Audiovisual Modules to Enhance Informed Consent in the ICU: A Pilot Study

Abstract

Objectives: Obtaining informed consent for commonly performed ICU procedures is often compromised by variability in communication styles and inadequate verbal descriptions of anatomic concepts. The objective of this study was to evaluate the efficacy of an audiovisual module in improving the baseline knowledge of ICU procedures among patients and their caregivers. Design: Prospective, observational study. Setting: Forty-eight–bed adult surgical ICU at a tertiary care center. Subjects: Critically ill surgical patients and their legally authorized representatives. . Interventions: An audiovisual module describing eight commonly performed ICU procedures. Measurements and Main Results: Fifty-nine subjects were enrolled and completed an 11-question pre- and postvideo test of knowledge regarding commonly performed ICU procedures and a brief satisfaction survey. Twenty-nine percent had a healthcare background. High school was the highest level of education for 37% percent of all subjects. Out of 11 questions on the ICU procedure knowledge test, subjects scored an average 8.0 ± 1.9 correct on the pretest and 8.4 ± 2.0 correct on the posttest (p = 0.055). On univariate logistic regression, having a healthcare background was a negative predictor of improved knowledge (odds ratio, 0.185; 95% CI, 0.045–0.765), indicating that those with a health background had a lower probability of improving their score on the posttest. Among subjects who did not have a healthcare background, scores increased from 7.7 ± 1.9 to 8.3 ± 2.1 (p = 0.019). Seventy-five percent of all subjects indicated that the video was easy to understand, and 70% believed that the video improved their understanding of ICU procedures. Conclusions: Audiovisual modules may improve knowledge and comprehension of commonly performed ICU procedures among critically ill patients and caregivers who have no healthcare background.

Short-form video informed consent compared to written consent for adolescents and young adults: a randomized experiment (Preprint)

“…On the other hand, participants in the written consent group had better understanding on one measure of study procedure. This differs from previous studies that found virtual multimedia informed consent had better understanding of use of their personal health information (PHI) and how to withdraw from the study, compared to their traditional paper consent counterparts [7,[17][18]. Our findings suggest that different formats may communicate different aspects of study information more effectively, and perhaps both video and written consent forms should be available to study participants.…”

“…We conducted an online experiment with 435 adolescents and young adults (aged [13][14][15][16][17][18][19][20][21][22][23][24] recruited by an online survey research provider. Each participant was randomly assigned to view either a short-form video consent or a written consent form describing a behavioral study of a social media-based vaping cessation program.…”

Is a Video Worth a Thousand Words?

“…In fact, audiovisual resources have been shown to improve informed decisions about cardiopulmonary resuscitation 12 and ICU procedures. 13 Affective Responses to Bodily Imagery Although visual information can be helpful in decision making, how this visual information is provided has ethical relevance because of the salience and affective impact of such information. Bodily imagery, in particular, has been employed to discourage various health-related choices, including by placing warnings in the form of images of rotting teeth and blackened lungs on cigarette packages to decrease smoking 14 and requiring the viewing of fetal ultrasound images with the intent of reducing abortions.…”

“…Although visual imagery can activate emotion-driven decision making, visual imagery is not, as we have said, necessarily incompatible with good decision making. 12,13 Yet, in many cases, the control that the clinician exercises over how or when the body is shown is manipulative because a patient's body is used as a means to the clinician's preferred decisional outcome. In Ms K's case, the clinical team believed her best interests were disregarded by her surrogates.…”