From face-to-face instruction to video demonstrations, RTs use a variety of methods to educate patients so they can be active participants in managing their care. AARC Members Bill Galvin, MSEd, RRT, CPFT, AE-C, FAARC, and Krystal Craddock, BSRC, RRT, RRT-NPS, AE-C, share their tips and best practices for educating patients.
Galvin keeps the acronym RAMP-2-FAME in mind when he teaches patient education skills. Each letter represents one of nine key principles of adult learning, as referenced in the “Respiratory Care: Principles and Practice” textbook (Law of Recency, Appropriateness, Motivation, Law of Primacy, 2, Feedback, Active learning, Multiple sense learning, and Exercise).
According to Galvin, the acronym is tied to teaching patients about their condition or how to use a piece of equipment or some technology. For example, the laws of recency and primacy refer to the fact that a patient is more attentive at the beginning and the end of the RT’s teaching session.
“When you first enter the room, the patient will generally stop what they are doing and immediately pay attention to you,” Galvin said. “They are curious about who you are and what you have to say. You have a captive moment and you want to take advantage of this, to hook them, and provide meaningful and valuable information.”
Galvin continues to explain that when you leave, you should repeat and reinforce the learning.
“Repetition has been proven to be a highly effective means to have information go from short-term to long-term memory,” Galvin said. “You want to leave them with the critical or key points of the learning session before you walk out the door.”
“Another of my favorites is active learning,” Galvin said. “Education theory tells us that if you want learning to occur, you must engage the patient (learner), and that means having them actively participate in the learning.”
Galvin sums up this process as: tell them, then show them, and then have them do it.
“Feedback is extremely important as well,” Galvin said. “Patients want to know how they are doing so give it often and in a constructive manner.”
According to Galvin, positive reinforcement is more effective than negative.
“Highlight what you see as positive and avoid criticizing,” Galvin said. “You should be clear and timely in providing feedback and avoid being harsh and overly critical.”
Know your audience
Galvin also encourages RTs to be mindful of a person’s age.
“Use examples that are age appropriate and be particularly aware that teaching younger individuals may be more effective if you allow them to do what it is you are attempting to teach,” Galvin said. “Use props and equipment. Younger folks like a hands-on approach and generally do not want to know all the detail.”
Craddock and her team at UC Davis Medical Center have also found that using visual aids works well.
“Just talking to the patient and asking ‘do you have any questions?’ doesn’t work,” Craddock said. “Education using teaching tools and visual aids improves the patient’s understanding.”
She encourages following up with an open-ended question, such as ‘what questions do you have for me?’ Craddock feels this type of question “allows for the patient to think about what they can ask, instead of asking the close-ended ‘do you have questions?,’ because you’ll often get a ‘no.’”
Craddock’s COPD Case Management team uses iPads to show videos showing disease process and pulmonary rehab, placebo inhalers to demonstrate the proper way to take their medications, lung model tools to explain the lung anatomy, as well as educational materials written at a fifth grade reading level. The patients are provided a medication action plan with pictures of their COPD medications, dose, frequency, and whether the mediation is maintenance or rescue, for a quick reference that they can refer to or share with their family.
“We do several teachings to break-up the information so that it isn’t too overwhelming for the patient,” Craddock said.
Communicate with the patient
“Be certain that you are communicating with the patient and not at the patient,” Galvin said. “This is what is meant by two-way communication and will better assure you are connecting with the patient and they are a part of the learning.”
This will help your patients take responsibility and ownership for their learning, strengthening self-control rather than leaning on ‘other-controlled.’
“Without this, they will simply remain as an outsider and take the position that others will do things for them,” Galvin said.
Involve the family
“We encourage all bedside education to be provided to the patient and family,” Craddock said. “It is important to involve those who care about the patient and who are involved in the care of the patient.”
She continued to explain that their pediatric and adult trach teams use hands-on training with a trach mannequin.
“The parents and caregivers of trach patients get to practice trach care and trach changing with instruction by the RCP prior to performing on their child or family member,” Craddock said. “They are discharged home with a trach travel bag to carry their supplies whenever they leave the home, as well as a handbook, written at a fifth grade reading level, that also includes pictures.”
When delivering instructions in the patient’s room, Craddock and her team turn off the television to decrease distraction. This helps patients and their family learn about their condition, devices, and medication.
“We assess retention by utilizing the teach-back method,” Craddock said. “This is having the patient and family explain in their own words, what they heard. We then can fill in any gaps and reassess as needed.”
Looking for more?
Develop and refine your patient education skills through the AARC’s 2018 Patient Education: More Than Telling Patients About Their Condition course.