Abstract: Objective: Previous research in primary care has shown that physicians are more informative and/or patient-centered when they interact with high participation patients (e.g., those who ask questions, express preferences and concerns). This study contributes to this literature by examining parents’ participation and physicians’ discourse in a pediatric surgery context.Methods: The audiotapes of 7 pediatric surgeons and 68 of their patients’ parents/guardians were coded and examined for physicians’ information exchange and support utterances as they interacted with parents/guardians with varying degrees of participation.Results: The results of a multilevel regression analysis showed, consistent with related research, that the same physicians were more informative overall and provided more information in response to parents’ questions when interacting with high participation parents. However, participation was not associated with physicians’ volunteered information, general explanations, or support utterances.Discussion and conclusion: The results are discussed with respect to the impact of participation on physicians’ information provision and implications for future research, particularly with respect to general explanations, volunteered information, and medical context.Practice implications: This study suggests that surgeons may provide more detailed information to patients who are active participants in the preoperative interview, thereby improving the adequacy and validity of informed consent for surgical procedures.