1. Educating the patient with COPD

2. Objective:
Explain the rational/value of the patient
education.
List and explain the four components of the
patient education process
Identify the barriers to learning
List and explain the principles of adult learning.

3. Illness/Wellness Continuum:
TotalWellness
Premature
Death
Disability Signs No Risks Motivation Well-Being
Symptoms Risks Education
Behavior
Change
Wellness Model (New
Thinking)
Illness Model (Old
Thinking)

4. Patient Education is a process....
With 4 distinct components...
Assessment
Planning
Implementation
Evaluation
Assessment
Planning
Implementation
Evaluation
Think of the four pieces of the pie

5. Assessment
-The 1st and most overlooked component of the patient
education process-
Assessing the need for patient education
(perform a mini-needs assessment).
Identifying common problems of the learner
(barriers to learning).
Assessing readiness of learner.

6. Frequently Asked Assessment
Questions:
Does the patient understand the nature of
his/her disease? The pathophysiology?
Is he/she aware of the risk factors for
progression of the disease?
Does he/she understand strategies to help
minimize dyspnea?
Advice when to seek help?
Has previous education about his/her condition
been provided?

7. Frequently Asked Assessment
Questions:
Does he/she understand the role of medication?
Does he/she smoke, drink?
Does he/she maintain on exercise program? Use
inhalers? Oxygen?
What is his/her level of education is he/she
literate?
Is Arabic the primary language spoken at home?
Are there any unusual cultural influences on
his/her health beliefs or practices?
Is there adequate medical coverage?

8. Common Problems of the learner
-barrier to learning-
Lack of readiness – stages of learning.
Physical obstacles – sensory deprivation,
discomfort/ illness, energy limitations,
decreased mobility.
Emotional obstacles – denial, anger, depression,
withdrawal, anxiety, low self esteem.

9. Common Problems of The
Learner
- barriers to learning-
Language and culture – multiple dialects,
religious beliefs, diversity of socioeconomic
groups
Low health literacy level
Reading level – average adults at 8th grade level
(in US).

10. Key Risk Factors for Limited
Literacy:
Elderly
Low income
Unemployment
Did not finish high school
Minority ethic group
Recent immigrant who do not speak local
language
Born in Egypt but Arabic is second language

11. Low Health Literacy is Associated
With:
Medications
Appointment slips
Informed consent
Discharge instructions
Health education materials
Insurance applications

12. Steps to Address/Improve low
Literacy Levels
Slow down
Use plain language, non-medical language
Show or draw pictures
Limit the amount of information provided, and
repeat it
Use the teach-back or show-me technique

13. Assessing Readiness
-Stages of Learning-
Precontemplative stage
Contemplative stage
Action stage
Maintenance stage/ termination stage

14. Planning
-the 2nd component of the patient education process-
Establishing goals and objectives
Learning domains:
▫ Cognitive
▫ Psychomotor
▫ Affective
Develop content

15. Planning is all about having
directions and planning entails...
Goals and objective:
 Goals are generally broad statements of what
would you like to accomplish and should be
“SMART”
Objectives are more specific and should follow
the “ABCD” rule.

16. Goal Statements should be:
Specific
Measurable
Achievable/Attainable
Realistic/Relevant
Timelines/ Trackable.

17. The ABCD’s of
Audience – The who
Behavior – the what
Condition – the how – any circumstances or
conditions that must be met
Degree – another how – to degree of accuracy,
or to what standards.

18. Example
Given the components of a metered- dose
inhaler and without the aid of the RT or
manufacturer‟s literature (condition), the patient
(audience) will be able to assemble a metered-dose
inhaler (behavior) in assembled working order
within 3 minutes (degree).
Legend:
o A = Audience
o B = Behavior
o C = Condition
o D = Degree

19. Learning Domains:
Cognitive - the knowing (being book smart –
knowing the factors), what is COPD, what meds
should I take, what are signs/symptoms.
Psychomotor – the doing (being able to
perform certain skills), how to monitor your BP,
how to use your MDI
Affective – the attitudes / feeling (how patient
perspective illness – what they think/ believe),
do they believe that the meds work, that they can
control their COPD?

20. Another View of How We Learn
- the three learning domains -
Cognitive Psychomotor Affective
The point: we have to know the facts, be able to perform or do, and
finally have feeling towards it

21. Implementation
-The 3rd component of the patient education process-
Teaching/learning
Learning styles
The actual teaching (principles of adult
learning)
The teaching methodology:
▫ Lecture
▫ Demonstration
▫ Audiovisuals
▫ Printed materials
▫ Simulations
▫ Role playing

22. Patient Education Skills
-Definition-
Teaching - is the process of sharing , knowledge
and insight, or facilitating (../ „ another to
learn knowledge, insight, „ and/or skills
Learning - is the process of acquiring wisdom,
knowledge, or skill; an overt change in
behavior may be observed

23. A Word about Learning and
Learning Styles....
Do you find yourself not being able to get your
point across to certain patients?
Getting a confusing look, a look that tells you
they may not fully understand
Why is that so?
Answer: research suggest that teaching/
learning styles may be misaligned

24. Learning Styles
 Visual
 Auditory
 Tactile
Point: Patients learn differently and for more effective patient
teaching align your teaching style with your patient's learning
style

25. Learning Styles
-Implications for Visual Learners-
 Important for them to organize their learning
 Use color-coded highlighting
 Use illustrations , graphs, diagram
 Use visual analogies
 Use flashcards
 Include videotapes in learning
 Encourage them to take notes

26. Learning Styles
-Implications for Auditory Learners-
Encourage them to explain to others repeat
rhymes to remember facts , dates, names
Make up songs to coincide with subject matter
read explanations out loud
Use audiotapes to review
Record lectures
Say words in syllables

27. Learning Styles
-Implications for Tactile Learners-
 Hold book in hand while reading
 Encourage to stand when giving explanations
 Involve writing while reading/ talking
 Sit near front of class
 Use gestures when explaining
 Allow for extra time in lab sessions
 Use flash cards
 Use role playing when reviewing
 Use hands -on experiences
 Offer field trips

28. Learning Style:
We should attempt .. to identify the learning
style of our pat1ent and employ teaching
methods that complement his/her needs.
Some are visual, some auditory, some tactile
Point: patients will often subtlety tell you their preferred
learning style in the way they respond to you

29. Learning Domains
Teaching Strategies:
• Cognitive
• Psychomotor
• Affective
• lecture/guided discussion
audiovisual aid
• printed materials
• demonstration/drills
• instructional guide
• group discussion/role play
case study/ simulation
Learning Domains Teaching Method of Choice

30. Evaluation
-The 4th and last component of the patient education
process-
 Evaluation of patient education process
 Evaluation of individual learning (did it work?)
Point: return demonstration is considered a superior
method of evaluation.

31. The Basics of Effective Patient
Teaching
*Principles of adult Learning*

32. The Nine Basic Principles of Adult
Learning:
•Recency •Feedback
•Appropriateness •Active Learning
•Motivation •Multiple sense
•Primacy learning •2
•Exercise
Point: remember the expression ''ramp-2-fame"

33. Impressed the importance/ centrality of pt ed
Defined patient education and related terms
Identified the 4 components of the pt ed .
process
Identified barriers to learning
Principles of adult learning (Ramp-2-Fame)
Concluding remarks