The effect of stand-alone and additional preoperative video education on patients' knowledge of anaesthesia: A randomised controlled trial

Background: Fully digital preoperative information could save valuable time and resources. However, compared with face to face consultations, equivalent levels of safety, patient satisfaction and participation need to be maintained when using other methods to inform patients. This trial compared knowledge retention between preoperative stand-alone video education and face-to-face education by an anaesthesiologist.

Objectives: To assess if video education, alone or combined with face-to-face education, leads to better knowledge retention more than conventional face-to-face education.

Design: A randomised controlled trial with four arms: Video, Anaesthesiologist, Video & Anaesthesiologist, and Reference for baseline measurements and exploration of a test-enhanced learning effect.

Setting: A Dutch tertiary care centre from February 2022 to February 2023.

Patients: A total of 767 adult patients undergoing preoperative consultation for elective non-cardiothoracic surgery, with 677 included in the complete case analysis.

Interventions: Stand-alone preoperative video education and video education in combination with face-to-face education in the preoperative outpatient clinic.

Main outcome measures: Primary outcome, measured by the Rotterdam Anaesthesia Knowledge Questionnaire, was knowledge retention on day 0. Secondary outcomes included knowledge retention at 14 and 42 days, preoperative anxiety, and the need for additional information using the Amsterdam Preoperative Anxiety and Information Scale. Other outcomes were satisfaction, self-assessed knowledge, and test-enhanced learning effect.

Results: Stand-alone video education led to higher Rotterdam Anaesthesia Knowledge Questionnaire scores than face-to-face education on day 0: median [IQR], 87.5 [81.3 to 93.8] vs. 81.3 [68.8 to 87.5], P < 0.001. Combined education in the "Video & Anaesthesiologist" group led to better knowledge retention compared with both the "Anaesthesiologist" group and the Video group: 93.8 [87.5 to 93.8] vs. 81.3 [68.8 to 87.5], P < 0.001; 93.8 [87.5 to 93.8] vs. 87.5 [81.3 to 93.8], P = 0.01, respectively. No differences in the patients' preoperative anxiety and satisfaction levels were found.

Conclusion: Compared with face-to-face education by an anaesthesiologist, stand-alone video and combined video education improve short-term knowledge retention, without increasing patient anxiety.

Trial registration: ClinicalTrials.gov Identifier: NCT05188547 (https://clinicaltrials.gov/ct2/show/NCT05188547).