Introduction
Informed consent is a central aspect of the medical decision-making process, and represents an essential tenet of patient autonomy and respect for persons; this is especially critical before a patient undergoes a medical procedure.1 While informed consent has a medicolegal component, the primary aim is for the patient to understand the purpose, risks, benefits, and alternatives of the procedure when deciding on a treatment course.2 Unfortunately, due to the complexity of medicine and medical terminology and the overall health illiteracy of the general population, studies repeatedly show that patients poorly understand their medical treatments.3 Although patient autonomy requires diligent efforts to ensure patients comprehend their surgical procedures, this is made difficult by time constraints in the office, and the increasing pressure on physicians to provide better, more cost-effective health care while meeting high patient satisfaction standards.4 Novel techniques to deliver health care information that improve patient comprehension, satisfaction, and physician efficiency are paramount in this era of medicine governed by health care delivery reform.AJOG at a Glance
To determine the effectiveness of audiovisual materials on providing informed consent for a large proportion of the gynecological patient population, namely those undergoing hysterectomy.
Patients who were presented with audiovisual aids for their preoperative counseling for their upcoming hysterectomy had better knowledge of their procedure and retention of that knowledge. Also, using these materials reduced the time the physician spent with the patient during their preoperative visit.
This is the first study performed evaluating audiovisual tools to provide informed consent for this type of procedure in the gynecological field. Therefore, it is directly applicable to our patient population as gynecologists.
In an effort to harness growing technology resources and improve counseling effectiveness, thoroughness, and efficiency, our study aims to determine whether including a video-based multimedia presentation improves patient comprehension during informed consent for hysterectomy. Secondary outcomes include patient satisfaction, thoroughness of counseling content, and physician time efficiency.
Hysterectomy provides a promising test arena for enhanced patient counseling and surgical consent for several reasons. Firstly, as one of the most common surgeries performed in the United States, with >400,000 cases per year,5 improvements in both comprehension and efficiency with this procedure alone have the potential for broad impact. Moreover, there are clear indications for hysterectomy, well-defined risks and benefits, and often, common alternatives to the procedure to discuss or consider. Discussion of the procedure should include expectations of preoperative, intraoperative (including a description of the procedure itself), and short- and long-term postoperative periods. These known factors lend themselves to inclusion in a standardized video presentation.