59: Using a multimedia module to enhance patients’ recall of cesarean birth informed consent: a randomized control trial

Abstract

Informed consent (IC) is legally and ethically required. Our objective was to determine if an interactive multimedia (MM) program could lead to patients recalling more risks related to their planned cesarean delivery (CD) on post-operative day #1 (POD#1) compared to patients receiving standard verbal consent. We conducted a randomized control trial of patients undergoing scheduled CD. Patients were recruited the morning of their CD. Eligibility criteria included gestational age ≥37 weeks, English speaking, and age ≥18 years. Participants were randomized to one of three arms: group 1 (standard verbal consent), group 2 (scripted verbal consent), or group 3 (MM consent). They were asked to recall the risks and benefits covered during the IC process on POD #1 and 6 weeks postpartum (pp). Anxiety levels were assessed at each encounter via a validated questionnaire and the IC process was timed. A total of 133 patients were enrolled. Demographic characteristics were similar between groups, except for age (30.4 ± 4.6 v 31.9 ± 4.6 v. 33.0 ± 4.7 years, respectively, p = 0.03). There were no differences in anxiety levels between the groups on POD#1 or at 6 weeks pp. On POD#1, the median number of risks and benefits remembered was significantly greater for the MM group (Table). There was no difference in the median number of risks or benefits remembered at 6 weeks PP. On POD#1, 82% of MM patients recalled 2 or more risks compared to 50% in the verbal group (p=0.001). At 6 weeks PP, 61% of MM patients recalled 2 or more risks compared to 40% in the verbal group (p=0.049). Patients consented for CD with MM recalled more risks and benefits than those consented verbally. Unlike the MM consent method described, verbal consent is not typically standardized, does not target all types of learners, and often does not result in patients effectively processing the information given to them.