Excellent communication is critical to helping patients understand medical information—and to achieving truly “informed” consent for invasive and noninvasive interventions. Effective patient-provider communication also results in better information retention and more reasonable expectations of treatment outcome, and it’s one hallmark of a high-quality patient experience.
In the October 5, 2016 edition of The Journal, Egekeze et al. report the results of a randomized clinical trial evaluating retention of information provided to patients newly diagnosed with knee osteoarthritis. Each of 67 participants was randomized to receive one of three informed-consent information-delivery protocols, all of which lasted 10 minutes:
- A one-on-one clinician-delivered lecture about knee arthritis, written at an eighth-grade reading level (auditory input only)
- The same lecture as above but accompanied by a silent animated knee video (auditory + visual input).
- The same lecture but accompanied by an anatomic knee model that patients were encouraged to touch (auditory + visual + tactile input).
The third group’s comprehension scores were significantly higher than those of the other two groups, leading the authors to conclude that there is a “direct association between the amount of sensory input incorporated into an informed consent discussion and patient comprehension performance.”
I am quite sure that the majority of physicians, surgeons, PAs, and NPs treating patients for musculoskeletal problems already routinely use anatomic models to facilitate patient understanding, and this study supports continuation of that practice. In my experience, the use of pre-recorded video information, ideally including interviews with patients who have the condition the current patient is being evaluated for, is also very effective in shared decision making processes. Research such as that provided by Egekeze et al. should stimulate us to use multisensory methods when communicating with patients about treatment options and expected outcomes.
Marc Swiontkowski, MD