Effective teaching may be important in better health outcomes for patients, at least according to one review drawing on 56 publications that attempted to quantify the clinical and economic impact of patient education by Stenberg et al. (2018). [1] That review reasons that as patients are increasingly included in the management of their care, educating patients becomes critical for their health. Though the range of approaches to patient education and measures of cost and benefit for those interventions vary widely, Stenberg et al. found that patient education decreased hospitalization and visits to the emergency department and was beneficial in quality adjusted life years, based on their review of 56 studies. [1] About 40% of the interventions were group based and led by a health professional, and the objective of these patient education sessions were very similar to the more familiar setting of classroom education: not only the transfer of knowledge (of disease states and treatment) but also higher level learning of applying their knowledge to their own conditions and the changing course of illness. [1] And while their literature review approach limits the amount of detail Stenberg et al. can devote to any particular study, their findings broadly suggest an overlap between instructional design in more traditional academic settings, such as the didactic classroom of pharmacy school, and teaching community members.
One didactic approach used in pharmacy schools, possibly familiar to readers of this blog, is case-based lessons. Though case-based approaches vary widely, the defining trait of case-based education is that they are story-based and use that story to achieve set learning outcomes. [2] Using stories to transmit health messages are among the core strategies that Adam et al. (2019) describe as consistently successful in their five years of creating video-based health education programs. [3] Adam et al. (2019) note that embedding health information in entertaining stories has been especially important, especially stories with characters the audience can invest in. [3] While Adam et al. (2019) report specifically on video-based lessons, and thus some of their key findings, such as the importance of good production values, does not apply to other educational settings, their insight that education works when the learner sees themselves in the stories that are teaching them is consistent with case-based learning in school and engaging patients in education as described by Adam et al.
It’s possible that stories may not be critical to successful patient education. Kerkhoff et al. (2020) report on an intervention on a community-based program to care for and isolate COVID-19 positive community members in a socioeconomically vulnerable population in San Francisco California. [4] While patient education is only a part of their overall program, Kerkhoff et al. note that they key element of their education was using community-based workers to contact and educate patients. [4] By sharing community, these educators were able to perform a function somewhat like an engaging character in an entertaining video, their patients were able to see themselves safely isolating and following the best health practices promoted by their community health educators. [4] Thus, in the end, it may be a more basic part of education that determines success in patient or classroom settings: the ability to connect with the learner and make the information feel relevant, important, and connected to the learner’s own goals and life.
References:
1. Stenberg U, Vågan A, Flink M, Lynggaard V, Fredriksen K, Westermann KF, Gallefoss F. Health economic evaluations of patient education interventions a scoping review of the literature. Patient Educ Couns. 2018 Jun;101(6):1006-1035. doi: 10.1016/j.pec.2018.01.006. Epub 2018 Jan 12. PMID: 29402571.
2. Thistlethwaite JE, Davies D, Ekeocha S, Kidd JM, MacDougall C, Matthews P, Purkis J, Clay D. The effectiveness of case-based learning in health professional education. A BEME systematic review: BEME Guide No. 23. Med Teach. 2012;34(6):e421-44. doi: 10.3109/0142159X.2012.680939. PMID: 22578051.
3 . Adam M, McMahon SA, Prober C, Bärnighausen T. Human-Centered Design of Video-Based Health Education: An Iterative, Collaborative, Community-Based Approach. J Med Internet Res. 2019 Jan 30;21(1):e12128. doi: 10.2196/12128. PMID: 30698531; PMCID: PMC6372941.
4 . Kerkhoff AD, Sachdev D, Mizany S, Rojas S, Gandhi M, Peng J, Black D, Jones D, Rojas S, Jacobo J, Tulier-Laiwa V, Petersen M, Martinez J, Chamie G, Havlir DV, Marquez C. Evaluation of a novel community-based COVID-19 'Test-to-Care' model for low-income populations. PLoS One. 2020 Oct 9;15(10):e0239400. doi: 10.1371/journal.pone.0239400. PMID: 33035216.
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