Another Challenge to Patient Education: Mesofacts
There are three kinds of facts:
1. The facts that don’t change, such as “we need oxygen to live.”
2. The facts that change all the time, such as the temperature outside.
3. The facts that we tend to think of as unchanging, but which actually change slowly. These slow-changing facts are called mesofacts. For example, the number of people in the world with cell phones is a mesofact.
Meso refers to “middle of the scale.” These facts don’t change quickly enough to get our attention, but they could trip us up if we don’t notice them.
What does this have to do with patient education?
Many things we think of as facts are actually mesofacts. Did you ever hear about mesofacts in school? When you learned about the Periodic Table in chemistry, were you told it was a mesofact, and would change over time as we collected more information? Since 1970 it has grown by 12 elements.
Some other mesofacts include first-aid interventions, therapeutic diets, and medications. A lot of people base their self-care behaviors on things they believe are unchanging facts, but which are actually mesofacts.
My run-in with a mesofact
For example, years ago I was a certified CPR instructor. When I was actively teaching CPR, I totally knew it – the hand placements, the timing, one-man, two-man. After several years I stopped teaching, and just took my renewal CPR class as required. And every time they changed the class just a little bit. They added a barrier for the mouth. They changed the hand placement. They changed the timing. They added a machine that talks to you. I used to be a CPR expert. Now I find it really difficult to replace what I used to think was right with the new way of doing things. Oh, I understand how the research supports these changes. But in my mind, CPR was a fact, not a mesofact.
Implications for patient education
Our educational system tells us tests have right answers, not the right answers at this point in time. We are not primed to expect change. So as we age, we’re somewhat unprepared for the mesofacts that pop up.
When you’re teaching a patient or family member a new self-care skill, and you notice some resistance or hesitation, check to see if there’s a mesofact in the way. What does the learner believe? What does the learner expect? Why is hard for them to accept what you are saying?
This also applies to working with colleagues. Physicians may say the handouts they give to patients have worked for 25 years, and there’s no reason to change them. However, because they haven’t evaluated understanding lately, they are unaware that their patient population has changed. They haven’t heard about the research relating to functional health literacy, and impact of poor health literacy on health outcomes. These physicians just feel the frustration of noncompliance. But in reality, a mesofact is tripping them up.
Can you give any examples of mesofacts you’ve observed in your practice?
Source: www.mesofacts.org
©2010, Fran London, MS, RN
4 Responses to “Another Challenge to Patient Education: Mesofacts”
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Very interesting, Fran! I had never heard of mesofacts before, but you are right that this concept has a direct impact on patient education. A mesofact that I can think of within my practice as a CCU nurse/cardiac rehab nurse many years ago, was the resistance we got from patients and families when we began to accelerate their activity levels from what they may have experienced with family and friends who had heart attacks. Many patients and families were of the minds eye that more rest was better and didn’t understand the changes, based on research.
Sandy Cornett
While I am a librarian and not a nurse, librarians forget about these mesofacts and how much information has changed over time and thus has made much information obsolete. This is why regular weeding is so important. The information that’s even just 5 years or more old is often inaccurate but some think it is perfectly fine and should continue to be on the shelves. I just had a long philosophical discussion with my librarians about mending, and how much shouldn’t be mended, because there were probably more recent books available. Patients often rely on the library for health information and it is our responsibility to see that what we are providing is current.
As a video on demand system vendor in the healthcare space this is a very important issue with educational video. Many times hospitals hold on to videos that are outdated based on hair styles and clothes and in almost every case the educational information in these videos is also outdated and should be updated or tossed.
Good points, Candice and Chuck. Outdated information is all around us.