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  • The Efficacy of Interactive iBooks in Patient and Family Education on Traumatic Brain Injury and Concussion

    Final Number:

    Ronald Sahyouni BA; Amin Mahmoodi; Diem Kieu Thi Tran MD; David Bustillo; Amir Mahmoodi; Melissa Huang; Jefferson Chen

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2016 Annual Meeting

    Introduction: Surgeons are faced with the challenge of describing complex medical conditions to the patient and their families. Oftentimes, time constraints and varied educational backgrounds limit the amount of information that can be disbursed, leading to suboptimal patient understanding of their condition. This study seeks to (1) assess the utility of interactive iBooks on patient and family education on Traumatic Brain Injury (TBI) and concussion, and (2) assess the cross-cultural validity of this model in Korean, Vietnamese, and Spanish-speaking patients. We hypothesize that interactive presentation of information in the inpatient and outpatient setting will improve patient comprehension and enhance the patient-physician interaction.

    Methods: Following IRB approval and informed consent, neurotrauma patients/families at an American College of Surgeons verified Level 1 Trauma Center, (1) completed a pre-survey (5 point scale), (2) viewed an iPad-based iBook on either concussion or TBI in their native language, and (3) completed a post-survey. The surveys assessed knowledge, communication, and comfort constructs, and included a validity measure.

    Results: Inpatient data collection is in progress. When pre- and post-survey results were averaged (n= 173), preliminary data shows follow-up outpatients significantly improved (95% confidence paired T-test, P << .01) [Figure 1a] post-iBook scores (average pre-iBook score: 2.52 vs. post-iBook score: 4.01). Inpatients had statistically significant improvements (95% confidence paired T-test, P < .05) [Figure 1b] in their post-iBook scores as well (average pre-iBook score: 1.68 vs. average post-iBook score: 3.44). Tested constructs showed inter-construct reliability (Cronbach’s alpha > 0.7). Furthermore, inpatient responses showed significant improvement regardless of ethnicity, although Caucasian patients significantly improved (95% confidence unpaired T-test, P << .01) more than Hispanic patients.

    Conclusions: Interactive iBooks providing information on concussion and TBI increased (1) patient comprehension, (2) comfort with their medical condition and follow-up care, and (3) improved communication between the patient and the physician. Furthermore, these findings are cross-culturally valid.

    Patient Care: Our findings strongly suggest that augmenting patient education by providing easy-to-digest information in an interactive manner greatly enhances patient knowledge, comfort with their condition and follow-up regimen, and improves patient-physician communication regardless of the patients ethnic or linguistic background. This can dramatically improve patient satisfaction, compliance rates, and optimize the clinical and hospital visit. We hope to expand the use of interactive iBooks throughout the hospital setting, providing patients with customized iBooks unique to their condition.

    Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of interactive information disbursement in increasing patient comprehension of educational material. 2) Identify an effective approach to disseminating important medical information in a time-dependent manner to enhance the patient-physician interaction.

    References: Levinson, W., Gorawara-Bhat, R. and Lamb, J., 2000. A study of patient clues and physician responses in primary care and surgical settings. Jama,284(8), pp.1021-1027. Ferguson, W.J. and Candib, L.M., 2002. Culture, language, and the doctor-patient relationship. FMCH Publications and Presentations, p.61. Jamwal, Goldee, "Effective use of Interactive Learning Modules in Classroom Study for Computer Science Education" (2012). All Graduate Plan B and other Reports. Paper 225. Millis, B., and P. Cottell, Jr., “Cooperative Learning for Higher Education Faculty,” American Council on Education, ORYX Press, 1998. Cusea, J., “Collaborative & Cooperative Learning in Higher Education: A Proposed Taxonomy,” Cooperative Learning and College Teaching, Vol. 2, No. 2, 2–4, 1992. Payne, K. F., Goodson, A. M., Tahim, A., Wharrad, H. J., & Fan, K. (2012). Using the iBook in medical education and healthcare settings-the iBook as a reusable learning object; a report of the author's experience using iBooks Author software. Journal of visual communication in medicine, 35(4), 162-169. Stewart, S., & Choudhury, B. (2015). Mobile technology: Creation and use of an iBook to teach the anatomy of the brachial plexus. Anatomical sciences education, 8(5), 429-437. Summers, C. R., Ivins, B., & Schwab, K. A. (2009). Traumatic brain injury in the United States: an epidemiologic overview. Mt Sinai J Med, 76(2), 105-110. doi:10.1002/msj.20100 Kurowski, B. G., Pomerantz, W. J., Schaiper, C., Ho, M., & Gittelman, M. A. (2015). Impact of preseason concussion education on knowledge, attitudes, and behaviors of high school athletes. J Trauma Acute Care Surg, 79(3 Suppl 1), S21-28. doi:10.1097/ta.0000000000000675 Kroshus, E., Baugh, C. M., Hawrilenko, M., & Daneshvar, D. H. (2015). Pilot randomized evaluation of publically available concussion education materials: evidence of a possible negative effect. Health Educ Behav, 42(2), 153-162. doi:10.1177/1090198114543011

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