A randomized controlled trial comparing video-assisted informed consent with standard consent for Mohs micrographic surgery

Yueyue Miao; Victoria L Venning; Kylie-Ann Mallitt; Julia E J Rhodes; Noah J Isserman; Gilberto Moreno; Simon Lee; William Ryman; Gayle Fischer; Rebecca B Saunderson

doi:10.1016/j.jdin.2020.03.005

A randomized controlled trial comparing video-assisted informed consent with standard consent for Mohs micrographic surgery

JAAD Int. 2020 May 11;1(1):13-20. doi: 10.1016/j.jdin.2020.03.005. eCollection 2020 Jul.

Authors

Yueyue Miao¹, Victoria L Venning², Kylie-Ann Mallitt³, Julia E J Rhodes⁴, Noah J Isserman⁵, Gilberto Moreno⁶, Simon Lee², William Ryman^{2

6}, Gayle Fischer^{1

6}, Rebecca B Saunderson^{1

6

7}

Affiliations

¹ Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia.
² Sydney Skin Hospital, Darlinghurst, New South Wales, Australia.
³ Centre for Big Data Research in Health, The University of New South Wales, Kensington, New South Wales, Australia.
⁴ Department of Dermatology, The Alfred Hospital, Melbourne, Victoria, Australia.
⁵ The University of Illinois Urbana-Champaign, Champaign, Illinois.
⁶ Department of Dermatology, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
⁷ Department of Dermatology, Prince of Wales Hospital, Randwick, New South Wales, Australia.

Abstract

Background: There is a need for improvement in informed medical consent to address the lack of standardization and to increase patient engagement.

Objective: To investigate the use of a video to aid informed consent for Mohs micrographic surgery and evaluate patient understanding, satisfaction, anxiety, and time savings relative to verbal consent.

Methods: A 2-armed randomized controlled trial involving 102 patients compared video-assisted consent with a control group who underwent consent in the standard verbal manner. All participants underwent questionnaire-based testing of knowledge, satisfaction, and anxiety, and the time of each consultation was measured.

Results: Patients who watched the video performed significantly better in the knowledge questionnaire compared with the control group (P = .02), were more satisfied with their understanding of the risks of Mohs micrographic surgery (P = .013), and spent less time with their physician (P = .008). Additionally, 78.4% of video group patients reported that they preferred seeing the video before speaking with their physician.

Limitations: The study design may not replicate day-to-day clinical practice.

Conclusion: Video-assisted consent for Mohs micrographic surgery improves patient knowledge, leads to a better understanding of the risks, and saves physicians time without compromising patient satisfaction and anxiety levels in this study setting.