Effective communication is a fundamental step in providing best medical care and recognized as vital component of clinical anesthesia practice [1, 2]. Communication practices in healthcare have been strongly implicated in the outcomes of surgical patients [3]. Caregivers must provide accurate communication of the important findings, and individualized risk stratification at it benefits both the practitioners and the patients [4].

Poor communication hinders accurate preoperative assessment, which can compromise safety during perioperative management. It was indicated as a primary cause for medical errors and associated mortality and mortality [5, 6]. In-contrast, effective communication facilitates better understanding and potentially improves postoperative outcomes [1, 7]. Medical errors one of the leading causes of mortality and communication failures were indicated as one of the root causes [8,9,10]. These failures could occur either in patient-caregiver communication or/and inter-disciplinary communication which are the primary dimensions of communication in clinical practice.

A number of barriers and challenges have been identified for communication in healthcare [1, 5, 11,12,13,14,15,16,17,18]. Therefore; variety of approaches and models of communication have been proposed and implemented to facilitate optimal communication and interactions between patients and health professionals [2, 3, 5, 7, 15, 17, 19,20,21,22,23,24]. However, communication problems have been persisting challenges of clinical practice and multiple barriers has been identified [17, 24]. Hence, scholars urge to provide curriculum-based communication skill training during preservice training of medical programs and many schools have started teaching communication skills. Moreover, training in communication is also now objectively evaluated as a core competency in various accreditation settings in the developed world [17, 25].

The anesthetist usually faces communication challenges that are unique to the circumstances of anesthesia practice. As a key member of the perioperative team, they are expected to develop strong communication and inter-personal skills to enhance interactions with patients and other professionals in the complex inter-disciplinary environment [20, 22, 26]. Communication is not all language. Manners, habits, appearances, and inter-personal skills affect the impression the anesthetist makes on patients. Thus, clear, concise, respectful communication is essential in anesthesia practice [22]. An anesthetist who developed effective inter-personal and communication skills can prevent medical disasters, expensive interventions, and warrant the provision of optimal patient care [10].

Despite the irreplaceable role of communication in healthcare, there is extremely limited research-based evidence regarding patient-caregiver communication in the low- and middle-income parts of the world; particularly, perioperative patient-anesthetist communication (PPAC). Therefore; the objective of this study was to investigate the quality of anesthetist communication with surgical patients in the perioperative setting from patients’ perspectives at University of Gondar Comprehensive Specialized Hospital (UoGCSH), Northwest Ethiopia.

A descriptive cross-sectional study was conducted at University of Gondar Comprehensive Specialized Hospital (UoGCSH) from April 1, – May 30, 2021. The university hospital is the most senior of the four comprehensive specialized hospitals in the Northwest Ethiopia and found in Gondar town. During the data collection time, the hospital had 4 general, 2 obstetric, and 2 gynecologic operation theatres. As documented on the surgical registrations, all operation theatres usually served 20 – 30 surgical patients per day. However, due to COVID-19 pandemic, there was relative decrement in the flow of surgical patients.

All consecutive adult (18 +) patients who underwent surgical operations during the study period were eligible to be included in the study unless they were unwilling to participate, or unable to communicate due to variety of reasons such as head injury and psychiatric illness.

The dependent variable was perioperative patient-anesthetist communication (PPAC) which was measured by using 15-items Communication Assessment Tool (CAT). The tool was developed and declared as a valid and reliable tool to assess patient-physician communication by Makoul et al. It has a 5-points Likert scale which graded each item as Poor [1], Fair [2], Good [3], Very Good [4], and Excellent [5]. The CAT score ranges from 5 to 75 and PPAC was considered as adequate communication when CAT score was greater than or equal to 45 and below 45 was considered as inadequate communication [27].

The independent variables were socioeconomic-demographic factors (sex, age, educational status, occupational status, residency, and marital status), behavioral factors (alcoholism, smoking, and substance abuse), and clinical factors (ASA physical status, preoperative anxiety, previous anesthetic exposure, type, urgency, and grade of the current surgical operation).

Sample size was determined by using single population proportion formula was used at 50% proportion; 95% of confidence interval and 5% margin of error. The calculated sample size was 384; and when 10% of non-response rate was added, the total sample size became 423. All consecutive and eligible surgical patients were included in the study.

Ethical approval was obtained from Ethical Review Committee of Department of Anesthesia, University of Gondar (Reference number: ANST13/02/2021). Informed consent was obtained from each study participants after brief explanation about the study. Confidentiality was ensured by removing identifiers. All methods were performed in accordance with the relevant guidelines and regulations.

Data collection was executed by an anesthetist during postoperative time as the patients were optimally recovered from anesthesia. The collected data were cleaned and analyzed by using SPSS version 20 software (IBM Corporation). Descriptive analysis was performed and presented by using frequency, percentage, mean, median, and ranges. Relationships among variables were presented in cross-tabulations.