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Preoperative education is a common feature of the preoperative preparation for many surgical procedures. It is anticipated that this education will result in beneficial outcomes for the patient. Many studies have evaluated the effectiveness of different formats used to deliver the information, and the effect of this information on a variety of outcomes.While there has been substantial research and several meta-analyses undertaken on different aspects of preoperative education, there has been no previous attempt to summarise this body of research to evaluate its impact on knowledge and understanding of patients.The objective of this review was to present the best available evidence related to knowledge retention and/or correct performance of postoperative activities after preoperative patient education.This review considered all studies that included adults in a hospital setting, either as inpatients or same day surgical patients, and who received some form of information and/or instruction before an operative procedure. Interventions were the methods of preoperative patient education, instruction or teaching, and included evaluations of the effectiveness of different presentations such as:in either group or individual formats, at either pre-admission or post-admission.The primary outcomes were those associated with the understanding of the information related to the operative or postoperative period that were provided in the intervention and included:This review considered randomised controlled trials that evaluated forms of preoperative patient education and their effect on patient understanding, knowledge and ability to perform postoperative activities.The findings of this review support the use of pamphlets to inform patients and to improve their skills.The role of videos as a preoperative instruction tool has not been rigorously evaluated. However, existing studies support the use of preoperative videos to improve patient knowledge and skill.The data suggest that the instructional method, the act of educating a patient by delivering directions for actions or behaviour is useful for improving patients’ knowledge of their treatment and their ability to perform and comply with required exercises. However, instruction is likely to be more effective if provided before admission. If teaching is to be done after admission, using a group format has been shown to be equally as effective as individual instruction.Although numerous studies have been performed on many aspects of preoperative education, little high-quality research has assessed the effectiveness of this information on patient knowledge and ability to perform specific skills such as exercises. Further research is required to examine: (i) the effectiveness of pamphlets and other written material for people with English as a second language or limited literary skills; (ii) the accuracy of information provided in preoperative pamphlets; (iii) the effectiveness of pamphlets on general populations; (iv) the role of videos and learning packages; (v) the effectiveness of preoperative instruction; and (vi) the changes in patient misconceptions with the provision of preoperative information.