View About Patient Learning In Health Care and Nursing Education

Health Care and Nursing Education and View About Patient Learning

Different View of Learning In Patient Education,General Reasoning About Patient Learning and Education

Different View of Learning In Patient Education

    Learning goals in patient education have been heavily focused on direct application to physician-prescribed actions. Another, potentially more powerful view, acknowledges that patients need basic thinking skills, that patient education can develop them, and that with additional effort they will generalize to other health care problems and beyond.  

General Reasoning About Patient Learning and Education

  Such general thinking skills include reasoning by analogy, understanding experimentation, means ends analysis, and causal reasoning in the health domain. More specifically, they might include how:

a. Physiological, social, or psychological means are leverage points on a health problem.

b. Specialty bodies of medical knowledge do not add up to a complete whole.

c. Narrowness of the professional body of knowledge, skills, and goals must be supplemented with lay knowledge and skills, or conversely how professional knowledge can supplement lay understanding.

d. Scientific knowledge dramatically and quickly shifts, and knowing how to identify and weigh scientific hype.

e. My body provides feedback to me, how to read it and to know when I've reached an equilibrium or a serious disruption.

f. Bodies and self's repair.

g. Disease or distress happens to me through influence of genetic, environmental, social, and psychological factors.

h. To harness motivation of oneself and others in one's environment, including family and health professionals, to solve a problem.

    It is reasonable to expect that patients who develop such basic thinking skills will be able to more quickly understand a health problem and work toward its resolution with less professional help. Wouldn't it be worthwhile to invest in development of such skills in patients? Does this development require a certain level of formal education to be successful? 

    Each of the developments described in this offers an opportunity for advancement of patient education. Although not yet widely acknowledged, the learning philosophy and the theory of constructivism fits well with the purpose of preparing patients to manage their illnesses in real situations. 

    The bridge to implementation is not yet constructed and would require considerable revamping of the traditional model of patient education. Understanding which patients are able to perceive symptoms in a way that is congruent with physiological indicators, and those who are not, offers a significant opportunity to improve safety in chronic disease. Some beginning interventions have been tested.

    Patient lay models used to be thought of as a curiosity, frequently so obviously different from professional models. It has now become clear that those models do not go away and ignoring them significantly impairs learning. Last, cumulative negative consequences of low health literacy are now understood to be catastrophic; yet, a significant program to deal with it has not been forthcoming. 

    This situation not only raises ethical concerns about denying patient education to large segments of the population, it also ignores immense economic and personal consequences of their inability to engage the health care system and manage their illnesses.

    The constant thread throughout all of these topics is acknowledgment of the necessity of patient centeredness and of effort placed on developing basic patient thinking skills. Whether these developments can become true advances depends more on the willingness of health professionals to than don a mindset that privileges the provider's view and patient compliance with it and to seek resources necessary to ensure that patients are competent learners.