Enhancing informed consent best practices: gaining patient, family and provider perspectives using reverse simulation

Area of Science:

• Clinical Medicine
• Patient Communication
• Healthcare Quality Improvement

Background:

• Informed consent is vital for safe, collaborative patient care but current standards may not align with patient, family, and healthcare provider needs.
• A gap exists in understanding whether established informed consent practices adequately address the perspectives of all stakeholders involved in clinical decision-making.

Purpose of the Study:

• To compare the perceptions and needs of patients, families, and healthcare providers regarding a standardized informed consent process.
• To identify disparities in information retention and priorities for informed consent among different stakeholder groups.

Main Methods:

• A web-based 'reverse' simulation paradigm was employed, where participants viewed a video of a standardized informed consent discussion.
• The simulation involved a scenario of a patient with psychotic symptoms being prescribed atypical antipsychotic medication.
• 107 participants completed an online debriefing survey after viewing the simulation.

Main Results:

• Significant disparities were observed in information retention across patient, family, and healthcare provider groups.
• Perceptions of the physician's performance during the informed consent discussion varied among the three groups.
• Priorities for essential elements within the informed consent process differed between patients, families, and healthcare providers.

Conclusions:

• Enhancing informed consent requires improving patient retention of critical treatment information, including short- and long-term adverse events and preventative measures.
• Reviewing alternative psychosocial and pharmacological treatment options, medication efficacy timelines, and safe maintenance strategies is recommended.
• The 'reverse' simulation model effectively identifies clinical practice gaps, offering a pathway to improve patient care and informed consent processes.