O2079: Efficacy of Patient Education in Orthopaedic Trauma: A Blinded, Randomized Controlled Trial

Background: Although studies have assessed the quality of online orthopaedic patient education materials, only a few have focused on materials for parents/guardians of pediatric orthopaedic trauma patients. The purpose of this study was to determine the readability, understandability, and actionability of educational materials from the Pediatric Orthopaedic Society of North America (POSNA, OrthoKids), and its efficacy in educating pediatric orthopaedic trauma patients.

Methods: The readability, understandability and actionability of the educational materials was assessed
using the Patient Education materials Assessment Tool (PEMAT). Five reviewers independently scored the educational materials. The efficacy was assessed prospectively by randomizing patients into two groups. The study included pediatric patients with ankle, elbow, femur, or forearm fractures that presented for their initial outpatient visit. The first group (Education) received the OrthoKids educational material related to the patient's fracture. The second group (No Education) did not receive materials. At the first follow-up visit, caregivers in both groups completed surveys. Statistical analyses included descriptive and univariate statistics.

Results: The understandability of all educational materials averaged 72% for all four fracture types. However, the materials had varying actionability scores of 40% for ankle fractures, 60% for elbow fractures, 20% for femoral shaft fractures, and 52% for forearm fractures. In total, 38 patients were randomized to assess the efficacy of educational materials (Education = 15 patients, No Education = 23 patients). There were no significant differences in sex, age, race/ethnicity, and level of education between parents/guardians in both groups (p > 0.05). Though only 9 of the 15 participants in the Education group reported using the materials they received, 13 out of 15 participants reported wanting to receive materials for their child’s fracture. In comparison, only half of the participants in the No Education group reported wanting materials (87% vs 52%, p-value = 0.01). In both groups, over 70% of parents/guardians reported searching the internet for information (p > 0.05). A similar proportion of respondents in both groups reported calling their orthopaedic surgeon’s office since the initial visit (p > 0.05); however, more patients in the No Education group reported calling their pediatrician’s office and this finding reached statistical significance (35% vs. 13%, p = 0.08).

Conclusion: Printed educational materials are not consistently used when provided. Almost half of patients who did not receive written handouts did not want written materials. Providing materials also did not significantly decrease the proportion of parents/guardians who contacted their orthopaedic surgeon or pediatrician’s offices. Over 70% of parents/guardians in both groups surveyed used the internet to access information regarding their child’s fracture. These findings suggest that written educational materials do not significantly decrease the number of additional resources parents/guardians seek for education. Furthermore, the OrthoKids materials can be improved to achieve higher understandability and actionability for patients.