Developmental levels are described in relation to age groups. However, some patients may be at a developmental level that is dif- Case study: Mrs. Thomas Mrs. Thomas is a 67-year-old woman who was admitted to a re- habilitation facility following an acute care stay for an ischemic stroke. She has right-sided deficits and aphasia because of her stroke, as well as a medical history of hypertension, asthma, and type II diabetes. Mrs. Thomas is a pleasant retired high school- teacher who immigrated to the U.S. from the Philippines when she was a teenager. She wears glasses and has a hearing aid in her left ear. Her husband and son arrived at the facility immediately after she was admitted. ● After reviewing her history, and in preparation for communicating and possible teaching, what assumptions can be made about Mrs. Thomas regarding her health literacy? Discussion : No assumptions can be made about Mrs. Thomas; preconceived notions may create a bias that results in ineffective teaching and communication. An assessment of health literacy Conclusion Multiple considerations affect communication between healthcare professionals and patients, and these considerations also influ - ence effective teaching and learning. Assumptions should never be made about patients, and assessments should be done prior Resources Health literacy and patient safety: Help patients understand. American for Healthcare Research and Quality (AHRQ). (2020). Health literacy: Hidden barriers and practical strategies. https://www.ahrq.gov/health-literacy/improve/precautions/1stedition/ tool3.html • Bass, B., & Nagy, H. (2022). Cultural competence in the care of LGBTQ patients. StatPearls [Internet]. StatPearls Publishing. • Bastable, S. (2021). Nurse as educator: Principles of teaching and learning for nursing practice (6th ed.). Jones & Bartlett Learning. • Centers for Disease Control and Prevention (CDC). (2018). A health literacy report: Analysis of 2016 BRFSS health literacy data. https://www.cdc.gov/healthliteracy/pdf/Report-on- 2016-BRFSS-Health-Literacy-Data-For-Web.pdf • Centers for Disease Control and Prevention (CDC). (2022a). Understanding literacy & numeracy. https://www.cdc.gov/healthliteracy/learn/UnderstandingLiteracy.html • Centers for Disease Control and Prevention (CDC). (2022b). What is health literacy? https:// www.cdc.gov/healthliteracy/learn/index.html • Davis, T., DeWalt, D., Hink, A., Hawk, V., Brega, A., & Mabachi, N. (2020). Health literacy: Hidden barriers and practical strategies. https://www.ahrq.gov/professionals/quality- patient-safety/quality-resources/tools/literacy-toolkit/tool3a/index.html • Guttman, O., Lazzara, E., Keebler, J., Webster, K., Gisick, L. & Baker, A. (2021). Dissecting communication barriers in healthcare: A path to enhancing communication resiliency, reliability, and patient safety. Journal of Patient Safety, 17 (8), e1465-e1471. • Hickey, K. T., Masterson Creber, R. M., Reading, M., Sciacca, R. R., Riga, T. C., Frulla, A. P., & Casida, J. M. (2018). Low health literacy: Implications for managing cardiac patients in practice. Nurse Practice, 43 (8), 49-55. References •
ferent than their chronological age. Modifications of teaching may be needed based on those developmental levels (Maryniak, 2019).
should be done immediately. As a high school teacher, she may have high literacy and numeracy, but her level of health literacy is unknown. ● What potential barriers to communication and readiness to learn are there for Mrs. Thomas? Discussion : One consideration is that this is a new environment for Mrs. Thomas, which may affect communication. There are physical concerns that may be barriers, such as the effects of her stroke, as well as visual and hearing impairment. There may also be cognitive effects from Mrs. Thomas’s stroke. Language may be a barrier, so it is important to ensure information is presented in her preferred language. The healthcare professional will also need to adapt to her cultural needs. Asking about her culture and how much she would like her family involved is also needed. Her learn- ing style should also be addressed.
to providing education. Strategies should be formulated based on these evaluations to address any barriers and provide patients opportunities to gain and retain the knowledge that they need.
Medical Association video of actual patients with various levels of health literacy. https://www.youtube.com/watch?v=cGtTZ_vxjyA
• Maryniak, K. (2019). Professional nursing practice in the United States: An overview for international nurses, and those along the continuum from new graduates to experienced nurses. Author. • Pacific University Oregon. (2022). Health literacy for interprofessional education (IPE) etoolkit. https://pacificu.libguides.com/HLeT/IdentifyingPatients • Schouten, B., Cox, A., Duran, G., Kerremans, K., Köseoğlu Banning, L., Lahdidioui, A. … Krystallidou, D. (2020). Mitigating language and cultural barriers in healthcare communication: Toward a holistic approach. Patient Education and Counseling, 103 (12), 2604-2608. • Sethi, D., & Rani, M. K. (2017). Communication barrier in health care setting as perceived by nurses and patient. International Journal of Nursing Education , 9 (4), 30-35. • UnitedHealth Group. (2020). Improving health literacy could prevent nearly 1 million hospital visits and save over $25 billion a year. https://www.unitedhealthgroup.com/ content/dam/UHG/PDF/About/Health-Literacy-Brief.pdf • U.S. Department of Health and Human Services. (n.d.). America’s health literacy: Why we need accessible health information. https://www.ahrq.gov/sites/default/files/wysiwyg/ health-literacy/dhhs-2008-issue-brief.pdf • U.S. Department of Health and Human Services. (2021). Health literacy in Healthy People 2030. https://health.gov/healthypeople/priority-areas/health-literacy-healthy-people-2030 • Varming, A. R., Torenholt, R., Møller, B. L., Vestergaard, S., & Engelund, G. (2015). Addressing challenges and needs in patient education targeting hardly reached patients with chronic diseases. Indian Journal of Endocrinology and Metabolism, 19 (2), 292-295.
CHAPTER 3: EFFECTIVE TEACHING STRATEGIES
Learning outcome After completing this chapter, the learner will be able to analyze teaching strategies that deliver effective learning to the patient and/or family, including: Demonstrate how to communicate at each literacy level
Discuss one on one teaching techniques Explain strategies for educating groups
INTRODUCTION
For patient and family education to be successful, there must be knowledge given and comprehension on behalf of the learner. There are many elements that can cause barriers to effective teaching and learning. Healthcare professionals must be able to identify these obstacles and create strategies to address and overcome them. Patients may have variations in their ability to learn medical infor- mation based on low health literacy. The individual also must be ready to learn. Individual learning styles and differences in com- munication must be considered. Patients may have certain limita- Universal approach to patient education Patient education should be individualized to each patient in terms of addressing health literacy, barriers to learning and com- munication, and content. Healthcare professionals should also use a universal approach to providing patient education for all patients, including standardized strategies.
tions or cultural considerations that may also impact teaching and learning. Strategies must be developed to address the needs of patients and effectively communicate and teach. There are standardized considerations when approaching patient education, and then individualization is needed. Assessments must be undertaken to determine which strategies are appropriate to implement. There are multiple avenues in patient teaching, which can include indi- vidual and group education.
The environment should be adapted to provide one in which ef- fective teaching can occur. This can include lighting that is suf- ficient but not overstimulating and a calm, quiet atmosphere with lowered noise levels if possible. The temperature of the room is
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Book Code: RPUS3024
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