Qualitative evaluation of a video-based tool to support informed consent in colonoscopy

Endoscopy unit efficiency is critical to provide timely and quality care, despite limited resources. In previous work, obtaining informed consent was the most common documented cause of delay. We developed a 4-minute animated video to facilitate the consent process, describing colonoscopy, its purpose, and potential risks and benefits.

In this study, we aim to assess (1) the ability of the video to support the informed consent process and (2) the extent to which the video is attractive, clear, acceptable, actionable and usable, from the perspective of the audience.

Using a critical case sample design with maximum variation, 12 participants completed pre- and postcolonoscopy 1:1 semistructured interviews after viewing the video. Questions evaluated whether key components of informed consent were conveyed and assessed the video using principles of learner verification (attractiveness, usability, comprehension, self-efficacy, acceptability). Interviews were recorded and transcribed. Data were coded inductively and deductively.

Regarding informed consent, most participants understood the purpose and nature of a colonoscopy, but alternatives and participants' right to refuse were less effectively communicated. As a communication tool, the animations engaged participants and aided comprehension of complex material. The language was accessible; however, some participants found the video too fast and the font too small. Most participants found the video acceptable and characters relatable. Some identified information gaps included sedation level and procedure duration.

The video-based tool can supplement standard approaches to informed consent for patients undergoing colonoscopy. Findings have informed revisions to the video and will guide its evaluation and implementation into clinical practice. Future research should assess its impact on endoscopy unit efficiency.