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      Strategies for improving the quality of verbal patient and family education: a review of the literature and creation of the EDUCATE model

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          Abstract

          Objective: Patient and family education includes print, audio-visual methods, demonstration, and verbal instruction. Our objective was to study verbal instruction as a component of patient and family education and make recommendations for best practices for healthcare providers who use this method. Methods: We conducted a literature review of articles from 1990 to 2014 about verbal education and collaborated on departmental presentations to determine best practices. A survey was sent to all nursing staff to determine perceptions of verbal education and barriers to learning. Results: Through our work, we were able to identify verbal education models, best practices, and needs. We then constructed the EDUCATE model of verbal education, which built upon our findings. Conclusion: Verbal education of patients and family members requires a multidisciplinary approach that takes into account learning styles, literacy, and culture to apply clear communication and methods for the assessment of learning. Providers need the skills, time, and training to effectively perform patient and family verbal education every time they care for patients. Further research needs to be performed on how to test, document, and quantify patients' comprehension and retention of verbal instructions.

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          Most cited references35

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          Effective teaching strategies and methods of delivery for patient education: a systematic review and practice guideline recommendations.

          The objective of this study was to determine effective teaching strategies and methods of delivery for patient education (PE). A systematic review was conducted and reviews with or without meta-analyses, which examined teaching strategies and methods of delivery for PE, were included. Teaching strategies identified are traditional lectures, discussions, simulated games, computer technology, written material, audiovisual sources, verbal recall, demonstration, and role playing. Methods of delivery focused on how to deliver the teaching strategies. Teaching strategies that increased knowledge, decreased anxiety, and increased satisfaction included computer technology, audio and videotapes, written materials, and demonstrations. Various teaching strategies used in combination were similarly successful. Moreover, structured-, culturally appropriate- and patient-specific teachings were found to be better than ad hoc teaching or generalized teaching. Findings provide guidance for establishing provincial standards for the delivery of PE. Recommendations concerning the efficacy of the teaching strategies and delivery methods are provided.
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            Patient comprehension of emergency department care and instructions: are patients aware of when they do not understand?

            To be able to adhere to discharge instructions after a visit to the emergency department (ED), patients should understand both the care that they received and their discharge instructions. The objective of this study is to assess, at discharge, patients' comprehension of their ED care and instructions and their awareness of deficiencies in their comprehension. We conducted structured interviews of 140 adult English-speaking patients or their primary caregivers after ED discharge in 2 health systems. Participants rated their subjective understanding of 4 domains: (1) diagnosis and cause; (2) ED care; (3) post-ED care, and (4) return instructions. We assessed patient comprehension as the degree of agreement (concordance) between patients' recall of each of these domains and information obtained from chart review. Two authors scored each case independently and discussed discrepancies before providing a final concordance rating (no concordance, minimal concordance, partial concordance, near concordance, complete concordance). Seventy-eight percent of patients demonstrated deficient comprehension (less than complete concordance) in at least 1 domain; 51% of patients, in 2 or more domains. Greater than a third of these deficiencies (34%) involved patients' understanding of post-ED care, whereas only 15% were for diagnosis and cause. The majority of patients with comprehension deficits failed to perceive them. Patients perceived difficulty with comprehension only 20% of the time when they demonstrated deficient comprehension. Many patients do not understand their ED care or their discharge instructions. Moreover, most patients appear to be unaware of their lack of understanding and report inappropriate confidence in their comprehension and recall.
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              Telephone-based re-education on the day before colonoscopy improves the quality of bowel preparation and the polyp detection rate: a prospective, colonoscopist-blinded, randomised, controlled study.

              Despite advances in bowel preparation methods, the quality of bowel preparation in some patients undergoing colonoscopy remains unsatisfactory. The effect of telephone re-education (TRE) on the day before colonoscopy on the quality of bowel preparation and other outcome measures had not been studied.
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                Author and article information

                Journal
                Health Psychol Behav Med
                Health Psychol Behav Med
                RHPB
                rhpb20
                Health Psychology and Behavioral Medicine
                Routledge
                2164-2850
                1 January 2014
                28 April 2014
                : 2
                : 1
                : 482-495
                Affiliations
                [ a ]Director of Library Services, Brigham and Women's Faulkner Hospital , Boston, MA, USA
                Author notes
                Article
                900450
                10.1080/21642850.2014.900450
                4346059
                25750796
                1e2192c5-fcd0-4eec-aec5-ee25e797a06b
                © 2014 The Author(s). Published by Taylor & Francis.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0/, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The moral rights of the named author(s) have been asserted.

                History
                : 14 November 2013
                : 28 February 2014
                Page count
                Figures: 0, Tables: 3, Equations: 0, References: 38, Pages: 14
                Categories
                Original Articles

                patient education,communication,interpersonal relations,health literacy,communication barriers,health education,teach-back

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