The Impact of a Videotaped Educational Tool on Medical Directive Choices

Abstract

Agreement on the appropriateness of the use of medical technology should be the standard for healthcare providers and consumers. An inventory and dialogue regarding end-of-life decisions between providers and consumers prior to the onset of illness avoids the potential for confusion and prevents compromised care. This quantitative experimental study collected data regarding the impact of a videotaped teaching tool describing commonly used critical care interventions on a medical directive. The term medical directive describes an advance directive document with specific interventional preferences linked with potential patient outcomes. The educational packets were divided into experimental and control. The control packet contained a trifold with the medical directive, a letter of introduction, a demographic data questionnaire, a teaching brochure, and informed consent. The experimental packet also contained the educational videotape in addition to the other documents. 811 packets were distributed in the Tampa Bay/St. Petersburg area. 175 medical directives were returned (93 experimental & 72 control). The hypothesis tested was that the number of negative responses will be higher in the experimental group when predicted outcomes are poorer. The null hypothesis stated that the percentages of yes and no answers would be equal between the control and experimental groups. The overall differences in the percentages of affirmative answers in recovery scenario #1 and #2 (no disability and minor disability) revealed no statistical significance (p=0.738 & p=0.408 respectively). There were statistically significant differences (both p=<0.001) between the control and experimental groups in recovery scenarios #3 and #4 (mod. disability and severe disability). This places the differences in responses in direct relationship to the potential outcomes. The most desired intervention in both control and experimental groups was antibiotics, and the least desired was endotracheal intubation. CPR was also consistently listed as more desirable in the control group than the experimental group. These data suggest additional education regarding critical care interventions may result in more informed decision-making.