Patient education only as good as staff teaching
Patient education only as good as staff teaching
Offer opportunities for learning teaching techniques
Question: How do you teach staff to teach? What key elements for teaching do they need to know, and what methods can you use to help them become effective teachers?
Answer: When a patient education document tool was implemented at Lexington (NC) Memorial Hospital, it soon became apparent that staff really didn’t know how to teach.
"When we looked at what was documented, how it was documented, and why it was documented, we found that people didn’t understand the concepts of patient education," says Marie Muskovin, MSN, RN, director of education at Lexington.
For example, Muskovin found that complex topics were taught once, and they were documented stating that the patient completely understood. The staff thought that if they told the patient something, the patient learned the information. When patients were interviewed, it was apparent that they did not understand the teaching.
"They could regurgitate it back at the moment of teaching, but long-range retention was not there," says Muskovin.
Another problem was that staff waited too long to start the education process and were trying to teach everything at the time of discharge.
When questioned, staff admitted that they were uncomfortable with many aspects of patient education. For example, many found that assessing a patient’s readiness to learn was embarrassing.
Now Muskovin is writing a curriculum for a 21¼2 hour seminar on teaching that all clinical staff will be required to attend. She’s designing the curriculum around a booklet titled A Guide to Educating Patients that covers assessing, planning, implementing, and documenting patient education.
"We will use case studies to show people how to apply the techniques and then use some role-playing in small groups for practice. Most people are uncomfortable with role-playing unless you put them in a safe environment," says Muskovin. (For information on this booklet and other tools for designing a teaching curriculum, see p. 10.)
Staff become better teachers if you help them improve their communication skills, says Megan O’Conner Finch, RNC, MS, patient education coordinator at Union Hospital in Terre Haute, IN.
"We are teaching the staff to read between the lines and to use open-ended questions when talking to the patient," she explains.
Break information into bits and pieces
Yet staff at Union Hospital don’t attend an inservice to develop these skills. O’Conner Finch finds that education provided in bits and pieces, rather than in one long session, fits busy staff schedules better. She has written several self-study packets that focus on one topic, such as assessing readiness to learn, prioritizing education, or reading between the lines when interviewing patients. The packets are kept in the resource library in the nursing education department where people can check them out to take home or study on the unit. (Self-study packets will be available for purchase in the spring of 1998. For more information, see source box, above right.)
If the topic is made mandatory, because it is a topic that the nursing education department determined everyone needs to brush up on, a copy of the self-study packet is kept on each nursing unit. People are then required to sign a tracking sheet to show that they have studied the material.
Also, O’Conner Finch makes short teaching videos that staff can check out.’
"There haven’t been many professional videos produced on techniques of patient teaching that are short and to the point," she says.
Therefore, she uses a video camera to make short films on such topics as overcoming learning barriers. She simply films a short example with staff as actors, to demonstrate a teaching technique. The films are not Hollywood productions, she says.
Every opportunity to show staff how to teach is used by the education department. Teaching topics are covered in the nursing newsletter produced by the nursing education department. For example, one piece covered the types of questions health care professionals might ask if they suspect that the patient cannot read.
Teaching techniques are tagged onto all inservices on diagnosis, treatment, and procedures. "If we have a new piece of equipment, there is always a little information about the patient education that goes with it," explains O’Conner Finch. "That’s the same for a new procedure. Instead of making patient education a stand-alone issue, we’re trying to incorporate it into all practice."
Although O’Conner Finch doesn’t create hospitalwide inservices, she does work with all new nursing staff during their orientation. At the meeting, she uses complex case studies to help the new staff learn how to determine what is important to teach. For example, in one scenario, the patient is admitted for an acute congestive heart failure (CHF) episode, but he also is a diabetic and lives alone.
"When I use case studies, I try to get the professional to think about the patient as a whole, not just the part we are caring for in the hospital," explains O’Conner Finch.
For example, although the patient teaching is focused on CHF, the nurse might find during the assessment that the patient is following a good heart healthy diet but is eating foods that are bad for people with diabetes.
New nurses work with preceptors on the units as well, who watch and listen during patient education sessions to make sure the new nurse knows how to teach. When managers see a problem area on their unit, they invite O’Conner Finch in to do a short inservice on the topic for the nurses on the unit.
Today’s busy staff want facts, skills, and tools that help them become better teachers, but they don’t have time for lengthy inservices on teaching theory, says O’Conner Finch.
"It is my responsibility to base what I give them on learning theory, but theory is not what they need. They need to feel comfortable teaching patients," she says.
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.