Personalized Video Education in Surgical Consent: Lessons from a Diverse Safety-Net Population.

BACKGROUND

A key component of shared decision-making (SDM) is education. This article explores the role of videos as supplements to traditional decision-making, focusing on custom videos for surgical patients

METHODS

This study aims to assess the impact of customized video education on traditional surgical consent procedures. This is a prospective cohort study that took place at a county safety-net hospital in California, involving patients undergoing surgical treatment from August 2023 through January 2025. After surgical consultation, each patient received an electronically sent customized educational video addressing indications, procedures, and risks in the patient's preferred language. After watching the videos, SDM was evaluated using the CollaboRATE scale and questions evaluating satisfaction with video education.

RESULTS

A total of 204 patients participated: 134 English speakers (EN) and 70 Spanish speakers (SP). SP were older, with 48.6% aged 45-64 versus 21.6% of EN (p < 0.001). Educational differences existed, with 39.6% of EN reporting college degrees compared to 11.4% among SP (p < 0.001). The video types watched were 52% gallbladder, 20.6% breast, 16.2% skin surgery, 5.4% appendix, and 3.9% others. Both groups (94.8% of EN and 97.1% SP) expressed preference for video education over written. EN achieved CollaboRATE Top Scores more frequently (67.9% vs. 54.3%, p = 0.08). EN outperformed SP in knowing available treatment options (100.0% vs. 91.0%, p < 0.01), understanding benefits (95.5% vs. 82.9%, p < 0.01), and recognizing risks and side effects (91.7% vs. 80.0%, p = 0.05).

CONCLUSION

Customized video education for surgery leads to high rates of understanding treatment options, benefits, and risks. However, disparities between English and Spanish speakers reveal that language plays a critical role in patient engagement and perceived support. This suggests a need for targeted improvements in educational resources for Spanish-speaking patients to ensure equitable access to information and support.