Use of An Interactive Multimedia Presentation to Improve Patient Understanding of Endoscopic Procedures and to Standardize the Informed Consent Process

Abstract

Introduction: Before any procedure can be performed a patient must give informed consent, the situation where a person, (in the case of a child, a parent or guardian), agrees to the procedure based upon an appreciation and understanding of the facts and implications of the procedure. It is acknowledged that barriers to obtaining consent in general and for endoscopic procedures exist. Some of the barriers include: differences in physician communication styles, time constraints, language barriers, health care providers' use of jargon, and differences in patient and family members' literacy skills and learning styles. The aim of this study was to compare the usual procedure for obtaining informed consent to a procedure that was designed for easy understanding and for reproducibility. The experimental procedure incorporated a video with both visual and verbal information. Methods: 50 parents of child patients were randomly assigned to a control (usual procedure) or experimental condition. Participants in the experimental condition viewed an interactive multimedia presentation on upper and lower endoscopic procedures. All participants met with the physician performing the procedure. For the experimental group, consent was obtained after they had viewed the video and the usual process for obtaining consent was completed. All participants filled out pre and post measures, and answered a 12 question test on the endoscopic procedure that was to be performed. Results: Participants in the experimental group scored significantly higher than those in the control group on the 12 question test (p < .0001). The physician providing the informed consent perceived the experimental group as more knowledgeable than the control group (p = 0.04). Analysis of the post assessment results revealed an inverse relationship between participants' perceptions of how well they understood the procedure and their reported state anxiety (r = −.49, p < 0.0001). There was a significant positive correlation between how well participants understood the procedure and their reported level of satisfaction with medical care received (r = .58, p <0.0001). While both the experimental and control groups showed an increase in reported levels of state anxiety following the informed consent, participants in the experimental group showed less of an increase. Conclusion: These preliminary findings suggest that interactive multimedia presentations can increase patients' (or parent) understanding of upper and lower endoscopic procedures. When patient (or parent) understanding increases they report less anxiety and greater satisfaction with the medical care received.