Readability formulas may mislead you

The health-care literature has embraced readability formulas as a reasonable means of judging patient-education materials without adequately acknowledging the formulas' practical and theoretical limitations. This paper provides some background on readability formulas, describes their proper use in health education, and highlights some misuses. The paper concludes with suggestions for judging patient education materials and creating well-written texts independent of readability formulas.     

A model for developing and pre-testing a multi-media teaching program to enhance the self-care behavior of diabetes insipidus patients

A patient-education program was designed by members of the Neurology Nursing Service. The program was designed to provide patients with diabetes insipidus with the information needed to help them manage their condition in the hospital and at home upon discharge. The program was approved by the Nursing Department's Patient Education Committee. The nurses worked closely with the hospital's patient-education coordinator and television-production staff to produce a videotape for educating patients about managing diabetes insipidus. A literature review of patient-education resources on diabetes insipidus revealed that no materials were available in either audiovisual or print media. The program utilized the multi-media approach of a videotape that was shown over closed-circuit television and a booklet outlining the salient points of the television program. All patients utilizing the program have been pre-tested and post-tested to assess their achievement of behavioral objectives.     

Television as a patient education tool: A review of its effectiveness

Thirty-three studies of the use of television as a patient-education process are reviewed. While there are many different conditions addressed by the studies and many studies have methodological problems there are consistencies in the results that suggest how this medium has a role to play. Eleven studies randomized subjects and had a control group. All but one reported achieving their objective of knowledge gain, skill training, or behavior change. Video presentation alone was as effective as any other presentation method and was more effective than only written information. Recommendations for the use of television for patient education are included.     

A Nigerian experiment in presurgical patient counseling: A pilot study

While the effects of presurgical emotional and counseling interventions have been studied in western countries for over 20 years, the issues are relatively new in most of the developing world. A preoperative patient-education project in one Nigerian hospital was undertaken to test the relevance of such interventions in a third-world setting. The fact that an experimental group showed reduced analgesic intake and smoother reduction in anxiety levels encourages further research in patient education. Hospital policy and personnel orientations exist at present which need to be modified before long-term counseling services and the potential benefits deriving therefrom can be expected in Nigeria.     

The Maine State Patient Education Forum: networking system for a rural area.

Patient education councils are growing and prospering. The Maine State Patient Education Forum is one such council which has gone through a continuing developmental process to meet needs of patient educators in Maine. Involving many organizations and individuals who do patient education, having a clear direction and a common locus, scheduling regular meetings, and participating in national networking have all been ways to vitalize and strengthen the council. Maine as a rural state has found the forum to be a dynamic model to motivate patient educators to maintain flexibility and acquire new concepts so they can continue to provide high quality patient education services.     

A case for genetics education: collaborating with speech-language pathologists and audiologists

Because speech-language pathologists (SLPs) and audiologists (AUDs) are among the first referrals for parents of children exhibiting feeding, speech, language, hearing, and balance difficulties, it is important for SLP and AUD professionals to recognize genetic causes of and contributions to complex and Mendelian communication disorders. We review genetics in the curricula of speech-language pathology and audiology programs and obstacles to its integration throughout curricula. We present suggestions about how SLPs and AUDs can aid in diagnosis and contribute their clinical expertise in characterizing phenotypes, followed with a review of a new genetics-education website developed by the National Coalition for Health Professional Education in Genetics (NCHPEG), the University of Cincinnati, and the National Society of Genetic Counselors. The need to integrate genetics content into curricula and continuing education across disciplines is clear, as is the need for and benefit of multidisciplinary collaboration in patient care. The NCHPEG site for speech-language pathology and audiology begins to address those needs and may serve as a practical model for future multidisciplinary collaborations between genetics professionals and other health professions.     

