What patient education step did they leave out?

I just read this on the Internet. I won’t give the source because my intention is not to criticize them, but to inform you:

“A successful patient education program has three main elements:
– what to communicate
– when to deliver it
– how to deliver it”

What they said is true, but incomplete.

“What to communicate” refers to assessment. You need to find out what the patient already knows, needs to know, and in how much detail.

“When to deliver it” refers to readiness to learn. Taking advantage of teachable moments makes teaching more efficient. If the patient can’t pay attention, your efforts are wasted.

“How to deliver it” refers to individualization of teaching. Teaching is most effective when content is presented in a way appropriate for that learner.

So what critical element did they leave out?

You got it. Evaluation of understanding. You can assess and deliver the right information at the right time, but there still can be a misunderstanding or ineffective communication. You do not know if the patient understood and is able to apply the information to life until you evaluate understanding with teach back.

Your teaching is not complete until the patient understands.

So my message: When you read about the process of patient education, think critically. Don’t assume because content is in print on on the Internet it is true and complete. Too many professionals still think handing a patient a piece of paper or giving a lecture is patient education. But the evidence is very clear and consistent: presenting content is not enough to change behaviors and health outcomes. Interaction and active involvement are needed to transform information into self-care skills. If you want to see optimal improvements in health, there’s no getting around it.

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