Patient perceptions of surgical informed consent: is repeat back helpful or harmful?

Area of Science:

• Medical Ethics
• Patient Safety
• Surgical Procedures

Background:

• Informed consent comprehension is often suboptimal.
• Repeat back (RB) is a technique where patients restate key consent elements in their own words.
• RB is hypothesized to enhance the informed consent process.

Purpose of the Study:

• To evaluate the effect of RB on patient perceptions of surgical informed consent.
• To determine if RB impacts patient satisfaction, understanding, and information receipt during consent.

Main Methods:

• Secondary analysis of a randomized trial involving elective surgical patients.
• Patients used a computer-based informed consent platform (iMedConsent).
• Randomization to either RB (consent signing required satisfactory patient explanation) or standard consent procedures.

Main Results:

• 575 patients were enrolled; groups were comparable in decision time, satisfaction, and ease of understanding.
• No significant differences were observed in perceptions of information regarding indications, benefits, or risks.
• The RB group reported significantly higher satisfaction with information about surgical alternatives (P=0.01).

Conclusions:

• Patients reported high satisfaction with the repeat back method during surgical informed consent.
• The RB method is not detrimental to the informed consent process.
• RB may potentially improve the quality of informed consent for surgical procedures.