Preoperative Quiz for Improved Patient Education and Communication in Elective Orthopedic Spine Surgery.

Roos, Andrew; Schmidt, James; Hu, Rebecca; Nasr, Cyrus; Polemidiotis, Mark; Katsuura, Yoshihiro · Clin Spine Surg · 2025

retrospective_cohort · Level III

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Abstract

Retrospective Review. We describe and analyze the novel use of a preoperative quiz to help assess patient comprehension in orthopedic spine surgery. Counseling a patient about surgery can present difficulties depending on factors such as educational or socioeconomic background. Despite time-consuming preoperative educational efforts from physicians and nurses, patients often do not fully comprehend what surgery entails, including the risks versus benefits of surgery. In turn, surgeons frequently overestimate a patient's understanding of procedures. As such, new and efficient techniques for evaluating​​ patient comprehension are necessary. A retrospective review of 120 consecutive quizzes given preoperatively to orthopedic spine surgery patients over a year was conducted. All errors were recorded and an analysis of the error rate for each question was performed. Areas of poor patient comprehension were identified. The overall error rate for the quiz was low, at 2.32%. Incorrect responses highlighted areas where patient education needed improvement, such as in expectations of postoperative pain management (5.83% error rate), the impact of mental health on surgery (5.83%), and proper blood thinner management (2.50%). Quizzes indicated that patient understanding of surgical procedures is generally high in an orthopaedic spine surgery context. Preoperative quizzes present an excellent opportunity to verify patient understanding, provide education, and ensure that patient and surgeon expectations are in alignment. Due to their ease of use and modifiability, they are an underutilized tool that can be applied in almost any surgical setting.