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AAOS Now

Published 11/1/2016

Multisensory Patient Education and Informed Consent

Research recently published in the Journal of Bone and Joint Surgery finds that patient education involving the use of multiple senses (sight, hearing, and touch) during a surgeon-patient informed consent discussion improves patients' understanding of anticipated care and possible outcomes.

The randomized, controlled trial involved 67 consecutive patients with a new diagnosis of knee osteoarthritis and who were treated with a corticosteroid injection. Researchers evaluated three informed consent discussion methods to determine which approach enhanced patient comprehension and satisfaction. Patients were placed randomly into one of three groups in a 1:1:1 allocation ratio: verbal, where the patient listened to a discussion script explaining their treatment; verbal and video, where the patient listened to a discussion script while watching a silent animated knee anatomy video; and, verbal and model, where patients listened to the discussion script while touching and showing the treatment areas on a three-dimensional model of the knee. Study participants, healthcare staff members, as well as the outcome assessor were blinded to group assignments.

Each discussion script was performed by the same physician and was based on content drawn from OrthoInfo.org, the AAOS' patient education website. After each patient completed a validated comprehension questionnaire, patient satisfaction and the patients' preferred method of informed consent discussion were measured using a survey. Finally, each participant received a knee corticosteroid injection.

Analyzing results
The investigators found significant understanding in the three groups. Patients had the following mean comprehension scores:

  • 84 percent (verbal and model group)
  • 74 percent (verbal and video group)
  • 71 percent (verbal-only group)

More than 95 percent of all study participants expressed "high satisfaction" with the content of the discussion from OrthoInfo.org. No matter which group they were assigned, the majority of participants preferred the informed consent discussion incorporating an anatomic model.

"Research has shown that improving patient comprehension of an informed consent discussion may enhance patient engagement and patient compliance with surgeon recommendations," wrote Nkemakolam Egekeze, MD, lead study author and principal investigator. "We believe that our findings may play a role in improving patient-centered outcomes and physician-patient communication in the field of orthopaedic surgery."