Testing with feedback improves recall of information in informed consent: A proof of concept study

Roberts, Katherine J.; Revenson, Tracey A.; Urken, Mark L.; Fleszar, Sara; Cipollina, Rebecca; Rowe, Meghan E.; Reis, Laura L. Dos; Lepore, Stephen J.

doi:10.1016/j.pec.2016.03.014

Cited by 13 publications

(13 citation statements)

References 27 publications

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“…A range of strategies have been used to improve patients' and parents' comprehension, including illustrative materials, lea ets and pamphlets, video descriptions, interactive computer programs, [3,[44][45][46][47][48][49][50][51][52] and "repeat back to me" or testing with feedback strategies. [53][54][55] We found that baseline knowledge score and the use of an educational video were signi cant predictors of parental knowledge and understanding. Previous ndings indicate that the use of video to educate adult patients and facilitate informed consent in the ED is effective.…”

Section: Discussionmentioning

confidence: 73%

A parental educational intervention to facilitate informed consent for pediatric procedural sedation in the emergency department: a parallel group randomized controlled trial

Lin

Yeh

Chen

et al. 2020

Preprint

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Background Obtaining valid parental informed consent for pediatric procedures in the emergency department (ED) is challenging. This study compared a video-assisted informed consent intervention with conventional consent discussion to inform parents about pediatric procedural sedation in the ED. Methods A video-assisted informed consent intervention was developed to explain the process, benefits, risks, and alternatives of pediatric procedural sedation. A prospective randomized controlled trial was conducted with a convenience sample of parents of children recommended for procedural sedation for facial laceration in the ED. Intervention group participants watched the video. Control group participants received information from physicians during conventional discussion. Participants completed pre- and post-education knowledge tests and rated their satisfaction with the informed consent process. The primary outcome was efficacy of the video intervention compared with conventional discussion. Secondary outcomes were parental satisfaction and consent refusal. A covariate-controlled multivariable regression model was used to analyze between-group differences in knowledge and satisfaction. Results There were 32 participants in the intervention group and 30 in the control group. Mean knowledge scores were higher in the intervention group (91.67 ± [standard deviation] 12.70) than in the control group (73.33 ± 19.86). The intervention group showed significantly greater knowledge score differences (coefficient: 18.931, 95% confidence interval: 11.146–26.716). Intervention group participants showed greater satisfaction than control group participants. Conclusions Video-assisted informed consent was superior to conventional discussion for informing parents during an ED informed consent process. Video-assisted informed consent may improve parents’ understanding of pediatric procedural sedation and satisfaction with the informed consent process in the ED. Institutions should develop structured methods and strategies to better inform parents, facilitate treatment decisions, and improve parent satisfaction in the ED. Trial registration: The ClinicalTrials.gov Identifier is NCT01850329. Registered 9 May, 2013 - Retrospectively registered, https://www.clinicaltrials.gov/ct2/show/study/NCT01850329

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Section: Discussionmentioning

confidence: 73%

A parental educational intervention to facilitate informed consent for pediatric procedural sedation in the emergency department: a parallel group randomized controlled trial

Lin

Yeh

Chen

et al. 2020

Preprint

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“…However, our hypothesis that asking families to complete a checklist to verify their understanding of the surgeon would result in improvements in knowledge, satisfaction, patient experience, and decisional conflict during the informed consent process was not supported. While the checklist can identify different aspects of surgery that require further explanation, knowledge acquisition may primarily be influenced by supporting materials such as videos or the quality of the explanation [8,[18][19][20]. It is also likely that satisfaction and experience are more influenced by effective communication, minimal waiting times, and a pleasant office environment than use of a checklist [21].…”

Section: Discussionmentioning

confidence: 99%

Can a Checklist Improve the Informed Consent Process?

Shirley

Veronica

Neal

et al. 2021

Cureus

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Informed consent often fails to provide patients and families with a full understanding of the proposed procedure. We developed an informed consent checklist for identifying specific aspects of the surgical consent that were not fully understood by families. The purpose of this study was to measure the effect of using this checklist on families’ knowledge, satisfaction, experience, and decisional conflict during the consent process. The families of pediatric patients scheduled for an orthopaedic preoperative visit were prospectively randomized into one of two groups: checklist or traditional appointment. Families in the checklist group completed the informed consent checklist which was then used by the surgeon to further discuss aspects of the surgery that needed clarification. Those in the traditional group had similar discussions about surgery without the aid of a checklist. Sixty-one families participated in the study; 27 in the checklist group and 34 in the traditional group without a checklist. The checklist group reported no difference in mean scores for all satisfaction (P = 0.37), decisional conflict (P = 0.51), and knowledge items (P = 0.31). For patient experience, the traditional group reported the visits were significantly more relaxed (mean 4.9, 95% confidence interval (CI) 4.8-5.0) than the checklist group (mean 4.5, 95% CI 4.3-4.7). Our results suggest that having a family member complete the informed consent checklist prior to meeting with the surgeon did not improve, and may worsen, the consent experience for some families. Other methods need to be evaluated to determine the optimal consent process from the family’s perspective.

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“…Technology, such as consent videos that show IC information, have been demonstrated as improving information recall and retention. 27 For example, cognitive markers of success might be assessed through patient recall on tablet-based 'quizzes', and the use of interactive technology such as tablets have been suggested to improve comprehension as well as satisfaction. 28 Providers can thus focus on misinformation in need of further explanation.…”

Section: Innovationmentioning

confidence: 99%

A qualitative exploration of the informed consent process in hematopoietic cell transplantation clinical research and opportunities for improvement

Raj

Choi

Platt

2016

Bone Marrow Transplant

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Informed consent (IC) struggles to meet the ethical principles it strives to embody in the context of hematopoietic cell transplantation (HCT). Patients often participate in multiple clinical trials making it difficult to effectively inform the participants and fulfill complex regulations. The recent Notice of Proposed Rule Making would make major changes to federal requirements, providing a timely opportunity to evaluate existing practice. Twenty health care professionals within a Midwest Academic Medical Center involved in obtaining IC in the HCT clinic or involved in patient care during or after the IC process were interviewed to understand: (1) how they approached the IC process; (2) how they described a 'successful' IC process; and (3) opportunities for innovation. Narrative and discourse analyses of interviews indicate that providers understand IC to be a collaborative process requiring engagement and participation of providers, patients and caregivers. 'Markers of success' were identified including cognitive, affective and procedural markers focusing on patient understanding and comfort with the decision to participate. Opportunities for innovating the process included use of decision aids and tablet-based technology, and better use of patient portals. Our findings suggest specific interventions for the IC process that could support the process of consent for providers, patients and caregivers.

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Testing with feedback improves recall of information in informed consent: A proof of concept study

Cited by 13 publications

References 27 publications

A parental educational intervention to facilitate informed consent for pediatric procedural sedation in the emergency department: a parallel group randomized controlled trial

A parental educational intervention to facilitate informed consent for pediatric procedural sedation in the emergency department: a parallel group randomized controlled trial

Can a Checklist Improve the Informed Consent Process?

A qualitative exploration of the informed consent process in hematopoietic cell transplantation clinical research and opportunities for improvement

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