Physical, verbal reminders could improve preoperative preparation

By Sarah Guy, medwireNews Reporter

Patients may be unable to recall much of the preoperative information they are given by anesthesiologists, suggesting the need for reminders such as printed instructions, and telephone calls the night before their procedure is scheduled, says a US research team.

In a study of healthy, educated, student volunteers who watched a video containing a preoperative explanation of anesthetic options and instructions, less than a quarter of the information presented was recalled during follow-up tests.

"If healthy subjects not under stress recall so little, recall by actual patients must be even lower," suggest Elisabeth Sandberg (Vanderbilt University, Nashville, Tennessee) and colleagues in Anesthesiology.

Their findings showed that providing retrieval clues to test information absorption improved the participants' ability to recall facts that were discussed in the video, indicating that providing patients with instructions for later review may be beneficial.

The 38 male and 60 female responders completed three recall tasks: a free recall, where they were asked to record as much of the 80 discrete pieces of information in the video as possible, a cued recall task consisting of 10 open-ended questions, and a multiple-choice recognition test.

Sandberg and team report a mean free recall score of 17 out of the possible 80, giving a low average of 21.3% recall for items in the video per respondent.

Conversely, participants recalled significantly more information on the cued recall and multiple-choice tasks, at 67.4% and 83.0%, respectively. Recall on the multiple-choice task was significantly better than both of the other tasks, say the authors.

The best-remembered topics from the video in the multiple-choice test were identifying the medical disorder (a ganglion cyst), with 99% recognition, and stopping all foods after midnight before surgery, at 95% recognition.

Recognizing that some medications were permissible before surgery and the importance of avoiding aspirin before surgery were the least remembered topics in the multiple-choice test. These errors are "of meaningful concern," say Sandberg et al.

"A well-designed perioperative system should then provide multiple memory supports, such as night-before reminder phone calls, emails, or text messages to review instructions or help the patient remember to consult their written checklist," conclude the researchers.

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