Digital Patient Education in Informed Consent: Randomized Study on Total Hip Arthroplasty

ByMartin Klässner Hours Erstmalig veröffentlicht am Hours Zuletzt aktualisiert am

Sufficient Patient Education is a central prerequisite for a legally compliant and ethically sound Informed Consent process. Particularly in the case of elective, high-frequency procedures such as total hip arthroplasty (THA), the question arises as to how patients can be provided with complex information on the surgical procedure, alternatives and risks in a way that is as comprehensible as possible.

Against this background, von Hertzberg-Boelch et al. investigated in a recent randomized controlled study whether an additional educational video can improve the quality of Patient Education in the context of Informed Consent prior to total hip replacement. The study was published in 2025 in the journal International Orthopaedics (s00264-025-06503-6).

Study design: Randomized controlled trial on digital Patient Education

The prospective, randomized, single-center study included patients who were scheduled for primary total hip arthroplasty. The participants were randomized into two groups:

  • Control group: Standardized informed consent process based on a written information sheet, supplemented by a medical consultation
  • Intervention group: standard process plus an additional 18-minute educational video that was made available to patients digitally before admission to hospital

The medical staff who carried out the informed consent process on admission were not informed about the group membership. The effect of the educational video was assessed immediately after completion of the informed consent process using standardized questionnaires.

Endpoints: Patient understanding, subjective knowledge and emotional experience

The primary endpoint of the study was the objectively measured patient understanding of the relevant information content. This comprised four core areas of informed consent:

  • Explanation of the intervention
  • Participation in the decision-making process
  • Treatment alternatives
  • Risks and complications

Secondary endpoints were:

  • the subjectively assessed knowledge of the patients
  • the emotional state with regard to anxiety, satisfaction and preparation for the procedure

Results: Significant improvement in patient understanding through educational video

A total of 74 patients were recruited until sufficient completed questionnaires were available in both groups.

The central result of the study shows a significant improvement in objective patient understanding through the use of an educational video:

  • Intervention group: 86.5 % correctly answered knowledge questions
  • Control group: 78.6 % correctly answered knowledge questions
  • Statistical significance: p = 0.014

The effect was particularly pronounced in the areas of particular legal relevance for informed consent:

  • Treatment alternatives: significant improvement of 17 %
  • Risks and complications: significant improvement of 10.3%

This showed that digital Patient Education is particularly effective where traditional written information sheets are often perceived as overwhelming or inadequate.

No negative influence on subjective knowledge and emotional experience

Contrary to frequent fears, the additional educational video did not lead to an increase in anxiety or emotional stress. Neither the subjectively perceived knowledge nor the emotional state differed significantly between the two groups:

  • Subjective knowledge: p = 0.986
  • Emotional comfort: p = 0.333

The authors expressly emphasize that improved factual information did not come at the expense of patients’ emotional well-being.

Classification: Significance for informed consent and clinical practice

The results are consistent with the existing evidence that audiovisual information formats can improve patient understanding in the informed consent process. In contrast to previous studies, this study focuses specifically on total hip arthroplasty for the first time.

It is particularly relevant that the authors point out that standardized educational videos not only impart knowledge, but can also contribute to a standardization of educational quality. Against the background of increasing legal requirements, varying medical experience and growing information density, this is of great practical importance.

Conclusion of the study: Digital Patient Education as a useful addition

The authors conclude that the use of an additional educational video measurably improves the informed consent process prior to total hip arthroplasty. In particular, the objective understanding of key content was significantly increased without any negative impact on the patient’s emotional experience.

In the view of the study authors, orthopaedic facilities should consider integrating digital educational videos into the informed consent process in a structured manner in order to strengthen both the quality of Patient Education and legal protection

Source

The study was conducted by Hertzberg-Boelch, S., Fuchs, K., Schubring, J. et al. An informational video for informed consent improves patient comprehension before total hip replacement- a randomized controlled trial. International Orthopaedics (SICOT) 49, 1303-1308 (2025). https://doi.org/10.1007/s00264-025-06503-6

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