Efficacy of informed consent process using educational videos for skin biopsy procedures

Dichitchai Mettarikanon; Weeratian Tawanwongsri; Pitchaya Jaruvijitrattana; Sasipaka Sindhusen; Surinnart Charoenchitt; Patsaraporn Manunyanon

doi:10.30935/cedtech/13755

Dichitchai Mettarikanon ¹, Weeratian Tawanwongsri ² ^* , Pitchaya Jaruvijitrattana ³, Sasipaka Sindhusen ⁴, Surinnart Charoenchitt ⁴, Patsaraporn Manunyanon ⁵

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CONT ED TECHNOLOGY, Volume 15, Issue 4, Article No: ep477

https://doi.org/10.30935/cedtech/13755

Submitted: 11 July 2023, Published Online: 02 October 2023

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Abstract

The informed consent process is integral to medical procedures, including skin biopsies, which are the definitive method for diagnosing challenging skin lesions. Educational videos are recognized for effective delivery of information for informed consent. This study aimed to evaluate the efficacy of an informed consent process using educational videos to improve patient understanding and reduce preprocedural anxiety. This multicenter, randomized controlled study was conducted during December 2021-June 2023. Participants were randomly assigned to either the video or verbal group in a 1:1 ratio. They completed knowledge and anxiety questionnaires before and after biopsy. The final analysis included 54 participants (verbal group: n=28; video group: n=26) with a mean age of 51.9 years (standard deviation [SD] 18.1), and a balanced gender distribution. Post-intervention knowledge scores (median 10.0; IQR 8.0-10.0) significantly increased compared to pre-intervention scores (median 6.0; IQR 4.0-9.0), p<0.001. Post-intervention Spielberger state-trait anxiety inventory (STAI) scores (median 5.0; interquartile range, IQR 5.0-6.0) significantly decreased compared to pre-intervention scores (median 7.0; IQR 5.0-10.0), p<0.001. Knowledge scores increased more in the video group (median, 2.5; IQR 1.0-5.0) than in the verbal group (median, 1.5; IQR 0.0-4.0), p=0.217. There was no significant difference in STAI score changes between the video group (median 1.0, IQR 0.0-4.0) and the verbal group (median 1.0, IQR 0.0-3.0), p=0.824. Despite statistical insignificance, educational videos exhibited greater effectiveness in enhancing comprehension and demonstrated comparable efficacy in reducing anxiety compared to conventional intervention.

Keywords: educational videos, comprehension, anxiety, informed consent, skin biopsy

