CONTROLLED PROSPECTIVE CLINICAL TRIALS Extended preoperative patient education using a multimedia DVD—impact on patients receiving a laparoscopic cholecystectomy: a randomised controlled trial D. Wilhelm & S. Gillen & H. Wirnhier & M. Kranzfelder & A. Schneider & A. Schmidt & H. Friess & H. Feussner Received: 8 May 2008 / Accepted: 27 October 2008 / Published online: 17 January 2009 # Springer-Verlag 2009 Abstract Purpose The informed consent is a legal requirement prior to surgery and should be based on an extensive preopera- tive interview. Multimedia productions can therefore be utilised as supporting tool. In a prospective randomised trial, we evaluated the impact of an extended education on patients undergoing cholecystectomy. Materials and methods For extended patient information, a professionally built DVD was used. After randomisation to either the DVD or the control group, patients were informed with or without additional presentation of the DVD. The quality of education was evaluated using a purpose-built questionnaire. Results One hundred fourteen patients were included in the DVD and 98 in the control group. Patient characteristics did not differ significantly despite a higher educational level in the DVD group. The score of correctly answered questions was higher in the DVD group (19.88 vs. 17.58 points, p < 0.001). As subgroup analysis revealed, particular patient characteristics additionally impacted on results. Conclusion Patients should be informed the most exten- sively prior to any surgical procedure. Multimedia produc- tions therefore offer a suitable instrument. In the presented study, we could prove the positive impact of an information DVD on patients knowledge. Nevertheless, multimedia tools cannot replace personal interaction and should only be used to support daily work. Keywords Informed consent . Surgery . Multimedia . DVD . Education Introduction The informed consent of patients undergoing surgery is a legal requirement prior to any surgical intervention. It requires the patients’ free decision whether an intervention can be done or not. As the patient normally possesses only lay knowledge concerning specific procedures and does not have the ability to capture all potential consequences of a surgical procedure, the education dialogue is an essential issue and has to communicate all relevant information [1]. The extent of communicated information is still in discussion and depends on the type of surgery to be performed (elective plastic surgery vs. acute intervention for traumatic injury). The missing informed consent or its inadequate form and extent are one of the main points of criticism in case of medico-legal affairs and comprehends about one third of all lawsuits against doctors in Germany [2] and most likely also in other countries. Many factors seem to effect on the quality of the informed consent, such as the use of oral or written information or the implementation of illustrations [3–5]. Additionally, patient characteristics, such as age or intelli- gence quotient, impact on understanding medical educa- Langenbecks Arch Surg (2009) 394:227–233 DOI 10.1007/s00423-008-0460-x D. Wilhelm : S. Gillen : M. Kranzfelder : H. Friess : H. Feussner (*) Department of Surgery, Klinikum r.d.Isar, Technische Universität, Munich, Germany e-mail: feussner@chir.med.tu-muenchen.de D. Wilhelm : S. Gillen : H. Wirnhier : M. Kranzfelder : A. Schneider : H. Feussner Workgroup for Minimal Invasive Therapy and Intervention (MITI), Klinikum r.d. Isar, Technische Universität München, München, Germany A. Schmidt Institute for media informatics, Ludwig-Maximilian Universität München, München, Germany