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. 2017 Nov 1;81(5):787-794.
doi: 10.1093/neuros/nyx095.

Interactive iBook-Based Patient Education in a NeuroTrauma Clinic

Ronald Sahyouni  1 , Amin Mahmoodi  2 , Amir Mahmoodi  3 , Ramin R Rajaii  1 , Bima J Hasjim  1 , David Bustillo  3 , Melissa Huang  3 , Diem Kieu Tran  3 , Jefferson W Chen  3
Affiliations

Interactive iBook-Based Patient Education in a NeuroTrauma Clinic

Ronald Sahyouni et al. Neurosurgery. .

Abstract

Background: Traumatic brain injury (TBI) is a leading cause of death and disability in the United States. Educational interventions may alleviate the burden of TBI for patients and their families. Interactive modalities that involve engagement with the educational material may enhance patient knowledge acquisition when compared to static text-based educational material.

Objective: To determine the effects of educational interventions in the outpatient setting on self-reported patient knowledge, with a focus on iPad-based (Apple, Cupertino, California) interactive modules.

Methods: Patients and family members presenting to a NeuroTrauma clinic at a tertiary care academic medical center completed a presurvey assessing baseline knowledge of TBI or concussion, depending on the diagnosis. Subjects then received either an interactive iBook (Apple) on TBI or concussion, or an informative pamphlet with identical information in text format. Subjects then completed a postsurvey prior to seeing the neurosurgeon.

Results: All subjects (n = 152) significantly improved on self-reported knowledge measures following administration of either an iBook (Apple) or pamphlet (P < .01, 95% confidence interval [CI]). Subjects receiving the iBook (n = 122) performed significantly better on the postsurvey (P < .01, 95% CI), despite equivalent presurvey scores, when compared to those receiving pamphlets (n = 30). Lastly, patients preferred the iBook to pamphlets (P < .01, 95% CI).

Conclusion: Educational interventions in the outpatient NeuroTrauma setting led to significant improvement in self-reported measures of patient and family knowledge. This improved understanding may increase compliance with the neurosurgeon's recommendations and may help reduce the potential anxiety and complications that arise following a TBI.

Keywords: Concussion; Education; Ibook; Neurological surgery; TBI.

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Figures

FIGURE 1.
FIGURE 1.
Screenshots of the A TBI and B concussion iBooks depicting integration of video content, pop-up, and scrolling widgets, as well as interactive image galleries.
FIGURE 2.
FIGURE 2.
Flow chart depicting the diagnostic classification of patients in the study.
FIGURE 3.
FIGURE 3.
A, Significant postsurvey improvement is seen in all subjects receiving an educational intervention with either the iBook (Apple) or pamphlet (P < .01). B, Subjects receiving pamphlets significantly improved on the postsurvey, as did subjects receiving iBooks (P < .01). Despite similar presurvey scores, the iBook group had a significantly higher postsurvey score compared to the pamphlet group (P < .01). C, Patients in both the concussion and TBI groups significantly improved following iBook administration (P < .01). Patients in the concussion group had significantly higher pre- and postsurvey scores when compared to the TBI group (P < .01). D, Patients in both the concussion and TBI groups improved following pamphlet administration (P < .01); however, no significant difference in the pre- or postsurvey scores between the 2 groups is seen. E, Both patients and family members in the TBI group significantly improved following iBook administration (P < .01). TBI patients scored significantly lower in the pre- or postsurvey when compared to family members (P < .01 and P = .01, respectively). F, Both patients and family members in the concussion group significantly improved following iBook administration (P < .01). There was no significant difference in the pre- and postsurvey score between patients and family members.
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References

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