References

Ab Hamid, M. R., Mohd Yusof, N. D. B., Buhari, S. S., Abd Malek, K., & Noor, H. (2021). Development and validation of educational video content, endorsing dietary adjustments among patients diagnosed with hypertension. International Journal of Health Promotion and Education. https://doi.org/10.1080/14635240.2021.1958695
Abhishek, K., & Khunger, N. (2015). Complications of skin biopsy. Journal of Cutaneous and Aesthetic Surgery, 8(4), 239. https://doi.org/10.4103/0974-2077.172206
Agozzino, E., Borrelli, S., Cancellieri, M., Carfora, F. M., Di Lorenzo, T., & Attena, F. (2019). Does written informed consent adequately inform surgical patients? A cross sectional study. BMC Medical Ethics, 20, 1. https://doi.org/10.1186/s12910-018-0340-z
Armstrong, A. W., Alikhan, A., Cheng, L. S., Schupp, C., Kurlinkus, C., & Eisen, D. B. (2010). Portable video media for presenting informed consent and wound care instructions for skin biopsies: A randomized controlled trial. British Journal of Dermatology, 163(5), 1014-1019. https://doi.org/10.1111/j.1365-2133.2010.10067.x
Arpey, C. J., & Whitaker, D. C. (2001). Postsurgical wound management. Dermatologic Clinics, 19(4), 787-797. https://doi.org/10.1016/s0733-8635(05)70316-8
Bailey, C. S., & Bailey, J. A. (2007). Claims of alleged medical negligence in refractive surgery: Causes and avoidance. Contact Lens and Anterior Eye, 30(2), 144-147. https://doi.org/10.1016/j.clae.2007.01.003
Beauchamp, T. L., Childress, J. F. (2019). Principles of biomedical ethics. Oxford University Press.
Betti, S., Sironi, A., Saino, G., Ricci, C., & Bonavina, L. (2011). Effect of the informed consent process on anxiety and comprehension of patients undergoing esophageal and gastrointestinal surgery. Journal of Gastrointestinal Surgery, 15(6), 922-927. https://doi.org/10.1007/s11605-011-1517-7
Blake, K., Holbrook, J. T., Antal, H., Shade, D., Bunnell, H. T., McCahan, S. M., Wise, R. A., Pennington, C., Garfinkel, P., & Wysocki, T. (2015). Use of mobile devices and the Internet for multimedia informed consent delivery and data entry in a pediatric asthma trial: Study design and rationale. Contemporary Clinical Trials, 42, 105-118. https://doi.org/10.1016/j.cct.2015.03.012
Bounif, C., Ducos, V., Appourchaux, E., Ferrero, P. A., Roux, A., Mathonnet, M., & Taibi, A. (2022). Does increased patient comprehension decrease preoperative anxiety before digestive surgery? Journal of Visceral Surgery, 159(2), 114-120. https://doi.org/10.1016/j.jviscsurg.2021.02.009
Brame, C. J. (2016). Effective educational videos: Principles and guidelines for maximizing student learning from video content. CBE–Life Sciences Education, 15(4), es6. https://doi.org/10.1187/cbe.16-03-0125
Chaisriya, K., Kaeophanuek, S., & Gilbert, L. (2023). The effects of integrating digital storytelling with metacognition strategies (DSTMC) learning model to enhance communication abilities. Contemporary Educational Technology, 15(2), ep416. https://doi.org/10.30935/cedtech/12986
Convie, L. J., Carson, E., McCusker, D., McCain, R. S., McKinley, N., Campbell, W. J., Kirk, S. J., & Clarke, M. (2020). The patient and clinician experience of informed consent for surgery: A systematic review of the qualitative evidence. BMC Medical Ethics, 21, 58. https://doi.org/10.1186/s12910-020-00501-6
Davis, S. A., Feldman, S. R., & Fleischer Jr, A. B. (2014). Is the duration of skin disease visits decreasing in the United States? Dermatology Online Journal, 21(2), 13030/qt449576gx. https://doi.org/10.5070/D3212023814
Dawdy, K., Bonin, K., Russell, S., Ryzynski, A., Harth, T., Townsend, C., Liu, S., Chu, W., Cheung, P., Chung, H., Morton, G., Vesprini, D., Loblaw, A., Cao, X., & Szumacher, E. (2018). Developing and evaluating multimedia patient education tools to better prepare prostate-cancer patients for radiotherapy treatment (randomized study). Journal of Cancer Education, 33, 551-556. https://doi.org/10.1007/s13187-016-1091-5
Dettmer, P. (2005). New blooms in established fields: Four domains of learning and doing. Roeper Review, 28(2), 70-78. https://doi.org/10.1080/02783190609554341
Direksoonthorn, K. (2018). Informed consent in Thailand: What standard is it: Which one should it be. Asia Pacific Journal of Health Law & Ethics, 12(3), 1-32.
Done, M. L., & Lee, A. (1998). The use of a video to convey preanesthetic information to patients undergoing ambulatory surgery. Anesthesia & Analgesia, 87(3), 531-536. https://doi.org/10.1097/00000539-199809000-00005
Eberhart, L., Aust, H., Schuster, M., Sturm, T., Gehling, M., Euteneuer, F., & Rüsch, D. (2020). Preoperative anxiety in adults–A cross-sectional study on specific fears and risk factors. BMC Psychiatry, 20(1), 140. https://doi.org/10.1186/s12888-020-02552-w
Elston, D. M., Stratman, E. J., & Miller, S. J. (2016). Skin biopsy: Biopsy issues in specific diseases. Journal of the American Academy of Dermatology, 74(1), 1-16. https://doi.org/10.1016/j.jaad.2015.06.033
Farrell, E. H., Whistance, R. N., Phillips, K., Morgan, B., Savage, K., Lewis, V., Kelly, M., Blazeby, J. M., Kinnersley, P., & Edwards, A. (2014). Systematic review and meta-analysis of audio-visual information aids for informed consent for invasive healthcare procedures in clinical practice. Patient Education and Counseling, 94(1), 20-32. https://doi.org/10.1016/j.pec.2013.08.019
Fischbeck, S., Petrowski, K., Renovanz, M., Nesbigall, R., Haaf, J., & Ringel, F. (2021). Anxiety is associated with unfulfilled information needs and pain at the informed consent consultation of spine surgery patients: A longitudinal study. European Spine Journal, 30(8), 2360-2367. https://doi.org/10.1007/s00586-021-06824-1
Goldberger, J. J., Kruse, J., Kadish, A. H., Passman, R., & Bergner, D. W. (2011). Effect of informed consent format on patient anxiety, knowledge, and satisfaction. American Heart Journal, 162(4), 780-785.e781. https://doi.org/10.1016/j.ahj.2011.07.006
Grilo, A. M., Ferreira, A. C., Ramos, M. P., Carolino, E., Pires, A. F., & Vieira, L. (2022). Effectiveness of educational videos on patient’s preparation for diagnostic procedures: Systematic review and meta-analysis. Preventive Medicine Reports, 28, 101895. https://doi.org/10.1016/j.pmedr.2022.101895
