Real-Time Captioning for Improving Informed Consent

Abstract

Better methods are needed to improve physicians’ skill in communicating information and to enhance patients’ ability to recall that information. We evaluated a real-time speech-to-text captioning system to aid hearing-impaired patients that simultaneously provided a speech-to-text record for both patient and anesthesiologist. The goals of the study were to assess patient’s recall of an informed consent discussion about regional anesthesia using real-time captioning and to determine whether the physicians found the system useful for monitoring their own performance. Methods We recorded two simulated informed consent encounters with hearing-impaired older adults in which physicians provided descriptions of regional anesthetic procedures. The conversations were conducted with and without real-time captioning. Afterwards, the patient-participants, who wore their hearing aids throughout, were tested on the material presented and video recordings of the encounters were analyzed to determine how effectively physicians communicated with and without the captioning system. Results The anesthesiology residents provided similar information to the patient-participants regardless of whether the real-time captioning system was used. Although the patients retained relatively few details regardless of the informed consent discussio, they could recall significantly more of the key points when provided with real time captioning. Conclusions Real-time speech-to-text captioning improved recall in hearing-impaired patients and proved useful for determining the information provided during an informed consent encounter. Real-time speech-to-text captioning could provide a method for assessing physicians’ communication that could be used both for self-assessment and as an evaluative approach to training communication skills in practice settings.

Health Literacy and Clear Communication Best Practices for Telemedicine

“…With telephone encounters, the only available channel is voice. People who are hearing-impaired are at a disadvantage during in-person and telemedicine encounters but may benefit from the use of sign language interpretation during video encounters or the use of assistive technologies such as real-time captioning during telephone or video encounters ( Spehar et al, 2016 ). People who are visually impaired may rely more heavily on auditory and kinesthetic channels during in-person encounters, which could pose particular challenges for clear communication during either telephone or two-way video encounters.…”

BMI and specimen weight: impact on personalized risk profiling for optimized informed consent in breast reduction surgery?

“…Information retained by patients during informed consent for elective surgery varies and agreement on the use of information sheets is discussed without a definite conclusion based on evidence-based research 42–44 . Information supplied to a patient may be understood, but it can be easily and quickly forgotten.…”

Text Captioning Buffers Against the Effects of Background Noise and Hearing Loss on Memory for Speech

“…Therefore, it is unclear if the caption benefit is fleeting or extends into long-term speech memory. Finally, there is some evidence to suggest that real-time text captioning may provide benefits in real-world scenarios, such as for improving informed consent; Spehar et al (2016) showed that patients retained more information during simulated informed consent when consent was done with real-time assistive text captioning.…”