Electronic informed consent represents an opportunity to redesign the way that participants understand and elect to enroll in clinical research studies. However, electronic consent faces certain barriers common to all informed consent processes and other barriers specific to the technical environment. At Sage Bionetworks, we designed an electronic consent process as a software product and released it as an open source tool. We believe that using contemporary design processes to intentionally create cognitive friction, where potential study participants are confronted with interfaces that require them to slow down and contemplate study concepts, offers a significant opportunity for ethical design as research increasingly uses smartphones and digital methodologies.
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“Cognitive friction” is a phrase coined by Alan Cooper in his 1999 book The Inmates are Running the Asylum: Why High-Tech Products Drive Us Crazy and How to Restore the Sanity (Indianapolis, IN: Sams Publishing, 2004): at 19. In the modern design world, friction is “anything that gets between a user and a task” and is often considered a negative, especially when it's accidental and stops users from their tasks. But friction-on-purpose is a key part of designing a learning curve — and learning curves are at the heart of informed consent design.
