A patient undergoing
surgery requires an explanation of the complete procedure by the doctor.
However, such interviews with doctors often lack clarity. Very often, it is
done hurriedly due to lack of time and at other times even if the doctor
explains it well, the patients are so nervous that they are barely listening.
Most of the patients who go for a face-to-face interview with their doctors
about a surgical procedure do not understand what to expect and what they might
have agreed to. Understanding the surgical procedure is important as it helps
the patient to cope better with the procedure, and provides a
fully informed consent for it.
‘Video of a surgical procedure on tablets like iPad are better than doctors when it comes to understanding a surgical procedure and may be the way forward in getting a fully informed consent from a patient.’
A recent presentation at
the 'EUROPEAN ASSOCIATION OF UROLOGY CONGRESS' at Munich by a group of
Australian doctors describes how patients were prepared for surgical procedures
using iPads, and they found that patients' understanding was much better than a
"Patients often find it
difficult to understand the medical language used by doctors
during face-to-face standard verbal communication, and they often feel
intimidated by the interaction," said lead researcher, Dr
Matthew Winter (Royal North Shore Hospital, Sydney, Australia). "Often doctors
work within busy practices and clinical environments with time limiting the
quality of a consult and or verbal consent for a procedure. Patients often find
it difficult to comprehend their planned procedure. We have found that a patient's
knowledge is greatly improved through the use of portable video media and is
their overall preferred method of information delivery compared with standard
recruited 88 patients facing surgery for acute renal colic the abdominal pain
by kidney stones
. Prior to the procedure, 45 of the patients discussed the
forthcoming surgery with their doctor as normal, while the other 43 patients
were given a video presentation with cartoon animation narrated by a doctor
using an iPad. The patients' knowledge about the surgical procedure was tested
using a questionnaire. After this, they were switched, with those who had
received face-to-face counseling receiving the video, and vice versa, followed
by the same questionnaire. The participants were then asked to give their
overall preference for information delivery.
The researchers found that that use of
the video presentation increased patients' understanding by 15.5% compared to
the direct consultation. Also, 71 patients (80.7%) preferred the video tutorial
compared to 17 (19.3%) who preferred the face-to-face meeting.
"Informed consent for
patients undergoing procedures is both an ethical and legal responsibility and also crucially
important for optimizing treatment. Patients should be actively involved in decisions regarding their treatment, and
understanding their treatment is often vital to a good recovery. Although
medicine has advanced by leaps and bounds, there has been little change to the
informed consent procedure and how a doctor explains the treatment to the
patient. Through the use of portable video media, a doctor can present his/her
own practice and procedural technique in an innovative, dynamic and engaging
manner," said Dr Winter.
"We are not saying that using portable video
media should replace consent. Our work shows that there are alternatives to
interviews, which can help significantly, improve patient understanding and
satisfaction. Most patients prefer being able to use the portable media devices
to a face-to-face consultation which benefits both clinician and patient
through improved quality of care. Portable video media is a useful addition to
the informed consent process and I predict will form a crucial component of
this process in years to come," he added.
Professor Fiona Burkhard, Chairman
of the EAU Guidelines panel for Urinary Incontinence
innovative approach to patient information, using a cartoon animation narrated
by a doctor, allows each individual patient as much time as needed to
understand the proposed procedure. It should not replace a face-to-face
discussion with the physician, but will allow patients to meet the physician
already informed and prepared, thus benefiting both the physician and the
Kinnersley, P., et al.,
Interventions to promote informed consent for patients undergoing surgical and
other invasive healthcare procedures. Cochrane Database Syst Rev, 2013. 7: p.