Informed Consent Is a Moment. Comprehension Is a Journey.
Consent happens once. Understanding needs to happen throughout the trial. Here's why the post-signature experience matters more than we think.
The signature is not the finish line.
We've optimized the consent process. eConsent platforms make it trackable. Knowledge checks confirm participants read the key sections. Audit trails satisfy regulators.
But what happens after the signature?
Participants leave enrollment with a stack of paper—or worse, a PDF they'll never open again. They understood enough to say yes. But do they understand enough to stay?
The forgetting curve is real.
Within a week, participants forget most of what they learned at enrollment. The visit schedule blurs together. The medication instructions get filed somewhere. The list of symptoms to report? They remember it exists, but not what was on it.
This isn't a failure of intelligence. It's a failure of design. We front-load information at the moment of highest anxiety and lowest retention, then expect participants to recall it months later.
Comprehension requires ongoing access.
The solution isn't better consent forms—though that helps. It's making trial information accessible throughout the participant's journey.
When questions arise, participants should be able to find answers without calling the site. When a visit approaches, they should be able to review preparation requirements without digging through emails. When a symptom appears, they should be able to check whether it's expected without waiting for a callback.
This is what ongoing comprehension looks like:
Not more reminders. Not gamified engagement. Just the right information, accessible when participants need it, written in language they can understand.
Informed consent is a regulatory requirement. Ongoing comprehension is a retention strategy.