Providing patients with the tools to increase their health literacy is a vital part of optimising treatment outcomes. It is recognised as the most ethical and effective way to build informed consent. However, headlines increasingly warn that patients’ ability to engage with, or to absorb information is compromised by the ubiquitous use of digital technologies in daily life.
Attention span averages are not as dire as some would have us believe – there is no reliable evidence to support the oft-published claim that the average person now has an eight-second attention-span, for example. However, there is no doubt that the compulsive use of digital media, and repeated exposure to distractions is strongly linked to an impaired ability to concentrate. Clinicians should be cautious about assuming patients are able to engage with large amounts of information, or commit it to memory.
Sustained attention
Sustained attention (SA) is a complex field of study focusing on the ability to maintain attention while performing a mundane task. Simple answers to the question of what modern patients can absorb – and how information is best shared during consultations in the digital age – are hard to come by.
In studies on attention-span, the consensus seems to be that most neurotypical people have variable capacities at various points in their lives for remembering or engaging with information. The ability to commit information to memory and to sustain attentiveness largely depends on levels of interest as well as age.
Task-complexity has been shown to have an influence on SA, with more stimulating tasks predictably prompting more sustained and stable interest from participants.
Sustained attention between tasks, age groups and neurotype are very variable – in one single study of 262 individuals, average stable states of attention while completing a monotonous task ranged between 30 and 76 seconds. However, the overall range was very wide – between nine seconds (the lowest result among children in the study) and 190 seconds (the highest result, from a participating young adult). Broadly, children had the lowest average attention spans, and young adults the highest.
The concerns – where patients’ concentration might be impaired
In some studies, addictive behaviour around digital technology – predominantly gaming and social media – is linked to symptoms closely resembling those associated with attention deficit hyperactivity disorder (ADHD), although there is no causal link to the condition, and the long-term effects are not clear.
Other studies have considered the risks of “shallow information processing” in people overly relying on their digital devices. The availability of instant information on smartphones might be responsible for cognitive shortcuts that impair knowledge-construction in the brain. The phenomenon, known as digital amnesia, refers to a decline in memory capacity due to an over-reliance on digital devices for storing and retrieving information. Patients suffering from this condition might struggle to engage deeply with information, and may have less developed critical thinking skills.
Used positively, the digital environment can enhance cognitive abilities. A number of apps, websites and games have been shown to stimulate visual attention and reaction time, as well as enhancing learning and thinking skills. One study, using magnetic resonance imaging (MRI) to track brain activity during internet searches, suggests that simply using search engines can be a form of mental exercise that can strengthen neural circuits, improving cognitive function.
Digital-era patient engagement
To ensure patients are truly engaged with information, and are genuinely able to consent to treatment, effective education resources are a must. Educators are advised to combine auditory, visual and hands-on learning to ensure patients with different processing preferences are fully engaged and able to access the information. For patients with an impaired ability to pay attention, it is advised that information is well-organised, visual and clear, and repeated as many times as needed.
However, clinicians often find that time is limited in consultations, and that they lack the opportunity to provide bespoke learning material for patients. In a 2022 survey, 84.4 per cent of healthcare providers believed that electronic methods made patient education faster and more efficient. Enhanced digital engagement tools have been welcomed, and continue to evolve. For example, Kiroku produces notes 60 per cent faster, allowing clinicians to spend more time engaging with patients, as well as significantly reducing their own screen time. And at the touch of a button, Kiroku provides easy-to-understand information, which can be sent directly to patients, along with consultation summaries and digital consent forms, ensuring real understanding at the same time as protecting clinicians.
There may well be cause for concern in terms of capturing the attention of some patients in a world full of distractions. However, used correctly, digital tools can do much to enhance learning and inspire patients. Effective tools can also save much-needed time, allowing clinicians to spend less time on screens, and more time building real connections with patients.