Doctoral Project Defense: Laura Sullivan
Candidate: Laura Sullivan
Major: Nursing
Advisor: Krista A. White, Ph.D.
Implementing Teach Back During Oncology Clinical Trial Informed Consents
Health literacy remains a barrier to the understanding of health-related information. Oncology patients are often presented with treatment options, one being clinical trials. Health literacy is not assessed prior to presenting the health information in informed consent documents before patients agree to participate. Teach back is an evidence-based communication method shown to improve patient comprehension and recall of health-related information. The project’s primary aim was to determine the impact of teach back on patient understanding of content in the informed consent. The secondary aim was to determine if teach back was sustainable and feasible for the nurses. This quality improvement project used a pre- and post-test design measured during the Deaconess of Informed Consent Comprehension Test (DICCT). It was conducted at a large academic cancer center and involved one department of 13 research nurses who present interventional oncology clinical trial informed consents to adult patients. The DICCT was administered verbally by the research nurses at the completion of the informed consent presentation. Scores on the DICCT (range 0 – 28) during the six weeks of not using teach back compared to six weeks of using teach back were analyzed using the Mann-Whitney U test. The secondary aim was measured using qualitative data obtained through informal interviews with the nurses. Results revealed patients who did not receive teach back at the time of informed consent review (n = 13) achieved an average score of 26.0 (SD = 2.9). Patients who received teach back at the time of consent (n = 9) achieved a mean score of 24.7 (SD = 4.2). Results indicated that using teach-back during informed consent did not improve patient understanding of the information in the document (U = 47.5, p = .471). This may be attributed to scoring subjectively and a lack of detail of the DICCT rubric. Results from nursing interviews indicated that the strategy of teach back would be challenging to sustain due to time constraints. Although the results of this project were not statistically or clinically significant, using teach back after each element of the informed consent may be more feasible for future inquiry.