We have identified efforts by research ers to investigate interventions which seek to improve information delivery and consideration of information to enhance  informed consent .
The interventions used consistently improve patient knowledge , an important prerequisite for informed consent .
This is encouraging and these measures could be widely employed although we are not able to say with confidence which types of interventions are preferable .
Our results should be interpreted with caution due to the high levels of heterogeneity associated with many of the main analyses although we believe there is broad evidence of beneficial outcomes for patients with the pragmatic application of interventions .
BACKGROUND Achieving informed consent is a core clinical procedure and is required before any surgical or invasive procedure is undertaken .
However , it is a complex process which requires patients be provided with information which they can underst and and retain , opportunity to consider their options , and to be able to express their opinions and ask questions .
There is evidence that at present some patients undergo procedures without informed consent being achieved .
OBJECTIVES To assess the effects on patients , clinicians and the healthcare system of interventions to promote informed consent for patients undergoing surgical and other invasive healthcare treatments and procedures .
AUTHORS ' CONCLUSIONS Informed consent is an important ethical and practical part of patient care .
Informed Consent for Ankle Fracture Surgery: Patient Comprehension of Verbal and Videotaped Information
Background : The purpose of our study was to evaluate the effectiveness of using a videotape to give patients information about the risks , benefits , alternatives , and treatment of a common orthopaedic procedure before they sign consent forms . Methods : During a 9-month period , 48 patients with isolated closed ankle fractures requiring surgical intervention were r and omized into two groups that received either videotaped or conventional verbal information regarding consent for surgery . The study group watched a videotape containing information about the risks , benefits , and treatment alternatives , while the control group obtained this information verbally . To determine comprehension and retention , all patients completed a multiple-choice question naire immediately after receiving the information , and 37 patients ( 77 % ) were available to complete a question naire at an average of 10 weeks later . Results : The videotape group outperformed the verbal consent group by 40.1 % on the initial question naire ( p = .0002 ) and by 27.2 % on the followup question naire ( p = 0.0139 ) . Patients with educational levels of less than or equal to the 12th grade performed 67.8 % better on the initial question naire after watching the video than after receiving the information verbally . ( p = .0001 ) . Conclusion : Patients who received information about their surgery on a videotape before giving their consent demonstrated a significant increase in comprehension compared to patients who received this information verbally . The benefit was even greater for patients with lower education levels
We have identified efforts by research ers to investigate interventions which seek to improve information delivery and consideration of information to enhance  informed consent .
The interventions used consistently improve patient knowledge , an important prerequisite for informed consent .
This is encouraging and these measures could be widely employed although we are not able to say with confidence which types of interventions are preferable .
Our results should be interpreted with caution due to the high levels of heterogeneity associated with many of the main analyses although we believe there is broad evidence of beneficial outcomes for patients with the pragmatic application of interventions .
BACKGROUND Achieving informed consent is a core clinical procedure and is required before any surgical or invasive procedure is undertaken .
However , it is a complex process which requires patients be provided with information which they can underst and and retain , opportunity to consider their options , and to be able to express their opinions and ask questions .
There is evidence that at present some patients undergo procedures without informed consent being achieved .
OBJECTIVES To assess the effects on patients , clinicians and the healthcare system of interventions to promote informed consent for patients undergoing surgical and other invasive healthcare treatments and procedures .
AUTHORS ' CONCLUSIONS Informed consent is an important ethical and practical part of patient care .