Orientation covers teaching/learning process

Hands-on workshop provides practice

Knowing how to develop an individualized teaching plan for patients is a skill each newly hired nurse must know at Massachusetts General Hospital in Boston. Therefore, a two-hour orientation gets them up to speed on how to access online resources to support the plan and document the teaching outcomes.

This hands-on workshop is scheduled monthly and taught by a masters prepared patient education nurse who works in the hospital's Maxwell & Eleanor Blum Patient and Family Learning Center. Teaching is a mixture of didactic presentation illustrated with real life examples; hands-on computer experience with available online resources; and a case study example, explains Brian M. French, RN, BC, manager of the learning center and The Knight Simulation Program. The class includes computerized graphics with the talking points, and there are instructions for the teacher that explain the content to be covered.

The instructor begins with a discussion of the teaching/learning process, then the steps to effective patient education including the following:

• Assessment.

The instructor covers the process of patient education and discusses the need to find out what the patient already knows, what the patient wants or needs to learn, what he or she is capable of learning, and if there are any factors that might impact the learning.

Also covered is the Nursing Dataset Form, which is to be filled out within 24 hours of admission. That form documents issues that could impact a patient's learning such as language barriers, pain, cultural beliefs, and vision and hearing problems.

Assessing readiness to learn is the final point in this category, which includes looking for cues in verbal and nonverbal behavior and then verifying your assumptions, says French. For example, the nurse might ask: "So what I am hearing you say is that you are very anxious about your diagnosis?"

• Planning.

In this category, the instructor covers the need to review the assessment to determine how best to teach the patient, identifying appropriate resources and whether an interpreter is needed to overcome language barriers. Also covered is the need for the instructor to set mutual goals with the patient and family, says French.

• Intervention.

Many tips for effective teaching are reviewed in this category. They include using plain language, involving a family member or friend, and making sure the content of printed materials is reviewed with the patient.

• Evaluation.

Staff members are encouraged to use the teach-back or show-back method for evaluation.

• Documentation.

Nurses are taught to document the problem, what the knowledge deficit is related to, the assessment of a patient's readiness to learn, who was taught, the teaching method, the patient's response to the teaching intervention, and what progress the patient has made toward an expected outcome.

The instructor goes over the content covered with a practice scenario using a patient who has been prescribed warfarin, a medication to prevent blood clots.


For more information about the nursing orientation on patient education at Massachusetts General Hospital, contact:

• Brian M. French, RN, BC, Manager, The Maxwell & Eleanor Blum Patient and Family Learning Center and The Knight Simulation Program, The Institute for Patient Care, Patient Care Services, Massachusetts General Hospital, Boston. E-mail: BFrench@MGHIHP.edu.