Short, procedure-specific thyroid surgery videos improve patient understanding, standardise risk discussions and support informed consent.
Background
Informed consent is an important principle which underpins modern surgical practice. Patients are given information regarding their medical condition, discussion of the proposed treatment, expected benefit, recovery period and risks (both common and remote) and alternative treatment options available, including the option of no treatment.
For consent to be truly informed, clinicians are required to check understanding so patients can decide on treatment in line with their values. With surgical procedures becoming increasingly complex and NHS clinical negligence costs continuing to rise, improving how patients recall and understand potential surgical risks is more important than ever. Educational interventions such as information leaflets are well-established in clinical practice and are known to improve recall ability of surgical risk [1]. In UK ENT clinics, patients are typically given a procedure leaflet on the day of listing surgery – sometimes a hospital-specific resource and/or an ENT UK e-leaflet accessible through the ENT UK website [2].
Why video consent in thyroid surgery?
Video presentation is a natural adjunct to this process. It offers a standardised, on-demand resource that patients can watch (and re-watch) at home, with family and at their own pace. Zhang et al’s 2019 study suggested that patients without post-secondary education benefit most from audiovisual supplementation as there is less dependency on reading comprehension skills [3].
Although infrequently encountered, serious and life-threatening complications such as haematoma, vocal cord palsy with associated voice change, tracheostomy and permanent hypocalcaemia can occur in thyroid surgery. Given the complexities of the relevant anatomy and pathophysiology, it may be challenging for patients to understand these risks during a brief preoperative visit. Since thyroid surgery has specific complications, video-augmented consent offers an opportunity to provide standardised and accessible preoperative information.
The Oxford Regional Thyroid Surgery Group approach
In 2019, the British Association of Endocrine and Thyroid Surgeons (BAETS) produced a consent guideline for both total thyroidectomy and hemithyroidectomy procedures based on a consensus of BAETS surgeons and patients having undergone thyroid surgery [4]. Our regional thyroid surgery group decided to go a step further and produce procedure-specific consent videos that could sit alongside the clinic conversation.
In 2020, we released two short, procedure-specific videos for hemithyroidectomy and total thyroidectomy, hosted on the Royal Berkshire NHS Foundation Trust’s verified YouTube channel. The videos focus on an example patient’s journey, including what they can expect and potential risks/complications. The video does not show the actual operation itself.
Patients are shown or given a ‘business’ card with a QR link to the relevant YouTube video on the day of surgery listing, usually at the end of a verbal in-depth consent discussion with one of consultant thyroid surgeons, senior fellows or specialist registrars. Our patients are encouraged to watch the video soon after their clinic appointment, as well as closer to their scheduled operation. A further telephone clinic appointment is available upon request (patient-initiated). On the day of surgery, patients arrive with clearer expectations of risks and recovery, facilitating more personalised questions (e.g. scar care, return to work, calcium monitoring). These are answered without needing to revisit all of the core information about material risk, ensuring this final face-to-face discussion remains individualised, directly supporting a Montgomery-compliant consent process.
Although originally created to support patients undergoing thyroid surgery within the Thames Valley region, YouTube analytics show that the videos are being accessed well beyond our local catchment. YouTube’s subtitle facility, including auto-translation, further broadens accessibility for viewers whose first language is not English and for those in non-English-speaking countries.
The total thyroidectomy video can be viewed here.
The hemithyroidectomy video can be viewed here.
Video appraisal
We reviewed both videos against BAETS consent guidance, assessed understandability and actionability with the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V), captured YouTube analytics and ran a voluntary online patient/user survey over five years. Our analytics snapshot date was 31 May 2025.
Both videos fully adhered to BAETS standards, clearly presenting procedure risks and postoperative expectations. They had a combined view count exceeding 16,000 and ranked highly in relevant YouTube searches. Among online surveyed patients (n=30), half (50%) were notified of the video via word of mouth from the surgical team, with the rest via text message links, business cards, email or search engines. Of these, 96.5% accessed the videos without issue and 73.1% viewed them soon after being added to the waiting list. Over half (59.3%) watched more than once. The majority (68.9%) felt the videos resolved all questions, and 100% ‘strongly agreed’ or ‘agreed’ it added value to their care. This data suggests that active signposting by clinicians remains crucial for uptake, and the videos served as a consistent anchor during the waiting period. Both videos scored 11/12 for understandability and 3/3 for actionability on the PEMAT-A/V tool, omitting a brief end-summary.
Lessons learnt and practicalities for developing video consent resources
- Keep it procedure-specific: separate videos for hemi- and total thyroidectomy avoided confusion and allowed us to discuss risks proportionately for each operation.
- Use plain English and a logical arc: state the purpose upfront, chunk information into short sections, narrate in the active voice and include clear on-screen text to underscore key points.
- Host on a trusted channel: posting on an NHS-verified account reassures viewers about provenance and improves discoverability within YouTube’s health-source labelling.
- Signpost early and often: handing out custom QR cards/links and adding the website link to clinic letters all drove engagement; the survey data showed that personal recommendation from the surgical teams remains the most powerful nudge.
Conclusion
Our experience with the two procedure-specific thyroid consent videos show that short, well-designed audiovisual resources effectively standardise the delivery of key surgical risks, give patients time and flexibility to process information, and promote more meaningful consent discussions. Their use enhances patient experience and supports safer, more informed decision-making in thyroid surgery. In addition to patient information leaflets, the video-consent approach has the potential to be applied to other common ENT operations such as tonsillectomy, septoplasty etc.
References
1. Chan Y, Irish JC; Wood SJ, et al. Patient education and informed consent in head and neck surgery. Arch Otolaryngol Head Neck Surg 2002;128(11):1269–74.
2. ENT UK. ENT Conditions and Procedures.
https://www.entuk.org/patients/conditions/.
3. Zhang MH, Haq ZU, Braithwaite EM, et al. A randomized, controlled trial of video supplementation on the cataract surgery informed consent process. Graefes Arch Clin Exp Ophthalmol 2019;257(8):1719–28.
4. British Association of Endocrine and Thyroid Surgeons (BAETS). Patient Information Leaflet T3 – Consent for Thyroid Surgery.
https://baets.org.uk/patient-information
-leaflet-t3-consent-for-thyroid-surgery-2/.
[Links last accessed May 2026]
