What's the best way to inform patients about the risks and benefits of surgery — and make that message stick? If you think video aids and formal nurse education can have a big impact, think again, say researchers at the Minneapolis Veterans Affairs Medical Center.

For a study published in the journal Arthritis Care & Research, Michael R. Johnson, MD, and colleagues split a sample of 151 total knee arthroplasty (TKA) patients into 3 groups: The first filled out a standardized, computer-based informed consent and received a paper handout detailing the risks and benefits of the procedure. In addition to those methods, the second group also watched a video discussing the risks and benefits of TKA. And the third group received formal nurse education in addition to the video, paper handout and computer-based consent.

So which group retained the information best? The researchers were surprised to learn there was no clear winner.

All patients completed a 15-question form immediately after the consent process, on the morning of surgery and 6 weeks after the procedure to gauge their understanding of the risks, indications and expectations associated with TKA. Overall, their answers were about 75% to 80% correct, with no significant difference in scores among the 3 groups at any time the questionnaire was administered. All groups saw a drop in the number of correct answers from the pre-op to post-op period.

What did appear to have an impact on knowledge retention was the level of satisfaction patients felt with the informed consent process. Those who were more satisfied with it were more likely to score well. But satisfaction levels with the consent process were about the same — 92% to 97% — across all groups.

"Neither retention nor satisfaction was influenced by reinforcement methods, such as video or nurse education," conclude the researchers. "They may therefore be unnecessary."

Irene Tsikitas