Evidence Based Informed Consent for Caesarean Section Using MERLO - Meaning Equivalence Reusable Learning Objects

Abstract

By signing an informed consent (IC) form, patients authorize medical interventions. Application of ‘Meaning Equivalence Reusable Learning Objects (MERLO)’ assesses the level of patient understanding. We evaluated patients’ understanding of the information received during the IC for elective caesarean section. We mapped different topics that patients should understand and MERLO assessment items were prepared and scored. We evaluated 49 and 30 patients undergoing elective caesarean section at Meir Medical Center in Israel and in Mount Sinai Hospital in Toronto respectively and 14 residents that were used as a reference. The mean scores were similar: 76.1±18.0 and 81.1±10.4 for Meir and Mount Sinai, respectively (P>0.05). There were no differences between the scores by investigated topics. A patient score of 90 and above represents sufficient understanding (20% of the patients). A score of 70-90 indicates that some reinforcement of the explanations is needed (40% of patients). A score below 70 (40% of patients), indicates lack of understanding that requires revising the explanation. Evaluating patients' understanding of medical explanations prior to elective procedures has become a necessity and therefore needs to be evaluated. Using MERLO techniques, we can assess how patients’ understand the physician's explanations.