Improving informed consent in cardiac surgery by enhancing preoperative education.

OBJECTIVE: To investigate the effect of enhancing preoperative education in improving recall and understanding of a surgical procedure and its application to the informed consent process in cardiac surgery.

METHODS: Four electronic database searches were performed from January 2000 to August 2017. A total of 282 articles were identified from which 22 prospective studies assessing an intervention were selected according to predefined selection criteria.

RESULTS: Most articles that used additional written information and all that used multimedia presentations to enhance informed consent showed that their intervention improved risk recall and patient's understanding of the procedure. A single randomised controlled trial in cardiac surgery showed that audiotaped consultations improved patient's knowledge of the operation.

CONCLUSIONS: Patient recall and understanding of pre-operative information can significantly improve with a variety of educational tools. Procedure-specific forms with or without illustrations as well as interactive multimedia interventions enhance patient recall and understanding of information. In cardiac surgery patients, interventions need to meet patients' preferences, be repetitive on crucial points and consider the nature of the procedure.