Article from the Boston Globe’s On Call Magazine, June 2002

By Helen Osborne, M.Ed., OTR/L
President of Health Literacy Consulting

Patient education occurs when health providers and patients talk about the patient’s discharge instructions or medication information. It also happens when health providers recommend health-related booklets, videos, or websites to their patients. But patient education also can take place in a classroom setting in which there is designated teacher (health professional), students (patients), and an established curriculum.

“A class,” as defined in my book Partnering with Patients to Improve Health Outcomes, “is a meeting or series of meetings with a formal curriculum designed to achieve specific educational goals and objectives.” Classes can focus on specific diagnoses or conditions or on more general topics related to wellness and health promotion. Classes can also be a way to prepare patients for upcoming medical procedures such as childbirth.

Carol Tobias knows a lot about classes. As co-director of Health Promotion and Education at Harvard Vanguard Medical Associates, Tobias oversees the organization’s educational programs. For example, the Childbirth Education Program is a series of classes for expectant parents that is offered by Harvard Vanguard. Early pregnancy classes focus on the “what ifs” of pregnancy and topics include what’s normal, what’s not normal, proper nutrition, and environmental concerns such as the dangers of second-hand smoke. These classes also cover practical matters, such as how and when to make prenatal appointments and what to do in case of an emergency.

Prospective parents as well as their providers appreciate these classes. Tobias says that patients who attend these classes can make childbirth decisions based on their own accumulated knowledge rather than simply relying on what someone else tells them to do. Provider’s, too, are pleased when patients take these classes. They find that women are calmer throughout the childbirth process because they know what to expect and are aware of decisions they may be asked to make. “Classes are a joint partnership,” says Tobias. “We’re helping the patient and the patient is coming prepared.”

How to Benefit Patient and Provider

If classes are a regular component of your patient education program, you can use these tips from Tobias to help ensure that your classes benefit patients and providers alike.

Design programs to meet patient care needs. Consider starting a new class if you find that many patients ask the same questions or struggle with similar issues. At Harvard Vanguard Medical Associates, a lot of women patients are of the “baby boom” generation. Many of them want to understand what is happening to their bodies at menopause. To respond to this need, Tobias and her colleagues initiated a 6-week menopause class that covers an overview of menopause, cardiovascular health, cancer, musculoskeletal systems, and mental health. Like the childbirth classes many of the participants took years before, the goal of the menopause program is to empower women by offering them information about health concerns and helping them create healthy lifestyles.

Communicate with providers. Primary care providers are likely to be the main source of patient referrals. Make it easy for them to learn about your class and highlight how it can improve patient care. Let providers know when their patients enroll and keep them informed about how their patients are doing. One way to do this is to document in a patient’s medical record that he or she attended the class.

Be a “people person.” Health professionals who teach patient education classes need to do more than simply be knowledgeable about their subject matter. They also should be enthusiastic about teaching and enjoy working with people to help them learn. Tobias says that the best teachers are engaging, respectful, and caring. They are committed to helping people take charge of their own health and willing to answer questions during class and at breaks. Not everyone is right for the job, says Tobias. In looking for teachers, she looks for those who will be upbeat when they teach, regardless of what else is happening in their lives.

Use a variety of teaching methods. People learn by seeing, hearing, and doing. To take advantage of these varied modes, Tobias recommends that health professionals offer patients several avenues for learning. For instance a menopause that offers participants recipes for healthy foods might also offer participants nutritionally healthy snacks, such as tofu dips and brownies made with soy. That way, patients can taste these foods while they learn why they are good for them.

Create a comfortable environment for learning. Good teaching is more than simply presenting information. Teachers also need to be attentive to the classroom environment and know how to adjust the room temperature and make adjustments in lighting. They should also know where the bathrooms, telephones, and fire exits are. It’s also important to pay attention to appearance. Health professionals should look professional, yet approachable.

Be flexible. Something unplanned almost always occurs during the course of a class. For example, a room may not be set up properly or a guest speaker may not arrive on time. Teachers need to be flexible and ready to “wing it,” says Tobias. This means you need the ability to stay calm and to be ready to use the resources you have at hand.

Get feedback.Make sure that your classes meet the needs of both patients and providers. Ask participants informally about what they want to learn more about and use their suggestions to modify the agenda for the next session. Use a formal evaluation tool to assess the program at its conclusion. Ask not only about content and format, but also include a place for participants to tell you, in their own words, what their experience was like. And talk with the providers on a regular basis. Keep up to date with what they want patients to learn and experience, and confirm that your class addresses those needs.

How to Learn More:

• Carol Tobias is Co-Director of Health Promotion and Education at Harvard Vanguard Medical Associates, 1250 Hancock Street, Quincy, MA, 02169. You can reach her by e-mail at Carol_tobias@vmed.org or by phone at (617) 774-0835.
• To learn more about and register for Harvard Vanguard Medical Associates groups and classes, go to their Web site at www.vanguardmed.org or call (877) 439-5465.

Print Resources

• Lorig KR, Stewart A, Ritter P, Gonzalez V, Laurent D, Lynch J. Outcome Measures for Health Education and Other Health Care Interventions. Thousand Oaks, Sage Publications; 1996. Includes set of measures to help evaluate patient education, health promotion, and other health service interventions.
• Osborne H. Partnering with Patients to Improve Health Outcomes. Aspen Publishers, Inc., Gaithersburg, MD; 2001. Practical strategies that practitioners can use to help patients be more active in their treatment and care.
• Redman BK. The Process of Patient Education.St. Louis: Mosby Year Book; 1993. Chapters are organized around elements of the teaching-learning process and delivery systems for patient education.