Research highlights benefits of surgery schools

Group classes can help patients prepare well for surgery and recover quicker, new research shows.

The analysis shows that this preparation can lead to shorter hospital stays and quicker recovery times.

The study team are now recommending more research in the area.

Imogen Fecher-Jones, a Perioperative Advanced Clinical Practitioner at University Hospital Southampton (UHS), led the study. It is the most comprehensive review of surgery schools to date.

Findings have been published in BJA Open.

Preparing for surgery

Patients who increase their physical activity through exercise, eat healthily and manage their emotional well-being before surgery have been shown to have better outcomes.

This is where surgery schools come in. They teach patients how to physically and emotionally prepare for surgery, and how to recover effectively.

At UHS, surgery school is delivered as the ‘universal’ element of our Prehabilitation Service. It is a one-off interactive video conference call that lasts about an hour and a half. Around ten patients attend each session. Family and friends are also encouraged to attend.

The session helps patients prepare for their operation by making changes to their lifestyle. It covers nutrition, emotional well-being, exercise, and what to expect from their hospital visit.

At the end of the session, patients set goals based on what they’ve learnt.

Improving patients’ recovery

The researchers analysed data from 27 studies that took place between 1976 and 2022, involving almost 6,000 people. They looked at the patient outcomes each study reported.

They found that surgery schools are associated with a shorter length of hospital stay and may reduce the risk of complications.

The analysis also showed reductions in perception of pain and anxiety.

Attending surgery school did not, however, increase patient satisfaction with surgery and hospital stay. The researchers say more research is needed to understand why.

Imogen Fecher-Jones is part of the NIHR Southampton Biomedical Research Centre. She is also undertaking a doctoral clinical academic fellowship supported by the Southampton Academy of Research. She said:

‘We know from our own service evaluation that people find surgery school useful. Many of our patients report making lifestyle changes.

“However, this is the first time an international review of this type has been undertaken. We can now say that surgery schools may actually improve clinical outcomes.

“We need to understand more about how this works, but one of the likely mechanisms is that patients are making the lifestyle changes suggested at surgery school, improving their health and therefore their recovery following surgery.”

Currently there is no standardised curriculum as to what should be taught at surgery schools.

Imogen’s doctoral research is aiming to establish consensus and best practice on what should be taught. As a result of this work, she is currently working as a clinical advisor to NHS England advising on patient preoperative education programmes.