AI-Generated Avatar Videos for Postoperative Patient Education Among Health Care Workers: Pilot Randomized Controlled Trial

Background: Effective postoperative communication is vital for patient recovery, yet traditional text-based discharge instructions often lead to poor comprehension and adherence, particularly among patients with limited health literacy. Although educational videos improve understanding and retention, their widespread use has been hampered by high production costs. Generative artificial intelligence (AI) offers a scalable solution for creating engaging video content. Objective: The primary objective of this pilot study was to assess the feasibility of creating and deploying AI-generated, avatar-led videos for postoperative instruction delivery. Secondary objectives included comparing knowledge retention, engagement, perceived clarity, and user experience between AI-generated video and traditional text-based handout formats among health care workers. Methods: In this randomized pilot study, 38 health care worker volunteers were recruited as a convenience sample to pilot-test the intervention before patient implementation. Participants were assigned to either a text handout group (n=19, 50%) or an AI-generated video group (n=19, 50%). Both groups received information on 10 common postoperative topics. The primary outcome was objective knowledge, assessed via a 10-item quiz. Secondary outcomes, measured through surveys with 5-point Likert scales, included engagement time, subjective engagement, perceived clarity, usefulness, confidence in understanding, and information retention. Qualitative feedback was also collected. Results: Objective knowledge quiz scores did not differ significantly between groups (mean 8.89, SD 1.20 for the AI-generated video group vs mean 8.21, SD 1.78 for the text handout group; P=.17; Cohen d=0.45). Participants in the AI-generated video group demonstrated significantly higher engagement time (mean 15.11, SD 7.78 minutes vs mean 8.84, SD 4.03 minutes; P=.004; Cohen d=1.04). They also rated instructions as significantly clearer (mean 4.63, SD 0.50 vs mean 4.00, SD 0.82; P=.007; Cohen d=0.93), more engaging (mean 4.05, SD 0.78 vs mean 3.32, SD 1.00; P=.02; Cohen d=0.81), and more effective for retention (mean 4.42, SD 0.84 vs mean 3.37, SD 0.68; P<.001; Cohen d=1.38). Qualitative feedback highlighted the engaging nature of AI-generated videos but noted areas for avatar refinement. Conclusions: In this pilot study with health care workers, AI-generated avatar videos did not improve objective knowledge scores but significantly enhanced engagement, perceived retention and perceived clarity (Cohen d=0.81-1.38). Future studies in actual patient populations with diverse health literacy levels are needed to determine whether these engagement advantages translate into improved knowledge outcomes.