Communicating with patients
Overview
Patient education allows patients to play a bigger role in their own care. It also aligns with patient- and family-centered care.
To be effective, patient education needs to be more than instructions and information. Teachers and health care providers need to be able to assess patient needs and communicate clearly.
The success of patient education depends largely on how well you assess your patient's:
- Needs
- Concerns
- Readiness to learn
- Preferences
- Support
- Barriers and limitations (such as physical and mental capacity, and low health literacy or numeracy)
Often, the first step is to find out what your patient already knows and believes about their health care and condition. Use these guidelines to do a thorough assessment before starting patient education:
- Gather clues. Talk to the health care team members and observe your patient. Be careful not to make assumptions. Patient teaching based on incorrect assumptions may not be very effective and may take more time. Find out what your patient wants to know or take away from your meeting.
- Get to know your patient. Introduce yourself and explain your role in your patient's care. Review their medical record and ask basic get-to-know-you questions.
- Establish a rapport. Make eye contact when appropriate and help your patient feel comfortable with you. Pay attention to your patient's concerns. Sit down near your patient (with their consent).
- Gain trust. Show respect and treat each patient with compassion and without judgment.
- Determine your patient's readiness to learn. Ask your patients about their outlooks, attitudes, and motivations.
- Learn your patient's perspective. Talk to your patient about worries, fears, and possible misconceptions. The information you receive can help guide your patient teaching.
- Ask the right questions. Ask if your patient has concerns, not just questions. Use open-ended questions that require your patient to reveal more details. Listen carefully. Your patient's answers will help you learn the person's core beliefs. This will help you understand your patient's motivation and let you plan the best ways to teach.
- Learn about your patient's skills. Find out what your patient already knows. You may want to use the teach-back method (also called the show-me method or closing the loop) to figure out what your patient may have learned from other providers. The teach-back method is a way to confirm that you have explained the information in a way that they understand by asking them to act as if teaching it to you. Also, find out what skills your patient may still need to develop.
- Involve others. Ask if your patient wants other people involved with the care process. It is possible that the person who volunteers to be involved in your patient's care may not be the person your patient prefers to be involved with. Learn about the support available to your patient.
- Identify barriers and limitations. You may perceive barriers to education, and your patient may confirm them. Some factors, such as low health literacy or numeracy may be more subtle and harder to recognize.
- Take time to establish rapport. Do a comprehensive assessment. It is worth it because your patient education efforts will be more effective.
References
Bowman D, Cushing A. Ethical practice and clinical communication. In: Feather A, Randall D, Waterhouse M, eds. Kumar and Clark's Clinical Medicine. 10th ed. Philadelphia, PA: Elsevier; 2021:chap 5.
Bukstein DA. Patient adherence and effective communication. Ann Allergy Asthma Immunol. 2016;117(6):613-619. PMID: 27979018 pubmed.ncbi.nlm.nih.gov/27979018/.
Gilligan T, Coyle N, Frankel RM, et al. Patient-clinician communication: American Society Of Clinical Oncology consensus guideline. J Clin Oncol. 2017;35(31):3618-3632. PMID: 28892432 pubmed.ncbi.nlm.nih.gov/28892432/.
Reviewed By: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
