Educating patients about their injuries and upcoming surgeries is a key component of the doctor-patient relationship. It not only influences patient satisfaction, but it also likely helps the patient do well after surgery. How can you use online education to prepare for knee surgery?
I suspect that we as orthopedic surgeons don’t educate our patients as well as we could or should. Just look through the comments on my Sports Injury Locator posts or Ask Dr. Geier columns. You will see hundreds of questions from people who were told by their surgeons that they needed operations, but they don’t understand why they need surgery or what the procedures would entail.
Maybe orthopedic surgeons struggle with increasing numbers of patients we must now see in less time. Maybe it is the ever-growing time we spend on electronic medical records and data collection. We must find ways to appropriately counsel our patients about their surgeries.
Bob Yin, M.D. and other researchers at the Kerlan-Jobe Orthopedic Clinic in Los Angeles tested the effectiveness of a web-based tool for patient education for patients undergoing arthroscopic knee surgery for meniscus tears. As part of their practice, the surgeon sees the patient for a preoperative appointment 1 to 2 weeks before surgery to discuss the indications and nature of the surgery and the postoperative recovery.
They randomized a group of 64 patients, with one group watching a 20-minute web-based tutorial in addition to the standard preoperative appointment. The tutorial reviewed pertinent knee anatomy, injuries and general surgical instructions.
Dr. Yin and his group published their findings in a recent issue of the Journal of Bone and Joint Surgery. They observed some surprising trends among the patients who watched the online tutorial:
Before the preoperative visit
The patients who watched the tutorial were significantly more likely to report being informed and prepared for the surgery. They better understood the risks, benefits and alternatives to surgery. They understood the nature of the postoperative recovery better than the patients who only talked to the surgeon in the office.
On the day of surgery
The web tutorial group still reported feeling better informed about surgery than the patients who didn’t watch it. They were also more satisfied with the teaching and information they received than were the patients who only saw the surgeon in his clinic.
At the first postoperative visit
Patients who watched the online tutorial better understood the nature of the surgery they had. They were more likely to correctly identify whether they had treatment of the medial or lateral meniscus. They were more likely to know if the surgeon had also performed a chondroplasty. They were more likely to know if the surgeon found arthritis, and if he or she did find it, where it was located within the knee.
These patients felt that the tutorial was useful and worth their time. 85% felt that watching it made them more prepared to discuss the upcoming surgery with the surgeon at the preoperative visit. After surgery, they claimed to feel more informed about their recovery and satisfied with their pre-surgical teaching.
“Overall, patients who received the tutorial had higher satisfaction scores and an enhanced surgical experience,” Dr. Yin said in a press release, explaining the significance of their findings. “Having adequate knowledge is critical in the shared decision-making process because it empowers patients to make an informed decision about their care.”
I think these findings are fascinating. I hope and expect we will see more surgeons adopt these Internet-based teaching programs before surgery. I also expect more patients to start asking for them. Not only can these programs educate patients, but they can also help patients know what questions to ask about their injuries and surgeries.
If you have undergone orthopedic surgery, were you satisfied with your teaching by the surgeon ahead of time? Would a program like this have been of value to you? If you are an orthopedic surgeon, do you use an online education program or would you consider doing so? I love to hear your experiences below!
Yin B, Goldsmith L, Gambardella. Web-Based Education Prior to Knee Arthroscopy Enhances Informed Consent and Patient Knowledge Recall: A Prospective, Randomized Controlled Study. J Bone Joint Surg Am. 2015 Jun 17;97(12):964-71.
Patients give high marks to prepping for surgery online. Medical News Today. June 22, 2015.