Family physicians build long-term, trusting relationships with patients, providing opportunities to encourage and reinforce changes in health behavior. Patient education is, therefore, an essential component of residency training for family physicians. Patient education is critically important because it is clear that the leading causes of death in the United States i.
There is also strong evidence to suggest that counseling and patient education provide substantial benefits. Providing patients with complete and current information helps create an atmosphere of trust, enhances the doctor-patient relationship and empowers patients to participate in their own health care. Effective patient education also ensures that patients have sufficient information and understanding to make informed decisions regarding their care.
To provide effective patient education, a variety of practical skills must be mastered. These include ascertaining patients' educational needs, identifying barriers to learning, counseling concisely, evaluating and utilizing written, audiovisual and computer-based patient education materials, and incorporating education into routine office visits. Recognize patient education as essential to the discipline of family medicine and as an integral part of each patient encounter.
Recognize that educational interventions are essential in the treatment of disease and in the maintenance of health. Appreciate the importance of assessing a patient's educational needs, readiness to learn and comprehension of information.
Recognize that cultural differences affect health beliefs and that patient education must take these differences into account. Value the power of a trusting, long-term doctor-patient relationship in effecting behavior change. Promote the physician's role in influencing the health status of the community through involvement in community education projects. Principles of patient education Adapt teaching to the patient's level of readiness, past experience, culture and understanding.
Involve patients throughout the learning process by encouraging them to establish their own goals and evaluate their own progress. Provide opportunities for patients to demonstrate their understanding of information and to practice skills.
It represents core areas in which family practice residents should have knowledge of specific educational interventions and to which family practice residents should be exposed during teaching opportunities. Gather information about patient's daily activities, knowledge, health beliefs and level of understanding.
Short-term plans for acute illness Prepare patient for symptoms and effects of condition, examination or treatment. Assess patient's ability to carry out treatment plan; identify barriers and individualize treatment plan accordingly. Long-term strategies for chronic disease Involve patient in setting treatment goals and treatment plan. Assess influence of patient's background, home and work environment on treatment plan and adapt education accordingly. Health promotion Determine patient's health-risk behaviors through interview and health-risk appraisals.
Respond to patient's interest in health promotion with specific suggestions for behavior change e. Enlist assistance of other health care professionals e. Incorporation of patient education in practice Develop patient education handouts and protocols. Evaluate commercial education resources, such as brochures, books, audiotapes, videotapes and Internet materials. Select instructional materials appropriate for patient's readiness to learn and level of understanding. Each family practice residency program should ensure that faculty and preceptors who provide direct patient care include patient education as an integral part of each patient encounter in order to set examples for residents.
Faculty should demonstrate a commitment to patient education by including patient education issues in direct resident teaching and precepting. Questions regarding educational issues should be part of discussions of individual cases during rounds and precepting on an ongoing basis. Each residency is encouraged to form a patient education committee comprising residents, faculty, staff and, if possible, patients and members of the community.
This committee may participate in the patient education curriculum for the residency. The patient education committee may also help to design systems to incorporate patient education activities in a model office practice, so that residents can transfer this knowledge into their own practice situations after graduation.
Each residency is encouraged to maintain an adequate supply of patient education materials of all types, including written, audiovisual and computer-based materials.
These materials should be organized for easy access, with frequently used materials kept in patient examination rooms. Patient education materials should cover the common health problems in the community, as well as frequently requested health promotion topics. The materials should be appropriate for the reading and comprehension levels and the cultural and ethnic diversity of the patient population.
Each residency should maintain a current list of resources available in the community to supplement the patient education provided in the family practice center and should promote resident familiarity with these resources. Patient education should be taught longitudinally throughout all 36 months of family practice residency.
In addition to didactic hours on patient education, opportunities should be made available for residents to attend patient education conferences and to participate in community education projects.
While there are some commonalities between all learners, there are significant differences between adults and children as learners and both have characteristics which set them apart from each other. When providing adult patients and carers with education, it is important to consider and incorporate the principles of adult learning. Malcolm Knowles, a pioneer in the field of adult education, was the first to theorise how adults learn called andragogy , describing adult learning as a process of self-directed inquiry.
The principles of adults learning should always be considered when planning an education session for patients, carers and family members. The following resources may be useful in your clinical practice:. When providing paediatric patients and their families with education, it is important to recognise that a different approach is needed.
The ability of children to understand a diagnosis of cancer and its treatment can be dependant on their developmental level. Family education most often includes adults parents, guardians, family members as well as the young patient. The parent or guardian is always included; however, the child must also be included in the education, which must be directed to the child in an age appropriate manner.
Education sessions must be planned and delivered to meet the individual needs of the patient, carer and family and incorporate the principles of patient and family centred care [26, 32, 33]. Patient centred care: Patient-centred care can be defined as providing care that is respectful of and responsive to individual preferences, cultural traditions, family situations, social circumstances and lifestyle, to support active involvement of both the patient and their family in all health care decisions.
