title: Using a multimedia presentation to improve patient understanding and satisfaction with informed consent for minimally invasive vascular procedures.
abstract: OBJECTIVE
  As vascular procedures become more complex, patient understanding of their treatment(s) can become more difficult. We wished to evaluate the utility of multimedia presentations (MPs) to improve patient understanding of their vascular interventions.
  
  
  METHODS
  Patients undergoing endovascular aneurysm repair (EVAR), peripheral angioplasty, Hickman catheter and peripherally inserted central catheter (PICC) insertion were randomized into a control group receiving traditional verbal consent, and a MP group that were shown a two minute simplified video of their procedure on an iPad™ computer in addition to the traditional verbal consent. After obtaining consent, all patients completed a questionnaire assessing their comprehension of the procedure, and satisfaction with the consent process. Satisfaction was rated on a 5 point Likert scale with 5 being 'very helpful' in understanding the procedure.
  
  
  RESULTS
  Ninety-three patients were recruited for this study, 62% of which were male. The intervention significantly increased total comprehension in all procedure types controlling for procedure type (multimedia vs. control; F = 9.14, P = .003). A second ANOVA showed there was a significant main effect by intervention (F = 44.06, p < .000) with those in the intervention group showing higher overall satisfaction scores after controlling for surgery type.
  
  
  CONCLUSIONS
  This study suggests that patients find the use of MP during the consent process to be helpful in patient understanding and that there is improved satisfaction. Given the rapid rate of innovation in vascular interventions, increased regular use of MPs to help patients understand their procedures would be beneficial in the care of patients undergoing vascular interventions.
authors.affiliation: Division of Vascular Surgery, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Bowers
authors.affiliation: Division of Vascular Surgery, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Eisenberg
authors.affiliation: Department of Anesthesia and Pain Management, University Health Network, University of Toronto, Toronto, ON, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Montbriand
authors.affiliation: Department of Interventional Radiology, University Health Network, University of Toronto, Toronto, ON, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Jaskolka
authors.affiliation: Division of Vascular Surgery, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada. Electronic address: graham.roche-nagle@uhn.ca.
authors.forename: G
authors.initials: G
authors.lastname: Roche-Nagle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D032882:Comprehension; D005260:Female; D006801:Humans; D007258:Informed Consent; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D019212:Multimedia; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Informed consent; Multimedia presentations