Eur J Plast Surg (2003) 26:280–284
Abstract In plastic surgery patient education is impor-
tant but time consuming. It can be performed face-to-
face or it can be computer based. In order to examine the
merits of computer-based patient education, a research of
the literature was carried out. The results of this search
show that computer-based education is of great potential
benefit. Especially in retaining information, informed
consent and time management in the medical practice.
Keywords Patient education · Computer-based patient
In 1998 Van Den Borne defined patient education: a sys-
tematic learning experience in which a combination of
methods is generally used, such as the provision of infor-
mation and advice and behaviour modification tech-
niques, which influence the way the patient experiences
his illness and/or his knowledge and health behaviour,
aimed at improving or maintaining health or learning to
cope with a condition, usually a chronic one. Patient
education may also involve influencing emotions and at-
titudes and is often aimed at altering behaviour. Patient
education is therefore more than merely the provision of
information to the patient .
Patient education is one of the most time consuming
and repetitive aspects in the provision of health care ser-
vices, not only in plastic surgery. It is also one of the
most important tasks of the physician . Up to 25% of
office time in a general practice is spent on patient infor-
mation, instruction and counselling .
In 1984 Waitzkin found that doctors tend to underesti-
mate patients’ desire for information . Other studies
have shown that patients desire more information about
health care and information concerning their conditions,
treatment and prognosis [5, 6, 7, 8, 11, 24, 33]. When the
quality of information a patient receives improves, aware-
ness and knowledge of treatment goals, and compliance
with treatment objectives improve, patients take a more
active role in medical decision-making [14, 18, 40, 43].
Well-informed patients are more likely to become active
partners in the management of their own health [4, 14].
This ultimately creates a higher level of patient satisfac-
tion and an improved outlook on life [41, 43].
Patient education is an effective therapeutic tool. It
has been shown to improve health outcomes, measured
in terms of reduced medication needs, reduced duration
of treatment and hospital stays, improvement in risk re-
ducing behaviour [19, 26, 27, 30], and reduction of risk
factors (for example high blood pressure and cholesterol
levels) [17, 20, 27, 36]. Eventually it reduces morbidity
and mortality [17, 20, 25, 27, 36]. Vickery et al. 
found that self-care educational intervention can de-
crease (by 17–35%) the number of medical visits and
minor illnesses, and decrease medical care costs.
Lack of time and compensation for educating patients
about preventive health practices has been found by
Skinner to deter breadth of individual information .
Patient surveys have identified considerable dissatisfac-
tion with doctors’ lack of attention to patient education
. Also doctors themselves often voice doubt about
their success in patient education. They are pessimistic
about their ability to change patients’ lifestyle, and lack
confidence in their own treatment strategies [39, 42]. It
is proven that they overutilise ineffective education strat-
egies, and underutilise potentially more effective behav-
ioural or psychological treatments .
Patient education is very important as patients tend to
ask for more information. A physician is compelled to
The Isala Klinieken supported this research project with a grant
for medical care
An invited commentary to this paper is available at http://dx.doi.org/
B. J. Keulers (
) · P. H. M. Spauwen
University Medical Centre,
Nijmegen, The Netherlands
B. J. Keulers · P. H. M. Spauwen
Can face-to-face patient education be replaced
by computer-based patient education?
Received: 20 February 2003 / Accepted: 16 June 2003 / Published online: 19 September 2003
© Springer-Verlag 2003