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ECONOMICS, EDUCATION, AND POLICY

Clinicians Consistently Exceed a Typical Person’s Short-Term Memory During Preoperative Teaching

Elisabeth H. Sandberg, PhD^*, Ritu Sharma, PhD^*, Richard Wiklund, MD, and Warren S. Sandberg, MD, PhD

From the *Department of Psychology, Suffolk University, Boston, MA; and Department of Anesthesia, Harvard Medical School; and Department of Anesthesia and Critical Care, Massachusetts General Hospital, Boston, Massachusetts.

Address correspondence and reprint requests to Elisabeth H. Sandberg, PhD, Suffolk University, Boston, MA 02114. Address e-mail to elisabeth.sandberg{at}suffolk.edu.

Abstract

INTRODUCTION: Patient education is a critical part of preparation for surgery. Little research on provider-to-patient teaching has been conducted with systematic focus on the quantity of information provided to patients. This is important to assess because short-term memory capacity for information such as preoperative instruction is limited to roughly seven units of content.

METHODS: We studied the information-giving practices of anesthesiologists and nurse practitioners during preoperative teaching by examining transcripts from 26 tape recorded preoperative evaluation appointments. We developed a novel coding system to measure: 1) quantity of information, 2) frequency of medical terminology, 3) number of patient questions, and 4) number of memory reinforcements used during the consultation. Results are reported as mean ± sd.

RESULTS: Anesthesiologists and nurse practitioners vastly exceeded patients’ short-term memory capacity. Nurse practitioners gave significantly more information to patients than did physicians (112 ± 37 vs 49 ± 25 items per interview, P < 0.01). This higher level of information-giving was not influenced by the question-asking behaviors of the patients. Nurse practitioners and physicians used similar numbers of medical terms (4.0 ± 2.4 vs 3.7 ± 2.8 explained terms per interview), and memory-supporting reinforcements (2.3 ± 3.0 vs 1.4 ± 2.0 reinforcements per interview).

DISCUSSION: Given the known limits of short-term memory, clinicians would be well advised to carefully consider their patterns of information-giving and their use of memory-reinforcing strategies for critical information.