Genetic education and the challenge of genomic medicine: development of core competences to support preparation of health professionals in Europe

The use of genetics and genomics within a wide range of health-care settings requires health professionals to develop expertise to practise appropriately. There is a need for a common minimum standard of competence in genetics for health professionals in Europe but because of differences in professional education and regulation between European countries, setting curricula may not be practical. Core competences are used as a basis for health professional education in many fields and settings. An Expert Group working under the auspices of the EuroGentest project and European Society of Human Genetics Education Committee agreed that a pragmatic solution to the need to establish common standards for education and practice in genetic health care was to agree to a set of core competences that could apply across Europe. These were agreed through an exhaustive process of consultation with relevant health professionals and patient groups. Sets of competences for practitioners working in primary, secondary and tertiary care have been agreed and were approved by the European Society of Human Genetics. The competences provide an appropriate framework for genetics education of health professionals across national boundaries, and the suggested learning outcomes are available to guide development of curricula that are appropriate to the national context, educational system and health-care setting of the professional involved. Collaboration between individuals from many European countries and professions has resulted in an adaptable framework for both pre-registration and continuing professional education. This competence framework has the potential to improve the quality of genetic health care for patients globally.     

Factors affecting criteria met by hospital-based patient-education programs: a Michigan experience

A patient-education program model with 18 criteria was refined into a survey instrument and sent to 217 Michigan hospitals. Of these, 181 hospitals and one free-standing clinic responded, with 47 indicating they had no applicable programs and 135 providing data on 281 existing patient-education programs. A mean (+/- SD) of 12.1 +/- 3.9 criteria were met. The range included two programs that met only one criterion and 15 that met all 18. After it was established that the criteria operated independently of each other, six factors were analyzed to observe their impact on the number of criteria met by the 281 programs. Analysis of variation (ANOVA) showed that presence and type of program coordinator accounted for 17% of explained variance, subject for 8%, hospital size for 4.4%, existence of a defined budget for 4%, and geographic location for 3%. Because of unequal numbers, the full-time/part-time coordinator factor was not included in the ANOVA. More than one third of the variance affecting numbers of criteria met by patient-education programs was explained by these factors.     

人体生命科学馆作为“三生教育”基地模式的探讨

目的探讨以人体生命科学馆作为实践教育基地的“三生教育”模式,为更好的开展大学生“三生教育”探索新的思路和方法。方法在我校公共卫生学院2010-2012级新生入学教育中,把人体生命科学馆作为实践教育基地开展“三生教育”活动,并进行问卷调查。结果85．7％的人觉得“三生教育”的开展应该理论与实践结合;87．6％的人认为把人体生命科学馆作为“三生教育”实践基地,是一种新的“三生教育”模式,具有较好的效果。结论以人体生命科学馆作为实践教育基地的“三生教育”模式加深学生个人对生命价值和意义的理解,为“三生教育”活动的开展提供较好的思路和方法。     

BSACI guidelines for the management of drug allergy

These guidelines have been prepared by the Standards of Care Committee (SOCC) of the British Society for Allergy and Clinical Immunology (BSACI) and are intended for allergists and others with a special interest in allergy. As routine or validated tests are not available for the majority of drugs, considerable experience is required for the investigation of allergic drug reactions and to undertake specific drug challenge. A missed or incorrect diagnosis of drug allergy can have serious consequences. Therefore, investigation and management of drug allergy is best carried out in specialist centres with large patient numbers and adequate competence and resources to manage complex cases. The recommendations are evidence-based but where evidence was lacking consensus was reached by the panel of specialists on the committee. The document encompasses epidemiology, risk factors, clinical patterns of drug allergy, diagnosis and treatment procedures. In order to achieve a correct diagnosis we have placed particular emphasis on obtaining an accurate clinical history and on the physical examination, as these are critical to the choice of skin tests and subsequent drug provocation. After the diagnosis of drug allergy has been established, communication of results and patient education are vital components of overall patient management.     

The physician and patient education: a review.

Education is an essential part of medical care and must be conducted properly for the patient to receive optimal benefit. Since physicians are responsible for a major portion of the health care delivered, there is a need to understand how patient education is used by these practitioners. Our current understanding of physician-patient education practices is reviewed in this paper. The frequency of patient education by physicians, the educational content and processes employed, and physician attitudes toward patient education are examined. This analysis shows that patient education is a salient issue among physicians. They report a high frequency of use of patient education with as many as 20% of visits containing a major educational intervention. The content of these interventions is weighed heavily toward instructions and information, with little assessment, monitoring or reinforcement noted. Physician attitudes toward patient education reflect an awareness of its importance and insecurity with actual educational interventions. A number of substantive issues remain to be addressed, including interventions to improve physician educational practice.     

