title: Using a Multimedia Presentation to Enhance Informed Consent in a Pediatric Emergency Department.
abstract: BACKGROUND
  Informed consent is an ethical process for ensuring patient autonomy. Multimedia presentations (MMPs) often aid the informed consent process for research studies. Thus, it follows that MMPs would improve informed consent in clinical settings.
  
  
  OBJECTIVE
  The aim of this study was to determine if an MMP for the informed consent process for ketamine sedation improves parental satisfaction and comprehension as compared with standard practice.
  
  
  METHODS
  This 2-phase study compared 2 methods of informed consent for ketamine sedation of pediatric patients. Phase 1 was a randomized, prospective study that compared the standard verbal consent to an MMP. Phase 2 implemented the MMP into daily work flow to validate the previous year's results. Parents completed a survey evaluating their satisfaction of the informed consent process and assessing their knowledge of ketamine sedation. Primary outcome measures were parental overall satisfaction with the informed consent process and knowledge of ketamine sedation.
  
  
  RESULTS
  One hundred eighty-four families from a free-standing, urban, tertiary pediatric emergency department with over 85,000 annual visits were enrolled. Different demographics were not associated with a preference for the MMP or improved scores on the content quiz. Intervention families were more likely "to feel involved in the decision to use ketamine" and to understand that "they had the right to refuse the ketamine" as compared with control families. The intervention group scored significantly higher overall on the content section than the control group. Implementation and intervention families responded similarly to all survey sections.
  
  
  CONCLUSIONS
  Multimedia presentation improves parental understanding of ketamine sedation, whereas parental satisfaction with the informed consent process remains unchanged. Use of MMP in the emergency department for informed consent shows potential for both patients and providers.
authors.affiliation: From the *Section of Emergency Medicine, and †Center for Innovative Pediatric Practice, The Research Institute, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH.
authors.forename: Sandra P
authors.initials: SP
authors.lastname: Spencer
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Stoner
authors.forename: Kelly
authors.initials: K
authors.lastname: Kelleher
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Cohen
mesh_terms: D000778:Anesthetics, Dissociative / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007258:Informed Consent; D007649:Ketamine / Q000627:therapeutic use*; D008297:Male; D019212:Multimedia; D010290:Parents / Q000523:psychology*; D010372:Pediatrics; D010549:Personal Satisfaction; D011446:Prospective Studies; D011795:Surveys and Questionnaires
chemical_list: D000778:Anesthetics, Dissociative; D007649:Ketamine