Educating Patients: Creating Teaching Moments in Practice
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Question 2 : What assessments should be done with Mr. Frank before providing education? What other information about him should be considered? Commentary on question 2 : Mr. Frank should be assessed for his level of health literacy, as well as his learning style. He should be asked about his preferred language for learning. At this point, little is known about his personal and social background. Asking questions about his cultural beliefs will provide insight for individualizing teaching. Initial assessment shows Mr. Frank has low health literacy. He is primarily a visual learner and secondarily a tactile learner. He speaks and learns in English, although he was born and raised in Italy. Mr. Frank is a widower whose wife passed away last year from a heart attack. He states he is Catholic but hasn’t attended church for many months. Mr. Frank has a daugh- ter who lives with her family in a different state. He plays golf weekly and considers his main support system to be his friends from his men’s club, whom he socializes with frequently at the golf course. Other than those friends at the golf course, he doesn’t like to go outside his house. He says he doesn’t really like technology but does have a cell phone that he uses for texting. Question 3 : What are possible strategies for effective teaching with Mr. Frank? What is the important information to cover with Mr. Frank? Commentary on question 3 : Individual education with teach-back is one strategy to use with Mr. Frank. He could be asked if he would like one of his friends to participate, as a support for him. Visual aids are important to use with Mr. Frank because he is a visual learner. Written materials can also be used if they are concise, and the important points are empha- sized. Demonstration and return demonstration can also assist, as they are both visual and tactile. Group education may not be effective with Mr. Frank, as he has verbalized discomfort in social situations outside of his norm. Use of technology is not appropriate for him. Mr. Frank should understand that he has type II diabetes and be given an overview of what that is. He needs to know about his metformin—that it is for diabetes, and when and how to take it. He needs to when and how to check his blood glucose. Mr. Frank should know what high and low blood glucose readings are, how to manage his glucose level, and when to see a provider. Healthy eating should also be discussed. Teach-back should include return demonstration. Some examples of teach-back questions are “What can you tell me about diabetes?” “How often will you check your blood sugar?” “Show me how you will check your blood sugar” and “Show me how you will take your metformin.” Another consideration is having Mr. Frank bring any medications, including over the counter, in for a brown bag review
Conclusion There are many considerations when assessing patients prior to providing ed- ucation, including determining health lit- eracy, and learning styles. Teaching may be performed individually or in group set- tings. Teach-back is highly recommended as a strategy for effective patient educa-
tion. Technology can be used with some patient populations to enhance teaching. Language and culture must be consid- ered as they related to knowledge and re- tention. Healthcare professionals should also know how to deescalate behaviors as needed.
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