CONTINUING EDUCATION HELPS MEETING THE PATIENTS’ NEEDS

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Published: 29th December 2006
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CONTINUING EDUCATION HELPS MEETING THE PATIENTS’ NEEDS

By

Dr. Muhammad Imran Yousuf
Lecturer,
Division of Continuing Education,
University of Arid Agriculture, Rawalpindi

The ultimate goal of patient educational programs is to achieve long-lasting changes in behavior by providing patients with the knowledge to allow them to make autonomous decisions to take ownership of their care as much as possible and improve their own outcomes. Every educated and dedicated person can plan. Implement, and evaluate an effective and individualized patient education program.

Patient education is the process of providing learning opportunities for patients and their families to increase knowledge of the disease, improve skills in assisting with treatment-related tasks, and aid in the development of coping mechanisms. The goal of modern patient education programs is to achieve long-lasting changes in behaviors by providing patients with appropriate knowledge to allow them to make autonomous decisions that will improve their own outcomes. General goals of patient education can be stated as under;

 Adapt behaviors that maintain health and prevent illness
 Follow treatment programs once illness occurs
 Return to the previous level of health or the maximum level possible
 Minimize complications from illness or disease
 Improve quality of life
 Carry out the basic tasks of living
 Make informed decisions
 Support patient-directed autonomous decision making

Ultimately, education should empower patients to positively affect the prevention, promotion, maintenance, or modification of illness. A study of 372 randomly-selected patients found that higher levels of knowledge and a greater degree of self-management were associated with significant improvements in functioning and well being. The importance of education and teaching as vital components of the patient education process has been recognized now-a-days. This article provides a review of key components of the patient education process.

Assessing Patient Educational Needs

The patient educational process provides a method for individualizing patient care and education for each patient and event. The first step in this process is an assessment: the process of collecting data to identify the needs and problems of an individual patient and family. In the assessment process we collect information, sort and categorize data, and summarize or interpret it. The end product a diagnosis of educational need is a judgment based on sound data and information.

Many healthcare professionals have the misconception that assessment is a prolonged, time-intensive process. However, in many cases we form assessments instinctively on a day-to-day basis. Principles of assessment can be applied by integrating physical symptoms, a brief interview with the patient, and knowledge of the patient’s history and laboratory data to detect a clinical challenge.

A formal assessment of educational needs typically includes analysis of data from a variety of sources. Including the patient‘s history, medical chart and the family. Once educational opportunities have been identified, it is important to prioritize the most vital learning needs that are required to modify behavior and improve outcomes. Theories on adult education consistently state that the adults will devote energy to learn something in proportion to how they perceive it will help them perform tasks or deal with problems that they are currently confronting. As a result, it is vital that any educational topic that is identified is conventionalized in framework that highlights the patient’s needs rather than the interests of the healthcare team.

A guide who knows that a patient is very interested in improving his/her quality of life will be more likely to motivate patient interest if the educational session focuses on how to improve quality of life.

Planning a Patient Educational Session

Successful patient education is dependent on a well-designed plan that includes a clear statement of the goals and objectives of the educational process. Goals are the desired outcomes of learning, while objectives detail the behaviors that will be performed to achieve the goal.

Objectives should be specific, achievable, and measurable. They should begin at a level where the patient can succeed and advance to more complex objectives as the patient becomes more knowledgeable.

Setting goals and objectives ensures that learning interventions will be tailored to the patient’s individual needs. Conversely, when goals and objectives are not stated, the impact of teaching will not be optimized. A common unintended result of the latter approach is that the patient and family are provided with information, but they fail to understand how to use the information in their own environment and circumstances.

The plan should also account for individual patient characteristics that may affect the learning process, such as age, gender, race/ethnicity, culture, religious orientation, socioeconomic status, vision or hearing problems, and language/dialect. The reading level of individual patient is also an important consideration, especially if written materials are being distributed.

Patients will often be reluctant to admit that they have reading problems. A quick and easy general assessment of the reading level can be done in a few minutes. Ideally this test should be completed in private to avoid potential embarrassment for the patient. There are potential obstacles to patient education that should also be acknowledged and accounted for in the plan. Potential patient-related considerations include differences in learning styles, anxiety, physical-discomfort, financial concerns, or an inability to understand the information being presented. The patient’s emotional state should also be assessed as an indicator of the patient’s readiness to learn. It is important to remain flexible and willing to adapt to individual patient characteristics and situations.