A diabetes care team--role of diabetes specialists and certified diabetes educator]

In recent decades, diabetes care has undergone fundamental changes that have influenced the manner in which any type of diabetic patients are managed: (i) acceptance of tight metabolic control; (ii) recognition of primary care management; (iii) focus on quality improvement: and (iv) emphasis on cost containment. Then, the role of a diabetes care team has been recognized and acted upon to a far greater extent than before. Treatment of diabetes consists of two principal components: metabolic control and intervention to prevent complications. The former is a part of the primary health care scheme in which the indication for education, as well as care and treatment, frequently depend of the data produced by patients; the latter pertaining to hospital-based care. In 2001 in Japan, the number of the diabetes specialists is about 2500, and the certified diabetes educators certified are about 4300. However, the accessibility of the patients to the specialists still remains poor. Nurses, dietitians, medical technologists, pharmacists and physical therapists are eligible to take the examination of certified diabetes educator. They must be skilled at identifying the background of patients to improve care and health through life-style modification. Education for care and treatment consists of medical and educational models. In both of these, here are specific processes of diagnosis and therapy: along with medical diagnosis and treatment, through physical and laboratory examinations, assessment of the patient for indication of a curriculum by test of knowledge, skill and attitude for adequate educational therapy is necessary.     

Professional Status of Infectious Disease Specialists in Korea: A Nationwide Survey

BackgroundInfectious disease (ID) specialists are skilled facilitators of medical consultation who promote better outcomes in patient survival, antibiotic stewardship as well as healthcare safety in pandemic response. This study aimed to assess the working status of ID specialists and identify problems faced by ID professionals in Korea.MethodsThis was a nationwide cross-sectional study in Korea. An online-based survey was conducted over 11 days (from December 17–27, 2020), targeting all active adult (n = 281) and pediatric (n = 71) ID specialists in Korea (N = 352). Questions regarding the practice areas of the specialists were divided into five categories: 1) clinical practices of outpatient care, inpatient care, and consultations; 2) infection control; 3) antibiotic stewardship; 4) research; and 5) education and training. We investigated the weekly time-use patterns for these areas of practice.ResultsOf the 352 ID specialists, 195 (55.4%; 51.2% [144/281] adult and 71.8% [51/71] pediatric ID specialists) responded in the survey. Moreover, 144 (73.8%) of the total respondents were involved in all practice categories investigated. The most common practice area was outpatient service (93.8%), followed by consultation (91.3%) and inpatient service (87.7%). Specialists worked a median of 61 (interquartile range: 54–71) hours weekly: patient care, 29 (14–37) hours; research 11 (5–19) hours; infection control 4 (2–10) hours; antibiotic stewardship, 3 (1–5) hours; and education/training, 2 (2–6) hours.ConclusionID specialists in Korea simultaneously undertake multiple tasks and work long hours, highlighting the need for training and employing more ID specialists.     

Survey of asthma care in Taiwan: a comparison of asthma specialists and general practitioners.

BACKGROUND: Asthma is a common disease in Taiwan. The promotion of quality care for asthmatic patients should focus not only on new treatment remedies but also on patient adherence to treatment and a continuous education program integrated into treatment plans. One reason for patients' poor response to treatment is the lack of asthma knowledge on the part of physicians in terms of attitudes toward treatment. OBJECTIVE: To investigate the current status of asthma treatment among asthma specialists and general practitioners and their relative acceptance of and adherence to treatment guidelines. METHODS: One thousand questionnaires were distributed to physicians throughout Taiwan using a randomized sampling procedure. The questionnaire asked about the use of different kinds of medications, including inhaled corticosteroids, to treat asthma; adherence to asthma treatment guidelines; the use of a peak flow meter for monitoring asthma status; and self-efficacy in the treatment of asthma. RESULTS: A total of 526 questionnaires were returned. Of these, 90.4% of specialists and 63.2% of general practitioners would follow the guidelines for patient care (P = .002). It was significant that 79.8% of specialists but only 41.9% of general practitioners would instruct patients to use a peak flow meter to monitor symptoms (P < .001). Asthma specialists also seemed to be significantly more competent than general practitioners regarding asthma knowledge, instruction of inhalation techniques, use of peak flow meters to monitor symptoms, and making an action plan. CONCLUSIONS: To minimize the knowledge gap between specialists and general practitioners regarding asthma treatment, recognized treatment guidelines need to be popularized or simplified. Furthermore, the continuing education of general practitioners in asthma knowledge and management skills is important.     

