Mind Over Scalpel: Effectiveness of Preoperative Surgical Education.

Abstract

Multimodal preoperative educational interventions, delivered in various formats including written materials, videos, websites, and more, have shown potential in improving postoperative outcomes. Given the evolving landscape of surgical education, the effectiveness of these diverse strategies requires further assessment. This systematic review, meta-analysis and network meta-analysis evaluated multimodal preoperative educational interventions and their impact on surgical outcomes. A systematic review of randomized controlled trials (RCTs) published between 2005 and 2025 were conducted per PRISMA guidelines to evaluate the effect of preoperative educational interventions on surgical outcomes. RCTs were retrieved from MEDLINE, CENTRAL, and EMBASE databases (January 2025). RCTs with >45 adult patients were included. A random-effects meta-analysis was conducted to explore the effectiveness of preoperative educational interventions, and a network meta-analysis was further conducted to evaluate the effect of various intervention modalities. For this review, interventions were categorized as human-contact (e.g., in-person education or interactive educational sessions), written materials (e.g., pamphlets or booklets), digital (e.g., websites, videos, or virtual reality), and hybrid (a combination of human interaction and written or digital components). 40 articles comprising 4,113 patients were included. When analyzed via the pairwise meta-analysis, preoperative educational interventions were associated with improvements in length of stay, analgesic use, postoperative pain, anxiety, quality of life, patient satisfaction and knowledge. When evaluated further using the network meta-analysis, human-contact interventions were associated with reduced length of hospital stay (Mean Difference (MD)=-1.01 days, 95%CI:-1.86,-0.16, p=0.02). Both written materials (standardized mean difference (SMD) SMD=-0.82, 95%CI:-1.08,-0.56, p<0.0001) and hybrid interventions (SMD: -0.61, 95%CI:-1.11,-0.11, p=0.02) reduced postoperative analgesic use. Additionally, digital interventions demonstrated improvements in several subjective outcomes including postoperative pain, satisfaction and knowledge, while improvements in quality-of-life were nearing significance.