Implementing the plan

In view of the importance of the patient education and the many factors that may hinder the teaching-learning process, it is important to use the most effective teaching strategies possible. The keys to successful patient focused education are to keep it simple and make it understandable, while at the same time drawing the learner into the process. The intended outcome of the education is to empower patient to advocate for themselves by becoming active participants. If education is successful, the patient will be able to use the new knowledge and skills to help maximize comfort and quality of the life.

Choose an Appropriate Teaching Method

Education can be delivered in many ways: Choose the method that is appropriate for the content and for the learning style of the patient and family. Foe example Individual Instruction may be ideal for continued assessment and technical skill training. Group Instruction may encourage peer-influenced learning. Small group of two to five people offer some of the advantages of individual learning. Medium and larger sized groups are usually unacceptable for skill training but can be appropriate for lectures and videos. Self-directed and self-study programs may be useful to teach cognitive and psychomotor objectives. Whenever possible, use a variety of media that will appeal to be the patient’s learning style e.g., lecture, still pictures, motion pictures, television, audio recordings, text).

Set Realistic Objectives

Limit educational objectives to no more than four of the most important items. If additional objectives are necessary, schedule separate session. Objectives should be clear and meaningful to the individual.

Limit Education to Short Teaching Sessions

Short educational sessions (fifteen minutes or less) are proffered and should include breaks, repetition of important information, and ongoing assessments of knowledge as determined by questions and patient demonstration.


To Change Health Behaviors, Focus on Behaviors and Skills

It is needed to focus on action items for the patient and changing behavior that will lead to positive outcomes for patients. Patients may not need to know all the facts and principles that apply to the behavior; positive outcomes may be sufficient to cause behavioral changes. Similarly, a well-designed educational program can help to empower patients by involving them in the process of improving their own outcomes.

Present Context First

The context is what the patient already knows; everyone learns better with a foundation for new knowledge. It is important to move from basic to more complex information to give the patient a positive sense of understanding and accomplishment. Consider that the patient is familiar with- for example, start with discussion of the importance of having energy to perform daily tasks and how the body needs oxygen to supply that energy before talking about topics that the patient may find unfamiliar.

Partition Complex Information

Divide instructions into small, logical pieces. Health-related information can be overwhelming, and patients often are bombarded with information at a time when their ability to comprehend and retain it is impaired. As a result, a number of short educational sessions can often be much more effective than one lengthy session.

Make Learning Interactive

Interactive learning greatly increases interest and recall. Clinical studies have shown that interaction causes a protein change in the brain that stimulates information retention and long term memory. Encouraging interaction will assist experience. Also, whenever possible, consider including a family member and/or caregiver in the educational session.

Capitalize on Educational Opportunities When Patients Are Ready to Learn

Patient’s readiness to learn can be affected by how sick they feel or their ability to accept information at a given time. Similarly, the patient’s emotional or physical state may also interfere with the educational process. Anxiety, physical discomfort, financial concerns, or an inability to understand the information being presented may make the learning experience unpleasant and ineffective. In contrast, a patient who just experienced a decrease in quality of life may be very receptive to information on what can be done to help improve outcomes. These guidelines offer a framework for the design of health instruction in any medium and for any audience.

Evaluating and Continuing the Educational Process

Then continually assess whether behavioral objectives are being achieved. The evaluation process should include
a) measurement of the extent to which the patient has met the learning objectives,
b) indication of any need to clarify, correct, or review information,
c) notation of objectives that are not clear
d) documentation of shortcomings in the process, (specially in content, format, activities, and media), and
e) identification of barriers that have prevented learning from occurring.

If the evaluation reveals that a desired behavioral change has occurred, then the behavior should be reinforced with ongoing educational reminders. When providing reinforcement, remember that educational interludes need not be formally scheduled to be effective. It is also important to document teaching and the patient response to record so that other staff members can follow through on teaching topics.

Conclusion

Education provides patients with a knowledge base that empowers active participation in decisions about their own care and outcomes. To achieve desired outcomes, educational goals must be geared to the needs of the patient, with an educational plan that accounts for the learning style of the patient and potential barriers to the educational process. By continually educating patients about topics that important to them, can help patients improve outcomes, build positive attitudes regarding their treatment, and be more independent.

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