title: Systematic review of patient education practices in weight loss surgery.
abstract: BACKGROUND
  Education plays a key role in adherence to lifestyle modifications after weight loss surgery (WLS). Education given before and after surgery may decrease weight recidivism rates and improve outcomes.
  
  
  OBJECTIVE
  The purpose of this systematic review was to analyze educational practices in bariatric centers.
  
  
  METHODS
  The Cumulative Index to Nursing and Allied Health and PubMed databases were searched in May 2016 for English-language, peer-reviewed studies about WLS patient education practices from 1999 to 2016. Publications were: (1) rated with the Advancing Research and Clinical Practice through Close Collaboration levels of evidence hierarchy (see Melnyk's pryamid [http://guides.lib.umich.edu/c.php?g=282802&p=1888246]) and (2) analyzed according to surgical phase, curriculum, program delivery, and educator.
  
  
  RESULTS
  Twenty-four publications met the study criteria. Evidence ratings for preoperative (n = 16) and postoperative studies (n = 8) were levels I to III (n = 5) and IV to VII (n = 17). Two publications were not ratable. Preoperative and postoperative education programs varied in curriculum, teaching methods, and educator. Topics varied in depth. Commonalities were surgical procedure, nutrition, activity, and psychosocial behaviors. Preoperative education was mostly provided in small groups, whereas individual sessions were used postoperatively. Lecture and discussion provided by myriad of healthcare experts from multiple disciplines were typical in both phases. Written or web-based aides supported learning needs in both phases.
  
  
  CONCLUSIONS
  WLS patient education varied by curriculum and dose and commonly used passive learning methods (e.g., traditional lecture style instruction with minimal engagement from learners). Results shared can inform future bariatric education programs and accreditation standard development (e.g., Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program patient education standards). Additional study is needed, but existing evidence can guide improvements in high-quality, cost-effective, and patient-centered educational programs.
authors.affiliation: Department of Nursing and Public Health, Moravian College, Bethlehem, Pennsylvania. Electronic address: grollerk@moravian.edu.
authors.forename: Karen D
authors.initials: KD
authors.lastname: Groller
mesh_terms: D050110:Bariatric Surgery / Q000193:education*; D003479:Curriculum; D000070497:Healthy Lifestyle; D006801:Humans; D009765:Obesity / Q000601:surgery; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D011300:Preoperative Care; D055502:Secondary Prevention / Q000379:methods; D013531:Surgicenters; D013663:Teaching; D017216:Telemedicine; D015431:Weight Loss
keywords: Bariatric surgery; Education; Patient teaching; Weight loss surgery