The effects of self-assessment and supervisor feedback on residents’ patient-education competency using videoed outpatient consultations

Objectives

To determine the effects of residents’ communication self-assessment and supervisor feedback on residents’ communication-competency awareness, on their patient-education competency, and on their patients’ opinion.

Methods

The program consisted of the implementation of a communication self-assessment and feedback process using videoed outpatient consultations (video-CAF). Residents wrote down communication learning objectives during the instruction and after each video-CAF session. Residents’ patient-education competency was assessed by trained raters, using the CELI instrument. Participating patients completed a questionnaire about the contact with their physician.

Results

Forty-four residents and 21 supervisors participated in 87 video-CAF sessions. After their first video-CAF session, residents wrote down more learning objectives addressing their control and rapport skills and their listening skills. Video-CAF participation improved residents’ patient-education competency, but only in their control and rapport skills. Video-CAF participation had no effect on patients’ opinion.

Conclusions

Video-CAF appears to be a feasible procedure and might be effective in improving residents’ patient-education competency in clinical practice.

Practice implications

Video-CAF could fill the existing deficiency of communication training in residency programs.     

Patient education in Switzerland: from diabetes to chronic diseases

The Division of Therapeutic Education for Chronic Diseases at the University Hospital of Geneva has been playing an important role in the field of therapeutic patient education for more than 25 years. More than 16,000 patients have been hospitalised and an excess of 75,000 h have been spent with a rather novel interdisciplinary approach involving doctors, nurses, dieticians, psychologists, podiatrists and pedagogues. For the past 12 years, our division has held over 50 seminars of 1-week postgraduate training attended by over 3000 participants coming from more than 60 countries worldwide. In 1998, the faculty of medicine at the University of Geneva implemented a 3-year curriculum on therapeutic patient education leading to a postgraduate university diploma. In 1983, the WHO designated the Swiss teaching division as a WHO Collaborating Center for reference and research in diabetes education. In 1998, a WHO-Euro Working Group Report entitled "Therapeutic Patient Education. Continuing education programmes for health care providers in the field of prevention of chronic diseases" was published.     

Patient education in Europe: united differences

This issue of Patient Education and Counseling presents the state of the art of patient education in several European countries. It is based on papers presented at a meeting in Paris on the evolution and development of patient education in western, central and eastern Europe (May 1999). Also patient education in the US is presented in this issue. Patient education is defined as all the educational activities directed to patients, including aspects of therapeutic education, health education and clinical health promotion. Five important factors are identified in the development of patient education: (1) research and evidence based standards; (2) the organization of care; (3) training and methodological support; (4) professional values; and (5) acknowledgment, funding and place of patient education in health policy. Several of the discussed common orientations and priorities in the patient education in the reviewed countries are highlighted in this issue. And finally, an example of the possible integrated international practice in patient education in the field of diabetes is described in this issue. Several conclusions are drawn concerning future development of communication in health care within the framework of patient education in Europe.     

Handoffs in the era of duty hours reform: a focused review and strategy to address changes in the Accreditation Council for Graduate Medical Education Common Program Requirements

With changes in the Accreditation Council for Graduate Medical Education (ACGME) Common Program Requirements related to transitions in care effective July 1, 2011, sponsoring institutions and training programs must develop a common structure for transitions in care as well as comprehensive curricula to teach and evaluate patient handoffs. In response to these changes, within the Duke University Health System, the resident-led Graduate Medical Education Patient Safety and Quality Council performed a focused review of the handoffs literature and developed a plan for comprehensive handoff education and evaluation for residents and fellows at Duke. The authors present the results of their focused review, concentrating on the three areas of new ACGME expectations--structure, education, and evaluation--and describe how their findings informed the broader initiative to comprehensively address transitions in care managed by residents and fellows. The process of developing both institution-level and program-level initiatives is reviewed, including the development of an interdisciplinary minimal data set for handoff core content, training and education programs, and an evaluation strategy. The authors believe the final plan fully addresses both Duke's internal goals and the revised ACGME Common Program Requirements and may serve as a model for other institutions to comprehensively address transitions in care and to incorporate resident and fellow leadership into a broad, health-system-level quality improvement initiative.