Family centred care: The family is the basic unit of society and when a child becomes ill, the entire family can be affected. Family centred care involves working with the family as a whole unit, to make informed decisions about which services and support the child and family may require.
The strengths and needs of all family members are considered, and information about family dynamics can be invaluable in developing a plan which will be effective for both the child and family. A critical step in providing high quality education is assessing the learning needs, individual learning styles, readiness to learn, and the health literacy of the patient, carer and family. Other factors, for example, learning difficulties or impairments, the needs of non-English-speaking patients, and cultural sensitivities may also need to be considered.
In some instances, there are differences between the views of patients and health professionals about what the patient and family need to know, as the patient may not perceive the importance of certain information.
While acknowledging this difference, it is important to deliver vital information in such a way that the patient is able to understand why it is important. Everyone learns in different ways, and learning styles describe common ways that people learn. Generally speaking, most people have one preferred style however, many can learn using a combination of all styles.
From time to time, patients and families may seem uninterested in learning because they do not know what to ask or do not realise that they will need the information. In some instances, nurses and other health professionals may take it for granted that patients and families have a better understanding of their condition and treatment than they actually do and filter the information [13, 14]. As previously identified, individuals will not learn the information if they see no reason for it.
One of the most important roles of the health care professional is the ability to read patients, carers or family members to determine their readiness to learn specific material, or to perform required tasks. Before determining which teaching strategies and activities are appropriate, it is extremely important to determine the "readiness" of a learner otherwise no matter how important the information is, if the patient is not ready to learn, the information will not be absorbed.
Consideration of timing is important as a patient or family member who is not receptive to information at one time, may be more receptive to the same information at another time. Health literacy is the ability to obtain, understand and use healthcare information to make appropriate health decisions and follow instructions for treatment.
Health literacy is dependent on individual and system factors:. It is important to be aware of health literacy when planning education for patients and families. Some will have greater difficulty than others in understanding complex health information, deciding between treatment options and navigating the health system.
When planning and delivering education it is important to take into consideration how specific learning difficulties or impairments can affect how individuals take in, remember, understand or express information.
A learning difficulty or impairment may include:. For patients, carers and families who were born in a country where the primary language is not English, English may be their second language. It is important that education for these individuals is in their chosen language, either their primary language or English, to aid in their understanding and retention. Culture can be defined as shared practices, beliefs, customs, and values of a particular group, passed down through generations.
Culture provides a sense of belonging and identity, a feeling of cohesiveness, and a sense of connectedness to those who came before and will come after.
It is important that health care professionals recognise that culture may influence how people communicate, understand, and respond to health information and the delivery of education.
Culturally and linguistically diverse CALD is a term used to reflect the differences between cultures and refers to the wide range of cultural groups. The term CALD also acknowledges that groups and individuals differ according to religion and spirituality, racial backgrounds and ethnicity as well as language.
Cultural sensitivity can be broadly defined as an awareness and utilisation of knowledge related to ethnicity, culture, gender, or sexual orientation in explaining and understanding situations and responses of individuals in their environment. Cultural competence refers to how individuals can interact effectively with people of different cultures and socio-economic backgrounds and consists of four components:.
Developing cultural competence results in an ability to understand, communicate with, and effectively interact with people from different cultures.
If you are interested the Learning and Teaching Resources developed by the Department of Education and Early Childhood Development Victoria may provide some useful teaching strategies when working with CALD patients, carers or families. For more information see the Australian Government. National Health and Medical Research Council. Cultural Competency in Health: A guide for policy, partnerships and participation.
Canberra, December A core component of providing education is the ability to communicate effectively with patients. Effective communication assists in understanding the patient, and their wants and needs, as well as building trust, rapport and respect. Where communication is not effective, important information can be missed or misinterpreted leading to conflict and frustration. Where important information is missed, patient safety and patient outcomes can be affected.
Effective communication includes listening skills, as well as verbal and non-verbal communication []. Effective communication skills are essential when providing patient education to patients and family members and can be linked to improved patient satisfaction and compliance with treatment regimens as well as a reduction in patient complaints [32, 33]. Poor communication or inadequate information can cause much distress for patients and their families, who may want considerably more information than has been provided.
Lack of effective communication between specialists and departments can also cause confusion and a loss of confidence amongst the team. Informed consent is a process for getting permission before conducting a healthcare intervention. A health care provider may ask a patient to consent to receive therapy before providing it, or a clinical researcher may ask a research participant before enrolling that person into a clinical trial.
Additionally, patients should always be educated on possible future treatments, so they know what to expect. This will help patients feel more prepared for that treatment and will alleviate concerns or fears that stem from the unknown.
In addition to helping patients understand their conditions and treatments, patient education will teach patients how to avoid certain chronic diseases in the first place. This will help patients remain as healthy as possible and even save money they would otherwise be paying to treat a chronic condition. If a patient knows why they are being prescribed a certain medication or treatment, they will be much more likely to take responsibility for their role in the treatment process.
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