The impact of a Personal Outpatient Worksheet and Educational Reference form on patient engagement and communication in the surgical clinic: multicentre randomized clinical trial
In brief
A five-question clinic worksheet raised surgical patients' recall from 31% to 88%
In a two-hospital randomized trial, patients given the five-question POWER form recalled 88% of their appointment discussion one week later, versus 31% with standard care. The form offers a simple way to improve recall in general surgical clinics, but the trial measured recall rather than whether engagement, decisions, or health outcomes improved.
- Journal
- BJS open (Q1)
- Published
- 4 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Matheesha Herath, Jesse D Ey, Ellie C Treloar, Scarlotte Kulas, Jessie Martin, Harriett McConville, et al.
- PMID
- 42814592
- DOI
- 10.1093/bjsopen/zrag099
Why clinicians should know about it
- Picked for Breast and Endocrine Surgery (top studies of the week, 4 October 2026): Randomized trial, high-quality evidence
Abstract
BACKGROUND: In contemporary medicine, time pressure, limited resourcing, human factors, and health literacy are barriers to delivering high-quality patient-centred care. Improving patient engagement may mitigate these barriers. This study evaluated the impact of the Personal Outpatient Worksheet and Educational Reference (POWER) form on patient engagement in the surgical outpatient setting. METHODS: A multicentre, randomized clinical trial was conducted in two metropolitan hospitals between July 2022 and January 2025. Patients over 16 attending a general surgical outpatient appointment were eligible for inclusion. Participants were randomized into either intervention or control cohorts using a random number generator with 1 : 1 allocation stratified by sex. All participants underwent a surgical outpatient appointment, which was audio-visually recorded. The intervention cohort received a copy of the POWER form, a document with five suggested questions participants could ask during their appointment. The control cohort received standard care without the POWER form. Participants were telephoned one week after their appointment to complete a survey. The primary endpoint was patient recall, assessed by comparing survey responses with the recorded discussion, using an intention to treat analysis. RESULTS: A total of 143 participants were recruited (71 participants to intervention, 72 to control). Ten participants (five in each group) withdrew and were excluded from analysis of the primary endpoint. Mean recall in the intervention cohort was 88% (95% confidence interval 83 to 92) compared with 31% (26 to 35) in the control group (P < 0.001). CONCLUSION: Use of the POWER form in the general surgical outpatient setting significantly improves patient recall. Registration number: ACTRN12625000075482 (https://www.anzctr.org.au/).
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.