title: Internet based patient education improves informed consent for elective orthopaedic surgery: a randomized controlled trial.
abstract: BACKGROUND
  Obtaining informed consent is an essential step in the surgical pathway. Providing adequate patient education to enable informed decision making is a continued challenge of contemporary surgical practice. This study investigates whether the use of a patient information website, to augment patient education and informed consent for elective orthopaedic procedures is an effective measure.
  
  
  METHODS
  A randomised controlled trial was conducted comparing the quality of informed consent provided by a standard discussion with the treating surgeon compared to augmentation of this discussion with an online education resource (www.orthoanswer.org). Participants were recruited from orthopaedic outpatient clinics. Patients undergoing five common orthopaedic procedures were eligible to participate in the trial. The primary outcome measure was knowledge about their operation. Satisfaction with their informed consent and anxiety relating to their operation were the secondary outcome measures.
  
  
  RESULTS
  There was a statistically significant increase in patient knowledge for the intervention arm as compared to the control arm (p < 0.01). Patients in the intervention arm, had an average score of 69.25% (SD 14.91) correct answers as compared to 47.38% (SD 17.77) in the control arm. Satisfaction was also improved in the intervention arm (p = 0.043). There was no statistically significant difference between the control and intervention arm relating to their anxiety scores (p = 0.195).
  
  
  CONCLUSIONS
  The use of a patient education website as an augment to informed consent improves patient knowledge about their planned operation as well as satisfaction with the consent process whilst not increasing their anxiety levels. We recommend that all patients be directed to web based education tools to augment their consent.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12614001058662 .
authors.affiliation: Orthopaedic Department, Western Health, 160 Gordon St, Footscray, VIC, 3011, Australia. afraval@mac.com
authors.forename: Andrew
authors.initials: A
authors.lastname: Fraval
authors.affiliation: Orthopaedic Department, Western Health, 160 Gordon St, Footscray, VIC, 3011, Australia. janan.chandrananth@gmail.com
authors.forename: Janan
authors.initials: J
authors.lastname: Chandrananth
authors.affiliation: Orthopaedic Department, Western Health, 160 Gordon St, Footscray, VIC, 3011, Australia. yewming.chong@hotmail.com
authors.forename: Yew M
authors.initials: YM
authors.lastname: Chong
authors.affiliation: Orthopaedic Department, Western Health, 160 Gordon St, Footscray, VIC, 3011, Australia. lillianc@student.unimelb.edu.au
authors.forename: Lillian S
authors.initials: LS
authors.lastname: Coventry
authors.affiliation: Orthopaedic Department, Western Health, 160 Gordon St, Footscray, VIC, 3011, Australia. contactphong@gmail.com
authors.forename: Phong
authors.initials: P
authors.lastname: Tran
mesh_terms: D017558:Elective Surgical Procedures; D006801:Humans; D007258:Informed Consent; D020407:Internet; D008875:Middle Aged; D019637:Orthopedic Procedures; D010353:Patient Education as Topic / Q000379:methods*