Production of Evidence-Based Informed Consent (EBIC) With Meaning Equivalence Reusable Learning Objects (MERLO)

Abstract

Apparently, during an informed consent, patients remember little of the information given and their comprehension level is often overestimated by physicians. This study measures level of understanding of informed consent for elective cesarean surgery using an evidence-based informed consent (EBIC) model based on six MERLO assessments. MERLO recognition and production scores and follow-up interviews of 50 patients and their partners were recorded. Statistical comparison of scores within couples was performed by weighted kappa agreement, t-tests, and Ward's hierarchical clustering. Recognition score means were high for patients and partners with low standard deviation (SD), while production scores means were lower with higher SD. Clustering analysis showed that only 70% (35/50) of couples were assigned to the same cluster and t-test yields significant difference of scores within couple. Kappa yields moderate agreement levels on all items except for items D and C, which are lower. Follow-up interviews show that participants consider MERLO assessments to be helpful in improving comprehension.