The Learning Process

Most people teach someone about something by first giving them some literature to read, and asking them to formulate questions for later discussion. Unfortunately, that isn't always the most effective means of educating most people. It may be an effective means of supplementing or reinforcing information, but not of initially learning something new.

Encountering Illiteracy

There are many education theories, but in plain English, learning styles will affect how well your patient interprets and utilizes the information you provide. One of the primary barriers to learning from literature is illiteracy. You'd probably be quite surprised to find that your very bright, seemingly well-educated middle-aged patient is illiterate. He's probably very good at covering it up, and despite his inability to read and write, he has educated himself through other forms of media.

According to the U.S. Department of Education, more than forty million adults in this country are functionally illiterate. Another ten million can barely read and write. According to health literacy experts, almost ninety million Americans will have some degree of difficulty understanding information and forms provided to them by their health care system.

Given this information, the next time you give a patient a handout or other form of literature, be sure that he understands the information it contains. Don't expect him to learn from it, but rather it should serve to reinforce your verbal and hands-on teaching methods.

Try Different Methods

Some people will learn best from your verbal explanation while others require a demonstration or pictures. Some can follow step-by-step instructions well while others need to see the finished product before they can learn the steps. Some learn best by doing it themselves, while others retain the information better by watching several times first. Ask your patient what works best for him. How does he learn how to do things at work, at home, or with hobbies? By the same token, some are better at teaching by telling and others by showing. Think about what your strengths are, and if your patient needs something different, ask a coworker to try another approach.

Return demonstration is a vital part of patient teaching. Never assume that a patient understands and is competent without having him demonstrate it to you. And always document what has been taught, verbalized back, and return demonstrated, as well as what needs to be reviewed. Ask leading questions such as “what does this mean to you?” or “tell me what you think I just said.” This way you have an understanding of what the patient interprets. Don't just ask if he understands. Most people will say yes because they think that's what you want to hear. Build on what they do understand. And always use plain English, not nursing jargon.

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