The Influence of Anesthesiologist Gender and Experience on Risk Understanding and Anxiety Changes After Online Preoperative Patient Education: A Sub-Analysis of the iPREDICT Randomized Controlled Trial.

Background/Objectives: Digital health technologies are increasingly integrated into perioperative care to standardize information delivery and improve patient empowerment. However, the overall effectiveness of preoperative education depends not only on digital tools but also on interpersonal factors, such as physician gender and clinical experience, which may shape patients' perceptions and responses to digitally delivered content. Methods: Patients scheduled for elective surgery were included in the iPREDICT randomized trial prior to their preoperative anesthesia assessment. After preoperative anesthetic assessment, the anesthesiologist documented the communication quality and the risks explained. Patients completed a questionnaire to assess their knowledge of anesthesia-related risks and whether the consultation alleviated their fears. Results: A total of 275 included patients were consulted by 94 anesthesiologists, 65% of whom were female. Risk recall was mainly determined by patient-related factors, with online education significantly improving recall over time (β = 1.24, p = 0.034). Anesthesiologists with 1-4 years of clinical experience explained more risks than those with <1 year of professional experience (β = 2.30, p = 0.024). A reduction in post-consultation anxiety was noted when the anesthetist was female (β = 0.21, p = 0.022). Communication was overall rated as good, with higher ratings when anesthetists had more than 10 years of experience (β = 0.09, p = 0.049). Conclusions: Although we have shown with the iPREDICT study (registered in the German CTS; DRKS00032514; on 21 August 2023) that online education improves patients' recall of anesthesia-related risks, the current sub-analysis emphasizes that interpersonal interactions remain essential for alleviating fears and improving the quality of communication. Together, these findings underscore the complementary roles of digital education and face-to-face consultations in optimizing preoperative preparation.