| Planning Steps |
Explanations/Examples/Scripts |
Ref List |
| 1. Mutual Goal Setting Strategies |
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Partner with patient to devise mutually agreed upon learning goals.
Goals should focus on patient behaviors and be clearly stated, action-oriented, measurable and achievable by the patient.
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Patient and health care provider develop diabetic diet. The patient chooses the type of carbohydrate to eat based on their preferences and what makes them feel less sluggish.
The patient will learn the skills needed to demonstrate the following behaviors:
- Check blood pressure every day when you wake up.
- Take your blood pressure medicine every day.
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List 6 |
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Individualize/tailor education
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- Education meets patient’s individual health literacy needs such as patient with disability who needs recorded instructions.
- Education is approached in culturally sensitive manner. For example, patients are given diabetes diet information based on the foods they normally eat.
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List 7 |
| Consider preferred language |
- Offer education tailored to preferred oral and written language.
- Provide interpreter/translator as needed.
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List 8 |
| Include family, caregiver or significant other |
Identify support individuals and include in education whenever possible. |
List 9 |
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Build on current knowledge
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"Based on what you told me, you know the basics; the next step will be to learn how this will affect your day to day life."
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List 10 |
| Use Motivational Interviewing (MI) (Appendix 4) |
Motivational interviewing (MI) techniques include:
- Open-ended questions
- Affirmations (positive feedback)
- Reflection (mirror patient’s statements)
- Summary (summarize what the patient has said)
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List 11 |
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Consider the educational setting
A. Primary/Outpatient Care
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Primary care settings: education focuses on goal setting to optimize behavior change and safely transition patient from hospital to home.
- HbA1c at 6.0; able to count carbohydrates
Outpatient setting: add delivery of education through the internet, phone, and/or groups, based on patient and caregiver preferences and skills.
- Follow-up phone calls and text messages to remind patients to weigh themselves and take medication.
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List 12 |
| B. Pre-operative |
Education should be given pre-operatively to improve knowledge and reduce anxiety.
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List 13 |
| C. Acute Care |
In hospital settings, patient education should be started on admission and taught over time, allowing patients time to demonstrate comprehension.
- Session 1: Teach signs of infection
- Session 2: Dressing change
- Session 3: Follow-up care
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List 14 |
D. Discharge/last session
E. Education in all settings
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Include opportunities for structured education, including teach back and content reinforcement to achieve optimal outcomes.
- “What would you do if you gained more than 4 lbs in 24 hours?”
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List 15 |
| Back to Guidelines Homepage |
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| 2. Develop the Education Plan |
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Teach all patients in a manner they can understand
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- Use simple, direct messaging
- Avoid medical jargon
- Use common everyday language
- For a patient who has diabetes and eats rice with every meal, use plain language/clear communication such as, “You may eat a half-cup of rice 2 times a day for your carbohydrate servings.”
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List 16 |
| Identify content/key message to support learning objectives |
Objective: Daily Dressing Change
- Content to include:
- Hand hygiene
- Preparing dressing change area
- Old dressing removal/disposal
- Apply new dressing
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List 17 |
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Keep the message focused
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- Limit education to several key points
- Place most important information first
- Educate in small segments, “chunk and check”
- Stepwise instructions
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List 18 |
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Identify patient behaviors to demonstrate knowledge
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Build education to teach desired patient behaviors (teach to goal).
- Patient demonstrates toe-touch weight bearing
- Implement behavioral contract
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List 19 |
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Employ effective communication strategies
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Consider need for staff training in effective communication strategies (e.g. active listening, build rapport) and content. |
List 20 |
| Promote self-efficacy, skill mastery |
Maximize self-efficacy/ build confidence through
- Use of short term achievable goals
- Knowledge acquisition (classes, one on one sessions, practice hands on skills/problem solving)
- Modeling of behavior; self monitoring
- Positive reinforcement/ persuasion
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List 21 |
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Use team-based approach
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Team members (nurse, primary care provider, pharmacist) work with patient to achieve objectives.
- Use physicians, pharmacist or other health experts to teach health information
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List 22 |
| Use multi-modal approach |
For each learner use more than one teaching strategy at a time. For example, when teaching verbally provide a simple written handout. Additional examples of strategies that incorporate multi-modal approaches or can be combined with other strategies:
- Shared Decision Making (Appendix 8)
- Teaching verbally with written handout then follow-up with phone call.
- Education program with immediate feedback
- Addressing knowledge, emotional and behavioral changes
- Social support (parents, peers, school, healthcare team)
- Self-regulatory learning (self-testing, monitoring) (Appendix 9)
- Positive Affect and self-affirmation (Appendix 10)
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List 23 |
| Use multi-sensory approach |
Education should engage as many senses as possible (e.g., auditory, visual, tactile, smell).
- Combination of verbal and written health education
- Video with auditory and visual content
- Edutainment
- Pictures, illustrations, 3D models, images etc.
- Hands-on skill sessions
- Interactive games
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List 24 |
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Use multi-prong approach
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Offering the same education in various formats to meet the learning preferences of patients. Patients can select method to learn health information.
- In-person class, webinar, videos, 1 on 1 session, written materials
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List 25 |
| Have repeated contact with patient to reinforce teaching |
Examples: Follow-up phone calls, counseling or coaching sessions, group classes over a designated time period, pharmacy visits, unlimited access to skill learning on the web, start education early |
List 26 |
| Use problem-centered learning - patient knowledge is gained through solving real world problems |
- Patient can demonstrate what to do when blood sugar is too high or too low.
- Patient given physiological feedback with goal to improve health measure (i.e, HbA1C, blood pressure, cholesterol level).
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List 27 |
| Use experiential learning |
- Learn through “doing” and reflecting on learning.
- Patient with diabetes plans, shops for and prepares meal.
- Role Modeling: Provide role models for patients to learn from.
- Performance: Give patient an opportunity to perform health behaviors.
- Use analogies during education:
“Your knee joint is like a door hinge. A door hinge can become hard to move and squeaky over time. That is what can happen with your knee when you start to have arthritis.” |
List 28 |
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Use personalized action plans
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Develop an action plan with the patient that is individualized and meaningful to them.
- When blood sugar is low, patient will eat quick acting sugar product they prefer (favorite candy or juice)
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List 29 |
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Back to Guidelines Homepage
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| 3. Select Educational Resources |
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Consider available resources that support educational content
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- Written materials: use easy to understand language; available in languages other than English.
- Videos: available in languages other than English.
- Technology: promote ease of access to health information and interactive format (app, smart phones, tablets, kiosks, video games, eBooks, automated phone disease management, computer assisted video instruction).
- Blood pressure kiosks at mall or a phone “app” for tracking carbohydrate intake & blood sugars.
- Interactive games or activities: use to reinforce teaching message and skills.
- Decision aids used in shared decision making (Appendix 11)
- Pictures, illustrations, 3D models, images pictograms
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List 30 |