Ivarsson, B., Larsson, S., Lührs, C., & Sjöberg, T. (2005). Extended written pre-operative information about possible complications at cardiac surgery–Do the patients want to know? European Journal of Cardiothoracic Surgery, 28(3), 407-414. https://doi.org/10.1016/j.ejcts.2005.05.006
Jefford, M., & Moore, R. (2008). Improvement of informed consent and the quality of consent documents. The Lancet Oncology, 9(5), 485-493. https://doi.org/10.1016/S1470-2045(08)70128-1
Kadam, R. A. (2017). Informed consent process: A step further towards making it meaningful! Perspectives in Clinical Research, 8(3), 107-112.
Kuzminskaitė, V., Kaklauskaitė, J., & Petkevičiūtė, J. (2019). Incidence and features of preoperative anxiety in patients undergoing elective non-cardiac surgery. Acta Medica Lituanica [Lithuanian Medical Journal], 26(1), 93-100. https://doi.org/10.6001/actamedica.v26i1.3961
Mayer, R., & Mayer, R. E. (2005). The Cambridge handbook of multimedia learning. Cambridge University Press. https://doi.org/10.1017/CBO9780511816819
Nakagawa, S., Fischkoff, K., Berlin, A., Arnell, T. D., & Blinderman, C. D. (2019). Communication skills training for general surgery residents. Journal of Surgical Education, 76(5), 1223-1230. https://doi.org/10.1016/j.jsurg.2019.04.001
Nunnally, J. C. (1967). Psychometric theory. McGraw-Hill.
Pietrzykowski, T., & Smilowska, K. (2021). The reality of informed consent: Empirical studies on patient comprehension–Systematic review. Trials, 22(1), 57. https://doi.org/10.1186/s13063-020-04969-w
Pramono, A., & Raharjo, B. (2021). Preoperative patient anxiety level before and after informed consent for general anesthesia. Russian Open Medical Journal, 10(2), 1-3. https://doi.org/10.15275/rusomj.2021.0205
Raposo, V. L. (2019). Lost in ‘culturation’: Medical informed consent in China (from a Western perspective). Medicine, Health Care and Philosophy, 22(1), 17-30. https://doi.org/10.1007/s11019-018-9835-0
Razera, A. P. R., dos Santos Trettene, A., da Silva Demoro Mondini, C. C., Cintra, F. M. R. N., Razera, F. P. M., & de Lourdes Merighi Tabaquim, M. (2019). Construction of an educational video on postoperative care for cheiloplasty and palatoplasty. Texto & Contexto-Enfermagem [Text & Context-Nursing], 28. https://doi.org/10.1590/1980-265x-tce-2018-0301
Rosique, I., Pérez-Cárceles, M. D., Romero-Martín, M., Osuna, E., & Luna, A. (2006). The use and usefulness of information for patients undergoing anesthesia. Medicine and Law, 25(4), 715-727.
Rovinelli, R. J., & Hambleton, R. K. (1976). On the use of content specialists in the assessment of criterion-referenced test item validity. Tijdschrift voor Onderwijsresearch [Journal for Educational Research], 2(2), 49-60.
Schooley, B., San Nicolas-Rocca, T., & Burkhard, R. (2015). Patient-provider communications in outpatient clinic settings: A clinic-based evaluation of mobile device and multimedia mediated communications for patient education. JMIR mHealth uHealth, 3(1), e2. https://doi.org/10.2196/mhealth.3732
Seeliger, B., Kayser, M. Z., Drick, N., Fuge, J., Valtin, C., Greer, M., & Gottlieb, J. (2022). Graphic narrative based informed consent for bronchoscopy improves satisfaction in patients after lung-transplantation: A randomized controlled trial. Patient Education and Counseling, 105(4), 949-955. https://doi.org/10.1016/j.pec.2021.08.011
Steves, S. L., & Scafide, K. N. (2021). Multimedia in preoperative patient education for adults undergoing cancer surgery: A systematic review. European Journal of Oncology Nursing, 52, 101981. https://doi.org/10.1016/j.ejon.2021.101981
Tipotsch-Maca, S. M., Varsits, R. M., Ginzel, C., & Vecsei-Marlovits, P. V. (2016). Effect of a multimedia-assisted informed consent procedure on the information gain, satisfaction, and anxiety of cataract surgery patients. Journal of Cataract & Refractive Surgery, 42(1), 110-116. https://doi.org/10.1016/j.jcrs.2015.08.019
Wang, S.-C., Lee, D.-C., Lee, Y.-H., Chang, Y.-P., & Chu, I.-L. (2022). Effects of multimedia-based fall prevention education on the knowledge, attitudes, or behaviors of patients. Japan Journal of Nursing Science, 19(2), e12455. https://doi.org/10.1111/jjns.12455
Wong, J. L. C., Vincent, R. C., & Al-Sharqi, A. (2017). Dermatology consultations: How long do they take? Future Hospital Journal, 4(1), 23-26. https://doi.org/10.7861/futurehosp.4-1-23
Wongsawang, N., Lagampan, S., Lapvongwattana, P., & Bowers, B. J. (2013). Family caregiving for dependent older adults in Thai families. Journal of Nursing Scholarship, 45(4), 336-343. https://doi.org/10.1111/jnu.12035
Wooldridge, A. N., Arató, N., Sen, A., Amenomori, M., & Fetters, M. D. (2010). Truth or fallacy? Three hour wait for three minutes with the doctor: Findings from a private clinic in rural Japan. Asia Pacific Family Medicine, 9(1), 11. https://doi.org/10.1186/1447-056X-9-11
Yucel, A., Gecici, O., Emul, M., Oyar, O., Gulsoy, U. K., Dayanir, Y. O., Acar, M., Degirmenc, B., & Haktanir, A. (2005). Effect of informed consent for intravascular contrast material on the level of anxiety: How much information should be given? Acta Radiologica, 46(7), 701-707. https://doi.org/10.1080/02841850500215816
Zhang, M. H., Haq, Z. U., Braithwaite, E. M., Simon, N. C., & Riaz, K. M. (2019). A randomized, controlled trial of video supplementation on the cataract surgery informed consent process. Graefe’s Archive for Clinical and Experimental Ophthalmology, 257(8), 1719-1728. https://doi.org/10.1007/s00417-019-04372-5
Zhang, Y., Ruan, X., Tang, H., Yang, W., Xian, Z., & Lu, M. (2017). Video-assisted informed consent for cataract surgery: A randomized controlled trial. Journal of Ophthalmology, 2017, 9593631. https://doi.org/10.1155/2017/9593631
Zsido, A. N., Teleki, S. A., Csokasi, K., Rozsa, S., & Bandi, S. A. (2020). Development of the short version of the Spielberger state–Trait anxiety inventory. Psychiatry Research, 291, 113223. https://doi.org/10.1016/j.psychres.2020.113223

