In Brief

Patients who give consent for videotaping of their sessions with medical residents may not know what they're agreeing to or what their rights are, according to research published in the February 2002 Academic Medicine (Vol. 77, No. 2).

A study of consent forms for the procedure found that almost all forms left out important details about the extent of taping, the patient's right to limit taping or the right to rescind their consent.

Videotaping patient visits is a common teaching method, but it "poses serious and unique threats to confidentiality and privacy," according to study author Dennis J. Butler, PhD, of the Medical College of Wisconsin. He collected written consent forms for videotaping from 20 family medicine residency programs in six Midwestern states, and they were evaluated by three bioethics experts. Only one form was deemed acceptable by all three experts.

The group evaluated the consent forms using several measures: determining its reading-comprehension level, checking to see if each included the five core elements of informed consent (identifying risks of a procedure, voluntary participation, providing alternatives, not implying benefit to the patient and right of refusal), and looking at how they measured against guidelines created by the British General Medical Council.

The average reading level of the forms was grade 10.6, although the recommended reading level for educational materials is fifth grade. Much of the advanced language was apparently added due to liability concerns instead of further explanation of the procedure. Almost all the forms were unclear about who would have access to the tapes, where they would be stored, and when, or if, they would be erased.

Many different specialties use videotaping as part of the training process, but the United States has no guidelines on consent forms. "However," Butler says, "ethical practice dictates the first responsibility of medical educators is to ensure patients fully understand the voluntary nature of participation and have sufficient information to make an informed choice."