Abstract
BackgroundEnsuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process.MethodsA modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items to forecast outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery.ResultsThe modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department (ED) were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video.ConclusionsOur process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care.Trial registrationThe ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011 (retrospectively registered).
Highlights
Ensuring adequate informed consent for surgery in a trauma setting is challenging
We proposed a methodology that can be applied in developing content for informed consent for a specific surgery
The educational video contains sufficient information developed by a scientific method that integrated the opinions of different stakeholders, patients
Summary
Ensuring adequate informed consent for surgery in a trauma setting is challenging. Because most situations that occur in emergency settings involve time constraints, emotional stress and physical pain due to sudden injury in patients, the patients and their families often experience difficulty in understanding all the important information that is essential for providing informed consent [1, 2, 5]. Because of the unique conditions in emergency situations, the informed consent process is one of the most profound and emotional challenges for trauma patients and their families. During the traditional consent process, trauma patients have difficulty in retaining the vast amount of information presented to them. These patients are often unable to imagine how the surgery would proceed. The patients and their families might not provide appropriate consent because they are unaware of the risks and complications
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