Informed consent for ankle fracture surgery: patient comprehension of verbal and videotaped information.

Wenatchee Valley Medical Center, 820 N. Chelan Avenue, Wenatchee, WA 98801, USA.
Foot & Ankle International (Impact Factor: 1.63). 11/2004; 25(10):756-62.
Source: PubMed

ABSTRACT The purpose of our study was to evaluate the effectiveness of using a videotape to give patients information about the risks, benefits, alternatives, and treatment of a common orthopaedic procedure before they sign consent forms.
During a 9-month period, 48 patients with isolated closed ankle fractures requiring surgical intervention were randomized into two groups that received either videotaped or conventional verbal information regarding consent for surgery. The study group watched a videotape containing information about the risks, benefits, and treatment alternatives, while the control group obtained this information verbally. To determine comprehension and retention, all patients completed a multiple-choice questionnaire immediately after receiving the information, and 37 patients (77%) were available to complete a questionnaire at an average of 10 weeks later.
The videotape group outperformed the verbal consent group by 40.1% on the initial questionnaire (p = .0002) and by 27.2% on the followup questionnaire (p = 0.0139). Patients with educational levels of less than or equal to the 12th grade performed 67.8% better on the initial questionnaire after watching the video than after receiving the information verbally. (p = .0001).
Patients who received information about their surgery on a videotape before giving their consent demonstrated a significant increase in comprehension compared to patients who received this information verbally. The benefit was even greater for patients with lower education levels.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Patients must receive information in a manner that promotes understanding so they can make informed decisions about anesthesia and other medical interventions. Unfortunately, history is replete with examples of the negative consequences of inadequate disclosure of information and lack of patient understanding. While obtaining consent for anesthesia poses unique challenges, the ability of the anesthesiologist to engage the patient in meaningful discussion is critical as a means to ensure that the patient is truly informed. This narrative review aims to: 1) discuss the process of informed consent as it applies to anesthesia practice; 2) describe the salient issues related to patient capacity, disclosure, understanding, decision-making, and documentation of the informed consent process; and 3) discuss current strategies to improve the presentation and understanding of consent information.
    Canadian Journal of Anaesthesia 06/2014; 61(9). · 2.50 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction Standard print and verbal information provided to patients undergoing treatments is often difficult to understand and may impair their ability to be truly informed. This study examined the effect of an interactive multimedia informational program with in-line exercises and corrected feedback on patients’ real-time understanding of their cardiac catheterization procedure. Methods 151 adult patients scheduled for diagnostic cardiac catheterization were randomized to receive information about their procedure using either the standard institutional verbal and written information (SI) or an interactive iPad-based informational program (IPI). Subject understanding was evaluated using semi-structured interviews at baseline, immediately following catheterization, and 2 weeks after the procedure. In addition, for those randomized to the IPI, the ability to respond correctly to several in-line exercises was recorded. Subjects’ perceptions of, and preferences for the information delivery were also elicited. Results Subjects randomized to the IPI program had significantly better understanding following the intervention compared with those randomized to the SI group (8.3 ± 2.4 vs 7.4 ± 2.5, respectively, 0-12 scale where 12 = complete understanding, P < 0.05). First-time correct responses to the in-line exercises ranged from 24.3% - 100%. Subjects reported that the in-line exercises were very helpful (9.1 ± 1.7, 0-10 scale, where 10 = extremely helpful) and the iPad program very easy to use (9.0 ± 1.6, 0-10 scale, where 10 = extremely easy) suggesting good clinical utility. Discussion Results demonstrated the ability of an interactive multimedia program to enhance patients’ understanding of their medical procedure. Importantly, the incorporation of in-line exercises permitted identification of knowledge deficits, provided corrected feedback, and confirmed the patients’ understanding of treatment information in real-time when consent was sought.
    International Journal of Medical Informatics 05/2014; · 2.72 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study was carried out on volunteers to evaluate a newly developed interactive software package aimed at informing prospective Le Fort I osteotomy patients regarding the surgical technique and possible complications. The aim of the study was to compare two methods of information delivery; a multimedia tablet device delivering both graphic and verbal information, and an audio device delivering essentially the same information in verbal form only. The null hypothesis was that there would be no difference between the efficiencies of the two methods. The subjects' ability to recall the information delivered by both devices was assessed using a questionnaire with a total possible score of 900 points. The android device participants scored an average of 387 points, while the audio device participants scored an average of 268 points. The difference was statistically significant (p < 0.01), suggesting that the multimedia tablet device was more effective method.
    Journal of Cranio-Maxillofacial Surgery 09/2014; · 2.60 Impact Factor