Citation

Mettarikanon, D., Tawanwongsri, W., Jaruvijitrattana, P., Sindhusen, S., Charoenchitt, S., & Manunyanon, P. (2023). Efficacy of informed consent process using educational videos for skin biopsy procedures. Contemporary Educational Technology, 15(4), ep477. https://doi.org/10.30935/cedtech/13755

Mettarikanon, D., Tawanwongsri, W., Jaruvijitrattana, P., Sindhusen, S., Charoenchitt, S., and Manunyanon, P. (2023). Efficacy of informed consent process using educational videos for skin biopsy procedures. Contemporary Educational Technology, 15(4), ep477. https://doi.org/10.30935/cedtech/13755

Mettarikanon D, Tawanwongsri W, Jaruvijitrattana P, Sindhusen S, Charoenchitt S, Manunyanon P. Efficacy of informed consent process using educational videos for skin biopsy procedures. CONT ED TECHNOLOGY. 2023;15(4), ep477. https://doi.org/10.30935/cedtech/13755

Mettarikanon, Dichitchai, Weeratian Tawanwongsri, Pitchaya Jaruvijitrattana, Sasipaka Sindhusen, Surinnart Charoenchitt, and Patsaraporn Manunyanon. "Efficacy of informed consent process using educational videos for skin biopsy procedures". Contemporary Educational Technology 2023 15 no. 4 (2023): ep477. https://doi.org/10.30935/cedtech/13755

Mettarikanon, Dichitchai et al. "Efficacy of informed consent process using educational videos for skin biopsy procedures". Contemporary Educational Technology, vol. 15, no. 4, 2023, ep477. https://doi.org/10.30935/cedtech/13755

Mettarikanon D, Tawanwongsri W, Jaruvijitrattana P, Sindhusen S, Charoenchitt S, Manunyanon P. Efficacy of informed consent process using educational videos for skin biopsy procedures. CONT ED TECHNOLOGY. 2023;15(4):ep477. https://doi.org/10.30935/cedtech/13755