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Introduction: Proper informed consent allows patients to take an active role in their own treatment decisions and may improve treatment outcomes due to enhanced compliance. The objective was to determine if handwritten rehearsal of core and custom consent items would increase short-term recall and comprehension. Methods: Ninety patient-parent pairs were randomly assigned to two groups. After case presentation, each subject was provided 10 minutes to read a modified informed consent document. Group A received visual printouts containing the four core elements (root resorption, decalcification, pain, and relapse/retention) likely to be encountered by all patients and up to four custom elements (e.g. impacted teeth, orthognathic surgery or other case specific treatment issues). Subjects identified and wrote what the image depicted and how it could affect treatment. Group B viewed a PowerPoint presentation on all 18 elements arranged from general to specific. All participants were interviewed, and each provided their socio-demographic data, as well as completed their literacy, health literacy, and state anxiety questionnaires. The groups were compared for recall and comprehension through an ANOVA. Results: Item scoring intra-rater reliability was excellent. Subject reliability ranged from fair to substantial. There were no significant differences between Groups A and B for socio-demographic variables, except Group A had a larger proportion of subjects classifying themselves as white. The rehearsal intervention iii significantly improved recall and comprehension of the core elements (p=0.001) and improved both for the custom elements, but not significantly. For questions regarding the traditional domains of responsibility, risks, and treatment, Group B performed significantly better on treatment questions (p=0.001). Overall as anxiety increased, correct responses decreased. Conclusions: The rehearsal group improved recall and comprehension of the core and custom elements of informed consent, and as such, rehearsal and may be a more efficient method than an audiovisual presentation to provide informed consent. iv Dedicated to my family v Acknowledgments I would like Dr. Fields for all of the time and effort he gave me to develop and complete this project. I've learned a great deal of how much thought and consideration must be made in order to produce a quality research study from him. It's been wonderful to have you as a mentor and friend. Also, thank you to Dr. Johnston, Dr. Firestone, and Dr. Robinson for being on my thesis committee and contributing their ideas and knowledge in each of their personal expertise. I am also appreciative for David Heinlein's contribution and legal expertise. Sue Staples deserves a special thank you for being my research assistant, without whom, this project would not be possible. The commitment and time spent interviewing, recruiting subjects, and transcribing allowed me to see my patients in clinic! Thank you to my fellow residents for their support and comradery in completing this pro...

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