Interactive Patient Communication: Understanding Adult Learning

patient communication

Why does health literacy get so much attention in today’s healthcare system?

Evidence confirms that when patients and family members are engaged in care, patient outcomes improve.1 Patient participation in interactive education ensures that patients are involved in making healthcare decisions, which in turn helps to ensure that care is safer and more reliable.2

Rehabilitation professionals, including nurses, PTs, and OTs, are in the unique position of having the knowledge and skill required to creatively fashion approaches that take advantage of learning styles and preferences. These can serve to reinforce patient knowledge and skills gained as well as celebrate achievement.

Learning approaches to teaching that are specific to the domains of learning, along with tools to evaluate the effectiveness of your teaching, are key when it comes to engaging your patients and helping them get the most out of their rehabilitation care.

Teaching to Each Individual’s Learning Needs

Every patient has individual learning needs. While these vary from person to person, they also vary based on current health needs, including new or chronic disease and disability. You probably already know that one approach to patient education isn’t going to work for every patient.

For example, a middle-aged adult who is admitted to your rehabilitation unit with a left lower extremity amputation due to diabetes-related peripheral vascular disease has very complex education needs. Your knowledge and skill in patient education around such topics as diabetes management, skin care, phantom pain and sensation, and fall prevention are critical to helping this patient own and manage their health, function, and social needs beyond discharge.

While rehabilitation professionals usually take advantage of every teaching opportunity in collaboration with interdisciplinary team members, you must ensure that your patient learns this crucial information.

The Domains of Learning

The domains of learning are:

  • Cognitive or knowledge, which includes content knowledge and the ability to recall specific facts and concepts
  • Psychomotor or skills, which includes physical movement, coordination, and fine and gross motor skills
  • Affective or attitude, which includes feelings, values, and motivation

Given the differences between these domains, it makes sense that the education strategies for content, teaching, and learning evaluation methods are also different. You can evaluate learning in the cognitive domain using techniques like teach back, in which you have the patient repeat back to you the instructions you provided. To evaluate learning in the psychomotor domain, you can have the patient utilize the show-back technique, or physically demonstrate their understanding. Finally, in the affective domain, you can appeal to a patient’s emotions and personal values to help them see the value in what you are teaching them.

Two-Way Communication

Two-way interaction is essential to communication. Systems theory provides the framework for this two-way process, which is affected by:

  • The role of the message sender (you)—Are you using plain language to explain key concepts?
  • The environment in which learning takes place—Are there distractions and noise that can impede learning?
  • The receiver of the message (your patient)—What is your patient’s health literacy level? Are they under stress or do they have other limitations that might make it more difficult to understand the instructions being provided?
  • Available teaching aids and tools—Are your teaching tools designed with adult learning best practices in mind? Do they use plain language and clear graphics to illustrate concepts? Tip: MedBridge’s library of 400+ patient education resources meet these criteria and include education on type 2 diabetes, fall prevention, ADLs, transfers, and more!

For an example, see the patient education video below on type 2 diabetes!

Remember—all rehab professionals are educators, but teaching skills must be developed, improved, and evaluated. These skills, which serve as the basis for individualized education, include facilitated learning, teach-back for cognitive domain learning, and show-back for psychomotor skills domain learning.

Want to better position yourself to design and modify patient-centered and engaged education approaches? Dive deeper into these skills in the MedBridge course, “How Effective Is Your Patient Fall Prevention Education?”

As a rehabilitation professional, your goals are to improve your patients’ function, independence, confidence, and safety. Expanding your teaching and patient engagement skills will help you reach those goals.

  1. Hibbard, J. H. & Greene, J. (2013). What the evidence shows about patient activation: Better health outcomes and care experiences; fewer data on costs. Health Affairs, 32(2).
  2. Longtin, Y., Sax, H., Leape, L. L., Sheridan, S. E., Donaldson, L., & Pittet, D. (2010). Patient participation: Current knowledge and applicability to patient safety. Mayo Clinic Proceedings, 85(1): 53–62.