include self-reported knowledge, confidence, understanding of Appelbaum's criteria, distinction between capacity and competence, documentation skills, and legal/ethical considerations using 5-point Likert scales. Secondary measures included prior training, frequency of capacity assessments, perceived barriers, and educational preferences. Survey findings were utilized to create a targeted educational intervention. This was designed to be a one-hour interactive, case-based didactic addressing Appelbaum's four components of capacity, capacity versus competence, documentation, and legal/ethical considerations. A voluntary post-survey was administered to compare primary measures to pre-survey results. The population size for the educational intervention and post-survey had a maximum of 63 participants due to one family medicine program withdrawing. Independent t-tests compared pre- and post-intervention responses. Results Seventy-one residents (86% response rate) completed the pre-survey and 40 (63% response rate) completed the post-survey. Although 58% (n=41) reported performing capacity assessments weekly, no prior training was reported by 63% of PGY1s (n=15), 46% of PGY2s (n=12), and 19% of PGY3s (n=4). Common barriers included legal/ethical aspects at 70% (n=50) and time constraints at 62% (n=44). Mean scores improved significantly after the intervention for understanding of capacity components (3.44-4.55), capacity versus competence (3.15-4.60), documentation (3.00-4.68), legal/ethical considerations (2.99-4.70), confidence (3.28-4.62), and knowledge (2.17-4.78) (all
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