The aim of this study is to determine if supplementing normal physician counseling with a video presentation improves patient comprehension during informed consent for hysterectomy.METHODS:
This is a randomized controlled trial comparing physician counseling (control arm) to physician counseling plus video presentation (experimental arm) during the informed consent process. All subjects took knowledge questionnaires at four separate time points (enrollment, post-counseling, day of surgery, postoperative appointment). The control group was counseled in the standard fashion with face-to-face interaction with the surgeon. The intervention group watched a 10-minute scripted video about hysterectomy on a portable media device created specifically for this study. Medical literacy was determined using the REALM score (Rapid Estimate of Adult Literacy in Medicine). Patient satisfaction was measured by a validated questionnaire (CSQ-8). Two-tailed t tests were performed for comparisons between groups.RESULTS:
Among the 120 patients enrolled, there were no differences in REALM scores, baseline comprehension scores, CSQ scores, or demographics between arms. Subjects who watched the video had greater improvement in comprehension scores in both post-counseling (15.1% vs 5.2%, P<.01) and day of surgery questionnaires (8.3% vs 2%, P=.02). Postoperatively (4–6 weeks after surgery), scores between arms were equivalent.CONCLUSION:
The addition of electronic media to the counseling process for hysterectomy significantly improves patient comprehension both at the time of informed consent and the day of surgery. Other markers of quality care such as physician efficiency and thoroughness of physician counseling will be compared when audiotapes of subject/physician encounters are analyzed at study completion.