Digital Versus Face-to-Face Preoperative Physiotherapy Education in Thoracic Surgery: A Pilot Feasibility Randomised Controlled Trial
Related Experiment Video
Updated: Nov 8, 2026
E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Jessica L Ball1, Emmah Baque2, Ianthe Boden3
1Physiotherapy Department, The Prince Charles Hospital, Brisbane, Qld, Australia; School of Allied Health, Sport and Social Work, Griffith University, Gold Coast, Qld, Australia.
Aim:
This pilot study evaluated the feasibility, acceptability and fidelity of digital video preoperative physiotherapy education compared with face-to-face education for patients undergoing thoracic surgery. It also explored clinical outcomes to inform a future non-inferiority trial of digital education.
Method:
This prospective pilot feasibility randomised controlled trial was conducted at a tertiary centre in Brisbane, Australia. Participants were randomly allocated to receive face-to-face physiotherapy education or watch a 13-minute professionally made digital education video before thoracic surgery. Protocol feasibility was assessed as the percentage of patients receiving allocated education. Acceptability was measured using a pre/postoperative questionnaire and postoperative interviews. Protocol fidelity, defined as recall of receiving education, and treatment fidelity, defined as recall of key information, were assessed during postoperative interviews using a preset 24-point scoring schema. Feasibility measures included recruitment, retention and missing data. Exploratory outcomes included postoperative pulmonary complications, hospital length of stay and efficiency.
Results:
Sixty-four participants were randomised to face-to-face or digital education before thoracic surgery. All received allocated education, demonstrating 100% protocol feasibility. Both education modes were acceptable and perceived to help with information recall (87% vs 81%) and surgical recovery (93% vs 84%), and included the right amount of information (97% vs 84%). Protocol fidelity (83% vs 87%) and treatment fidelity (median 9.5 [interquartile range (IQR) 6-12] vs 9 [IQR 6-15]) were comparable between groups. Study feasibility was confirmed by 100% recruitment and retention and 95% complete datasets. Hospital length of stay and postoperative pulmonary complications were similar. Digital education was more efficient, saving a median of 10 minutes of preoperative physiotherapist time per patient.
Conclusions:
Digital preoperative physiotherapy education for patients undergoing thoracic surgery is feasible, acceptable and efficient, with protocol and treatment fidelity similar to face-to-face education.
