Literature Review about Research and Non Research Based Patient Education
Nursing Literature About Staff and Patient Education
The literature on patient and staff education, from both a research and non research based perspective, is particularly extensive in nursing. The non research based literature on patient education is prescriptive in nature and tends to offer anecdotal tips on how to take individualized approaches to teaching and learning. A computer literature search, for example, reveals literally thousands of nursing and allied health articles and books on teaching and learning that are available, ranging from the general to the specific.
Research Based Literature on Staff and Patient Education
Although many research based studies are being conducted on teaching specific population groups about a variety of topics, only recently has the field focused its attention on how to most effectively teach persons with long term chronic illnesses: Nurses must conduct much more research on the benefits of patient education as they relate to the potential for creating quality of life, enabling patients to lead a disability free life and manage themselves independently at home, and decreasing the costs of health care through anticipatory teaching approaches.
Studies from acute care settings tend to focus on preparing a patient for a procedure, with emphasis on the benefits of information in alleviating anxiety and promoting psychological coping. The evidence does suggest that patients cope much more effectively when taught exactly what to expect (Adams, 2010; Donovan & Ward, 2001; Duffy, 1998; Mason, 2001; Wong, Chan, & Chair, 2010).
Further Research Based Requirement
More research is needed on the benefits of teaching methods and instructional tools that use the technologies of computer assisted instruction, online and other distance learning modalities, cable television, podcasts, and Internet access to health information for both patient and staff education. These new approaches to information dissemination require a role change for the educator, from being a giver of information to becoming a resource facilitator, as well as a shift in the role of the learner, from being a passive recipient to becoming an active partner.
Effects of Technology on Learning
The rapid advances in technology for teaching
and learning also require educators to have a better understanding of
generational orientations and experiences of the learner (Billings &
Kowalski, 2004). Also, the effectiveness of videotapes and audiotapes with
different learners and in different situations must be further explored (
Kessels , 2003). Given the significant incidence of low literacy rates among
patients and their family members, much more research needs to be done on the
impact of printed versus audiovisual materials as well as written versus verbal
instruction on learner comprehension (Weiss, 2003).
Gender Issues In Learning Strategies
Gender issues, the influence of socioeconomics on learning, and the strategies of teaching cultural groups and populations with disabilities need further exploration as well. For example, the findings from interdisciplinary research on the influence of gender on learning remain inconclusive, although neuroscience is uncovering increasing evidence on the functions of the different parts of the male and female brain and how they interact. Research on the influence that socioeconomics has on learning reveals it plays a significant factor, but the underlying mechanisms of its effects are still unclear.
More research needs to be done on the extent to which teaching can improve health status of individuals and communities, decrease the incidence of disease, and enhance the quality and safety of healthcare delivery.Despite the questions that remain unanswered, nurses are expected to teach diverse populations with complex needs and a range of abilities in both traditional settings and nontraditional, unstructured settings. For more than 30 years, nurse researchers have been studying how best to teach patients, but much more research is required (Adams, 2010; Mason, 2001).
Also, relatively few studies have examined nurses' perceptions about their role as educators in the practice setting (Friberg et al., 2012). We need to establish a stronger theoretical basis for intervening with clients throughout “all phases of the learning continuum, from information acquisition to behavioral change” (Donovan & Ward, 2001, p. 211). Also, emphasis needs to be given to research in nursing education to ensure that the nursing workforce is prepared for a challenging, complex, and uncertain future in health care (Benner et al., 2010; Committee on Quality of Health Care in America & 10M , 2001; IOM, 2011; Meleis , 2016).
Cost Based Investigations on Education
In addition, nurses as educators should further investigate the cost effectiveness of educational efforts in reducing hospital stays, decreasing readmissions, improving the personal quality of life, and minimizing complications of illness and therapies. Furthermore, given the number of variables that can potentially interfere with the teaching-learning process, additional studies must be conducted to examine the effects of environmental stimuli, the factors involved in readiness to learn, and the influences of learning styles on learner motivation , compliance, comprehension, and the ability to apply ply knowledge and skills once they are acquired.
One notable gap is the lack of information in the research database on how to assess motivation. The Compliance, Motivation, and Health Behaviors of the Learner chapter proposes parameters to assess motivation but notes the paucity of information specifically addressing this issue.
More than 20 years ago, Oberst (1989) delineated the major issues
in patient education studies related to the evaluation of the existing research
base and the design of future studies. The four broad problem categories that
she identified remain relevant today:
1. Selection and measurement of appropriate dependent variables
(educational outcomes).
2. Design and control of independent variables (educational
interventions).
3. Control of mediating and intervening variables.
4. Development and refinement of the theoretical basis for education.
Nurses can be considered information brokers educators who can make a significant difference in how patients and families cope with their illnesses and disabilities, how the public benefits from education directed at prevention of disease and promotion of health, and how staff and student nurses gain competence and confidence in practice through education activities that are directed at continuous, lifelong learning.
As the United States moves forward in the 21st century, many challenges and opportunities lie ahead for nurse educators in the delivery of health care.The teaching role is becoming even more important and more visible as nurses respond to the social, economic, and political trends affecting health care today. The foremost challenge for nurses is to be able to demonstrate, through research and action, that definite links exist between education and positive behavioral outcomes of the learner.
In this era of cost containment, government regulations, and health care reform, the benefits of client, staff, and student education must be made clear to the public, healthcare employers, healthcare providers, and payers of healthcare benefits. To be effective and efficient, nurses must be willing and able to work collaboratively with one another to provide consistently high quality education to the audiences they serve.
Nurses can demonstrate responsibility and accountability for the delivery of care to the consumer, in part, through education based on solid principles of teaching and learning. The key to effective education of the varied audiences of learners is the nurse's understanding of and ongoing commitment to the role of educator.
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