Teaching moments create learning opportunities

Watch and listen to clues

Got a minute? Sometimes that’s all it takes to educate patients when they are receptive to teaching. Times like these, often referred to as teachable moments, are easy to recognize.

Practitioners can recognize a teachable moment by one of many cues, says Fran London, MS, RN, a health education specialist at Phoenix (AZ) Children’s Hospital. Cues include:

  • Questions: The learner asks a question such as, "What’s that pill for?"
  • Concern: The learner expresses a concern. For example, he or she might say, "I’ll never be able to do that!"
  • Lack of understanding: The learner makes a statement that is incorrect such as, "I don’t want morphine. I don’t want to become a drug addict."

Educators often can tell by looking at people that they are ready to learn. The learner’s eyes light up and their ears seem to perk up, says Naomi Holtz, RN, BSN, a health education specialist at St. Luke’s Regional Medical Center in Sioux City, IA. "They are eager and able to absorb what you have to offer and may be more motivated than usual to change some of their unhealthy behaviors," she says.

When patients ask questions, they are receptive to learning. At that point, they can be given some interventions that they can do to help with the problem. "It’s good to give patients little, easily digestible bits of information and then, if possible, reinforce them frequently," says Holtz.

What educators need to know is that when a teachable moment arises, they need to respond immediately, says London. If a learner has a question, answer it, or if a learner has a misperception, correct it, she advises. An educator may have to use a delaying tactic, such as giving the patient a handout to read and promising to return in 30 minutes to discuss it. However, acting on the teachable moment immediately in some way keeps the moment open, says London.

Many factors can create a teachable moment. It may be a symptom a patient is experiencing or an external experience. It can come in a classroom setting, a clinic, at the bedside, or during a formal teaching setting. For example, there may have been a fatal house fire in the neighborhood, so a person is very receptive to teaching about fire safety at that point, says Holtz.

"Once you recognize a teachable moment, you need to figure out how best to respond," says London. One consideration is how to individualize the presentation of the information to meet the needs of the learner. If a patient has poor eyesight or poor literacy skills, it would be inappropriate to respond with a handout, she says.

"You need to know your patients before you teach them," says Theresa Towne, RN, MSN, an inpatient educator at Bayhealth Medical Center in Dover, DE. At Bayhealth, an initial assessment is done when a patient is admitted that includes barriers to learning, such as the inability to speak English and ways the patient likes to learn.

It’s always important to really listen to what the patient is saying. "Have a good ear as to what they really need to know," says Towne.

Often the learner tells you either directly or indirectly what he or she needs to know, she says. Learning needs also can be assessed by evaluating the learner’s understanding of self-care skills such as medication or diet.

Whenever teaching takes place, whether it is an extended session or a teachable moment, it should be evaluated and documented. "Just because we said it, or gave a handout, there is no guarantee that the learner got it or got it right," says London. Educators should ask the learner to teach the information back to them or demonstrate the skill independently.

It may take several teaching sessions from several different approaches before the learner understands. That’s why all teaching, whether formal or informal, should be documented, says London. The purpose of documentation is to communicate the learner’s status to the health care team so each can build on one another’s progress and to have a record of the learner’s informed consent and readiness for self-care, she explains.

It’s important that educators never ignore a teachable moment. Instead of learning the information they are after, patients might learn that the environment at the health care facility is not responsive to patients and the information is not available. Then when educators want to teach, they may find that patients are not ready to learn. Teaching could become a time-consuming chore. "Taking advantage of teachable moments may both save time and improve outcomes," says London. 

Need More Information?

  • Naomi Holtz, RN, BSN, Health Education Specialist, St. Luke’s Regional Medical Center, 2720 Stone Park Blvd., Sioux City, IA 51104. Telephone: (760) 279-8941. E-mail: holtznao@stlukes.org.
  • Fran London, MS, RN, Health Education Specialist, The Emily Center, Phoenix Children’s Hospital, 1919 E. Thomas Road, Phoenix, AZ 85016-7710. Telephone: (602) 546-1397. E-mail: flondon@phoenixchildrens.com.
  • Teresa Towne, RN, MSN, Inpatient Educator, Consumer Health Education Department, Bayhealth Medical Center, 640 S. State St., Dover, DE 19901. Telephone: (302) 744-7135. E-mail: Towne@bayhealth.org.