Advantages of audiotapes

Several studies found that audiotape recordings used to educate patients have several advantages. Some conclusions were that:

• patients can share the information on an audiotape with family members, to decrease misunderstandings and forgotten details and increase family communication (Ah-Fat, Bruera, Butt, Davison 1997, Deutsch, Hogbin 1989, 1992, Krackow, McHugh, Nathan, Ong, Reynolds, Rylance, Tattersall 1994);
• recorded information is easily accessed by patients (Hagopian);
• audiotapes can potentially decrease consultation time and phone calls from patients (Nathan) as well as reduce overall health care costs (McClement);
• patients can review recorded consultations before a follow-up (Krackow);
• recording an audiotape is relatively inexpensive (Deutsch, North, Rylance, Treacy); and
• the spoken word has a greater power to hold attention than the printed word (Oakley).

Limitations of audiotapes

While most studies indicated that audiotapes were advantageous, some limitations were found.

For patients, these include that:

• the information on the audiotapes was too general and not personalized enough (Hogbin 1989); and
• they need a tape recorder, although not many people actually found it to be a problem (Butt).

For physicians, the limitations include that:

• taping a consultation may inhibit open discussion (Tattersall 2002);
• recording a consultation may expose physicians to malpractice lawsuits (Krackow, Nathan); and
• recording a consultation may compromise physician recommendations (Krackow).

Looking ahead

Patients and their families found tape-recorded medical consultations and information valuable, and positive results were identified in patients’ behavioural change and self-care. However, there were no clear trends in reducing patient anxiety levels or increasing their knowledge and recall of information through the use of audiotapes.

This review showed that there is limited literature on the use of audiotapes with patients who have specific barriers to communication. None of the studies analyzed the effects of recorded information on any specific “hard-to-reach” patient subgroup. Therefore, the hypothesis that these patients can more easily gain knowledge from information recorded on an audiotape still needs to be empirically tested. Future studies could examine assumptions such as audiotapes allow patients to hear the information as many times as needed, or elderly patients with limited memory can reduce confusion by listening to a cassette or giving it to family members.

The population that has often been characterized as “hard-to-reach” by health care professionals in fact includes several subgroups or minorities, e.g. low-literate, visually impaired, second-language speakers, cognitively impaired, and more. If all these subgroups are considered as a whole, they comprise a large percentage of the population. They should not be marginalized by health care practices related to receiving necessary information or being participants in research studies.

When it comes to health, even highly educated individuals struggle with medical terminology when they confront a complicated illness or a novel hospital procedure. This synthesis concludes that if the average person is compromised in the context of information exchange, populations with communication barriers are at even greater risk. More research is needed to explore the value of using tape-recorded consultations and medical information with at-risk populations.

Key Findings

• Medical research has not explicitly considered the impact of recorded medical information or consultations on people with limited literacy or other barriers to communication.
• Patients and their families who were studied found recorded medical consultations and information valuable.
• Patients who were studied experienced positive results in behavioural change and self-care when they were given recordings of their consultations or information on their procedures.
• The literature is inconclusive about the impact of audiotapes on reducing patient anxiety or increasing their knowledge and/or recall of information.
• More research needs to be done to study the impact of recorded medical information and/or consultations on patients in at-risk populations.