80 C. MacGregor et al.
underpinning the research. For example, more research participants
understood iPSC pluripotency. The proportion of correct responses rose
from 75% (36) to 94% (47) with the addition of the video animation
to standard consent (p = 0.009), and rose from 75% (36) to 95.9%
(47) with the addition of the interactive exam (p = 0.003).
An increase in the comprehension of several problematic issues,
namely that animals would be used in the research, that their tis-
sue samples would not be injected into humans and that their sam-
ples would not be used in reproductive cloning, all improved greatly
within the video animation and interaction consent procedures. Only
47.9% (23) of the standard consent group were aware that animals
could be used in the research, while this was understood by 92.0%
(46) of the video animation group and 98.0% (48) of the interactive
exam group (both, p < 0.001). Only 58.3% (28) of the standard con-
sent group and 66.0% (33) of the video animation group understood
that their samples would not be injected into humans, while this was
understood by 89.9% (44) of the interactive consent group (p < 0.001,
p = 0.004, respectively). The potential for pharmaceutical compa-
nies to be involved in research was understood by 45.8% (22) of the
standard consent group compared to 88.0% (44) of the video anima-
tion group (p < 0.001) and 100.0% (49) of the interactive consent
group (p < 0.001). The proportion of respondents who understood
that samples would not be involved in reproductive cloning was 70.8%
(34) amongst the standard consent group and 84.0% (42) among the
video animation group. Understanding was greatest among the inter-
active consent group (100%), compared to both the standard consent
(p < 0.001) and the video animation group (p = 0.006).
We would argue that the use of video animation and interactive con-
sent procedures is an effective way to improve research participants
understanding (McCaughey et al. 2016a, b). However, we believe a
major part of the success with the interactive consent procedure was due
to our previous ethics and informed consent study that helped identify
problems in participants understanding of iPSC and what their samples
would be used or not used for. Identifying these issues early on meant
that we were able to design a script for the video that was attentive to
the issues that participants had trouble understanding. Another key