Health literacy, numeracy, and preoperative preparation and communication: A narrative review of evidence and practice

Patients preparing for surgery vary in their ability to understand written and numeric information, which can affect effective preoperative preparation and communication (PPC) and patient understanding. Within preoperative care workflows, the clarity, accuracy, and readability of materials and conversations shape whether instructions are understood and followed. This narrative review examines links among literacy, numeracy, and preoperative preparation and communication; summarizes the state of patient-facing materials; reviews communication and education approaches; integrates equity and social risk considerations; and proposes a practical preoperative preparation and communication framework for everyday use. Promising strategies include structured consent with teach-back, clear visual presentation of risk, concise video explanations, and targeted follow-up through phone or digital tools. In selected contexts, virtual reality, three-dimensional models, and illustrated instructions can be used to support understanding and confidence. Large language models may help simplify language when content is reviewed and approved by clinicians. Treating literacy and numeracy as core safety considerations within standardized preoperative preparation and communication workflows offers a pragmatic path to clearer communication, more reliable preparation, and a more equitable patient experience.