When providing patient education, individualize the information; prioritize the information most important to the patient, focusing on expressed concerns and demonstrated knowledge gaps. When individuals are presented with too much information at once, they may forget or remember incorrectly much of the information provided.
For this process to be successful, the patient needs to have the new information integrated into their knowledge base. This integration requires several steps. The patient will need to have...
heard the information (not always easy if they are distracted or anxious)
understood the information--which requires it to have been delivered in a language they speak, using terms they know
remembered the information
processed the information in order to recall it when needed
Integrated the new information into their knowledge base in order to use it as part of decision making
People don’t take in large amounts of information all at once. People can integrate quite a bit of new information if it is broken up with questions.
Skills for sharing information
Integrating New Information
Assuming that someone hears and can understand the information, these things can help ensure the patient integrates the new information so they can make an informed choice:
Highlight important facts by presenting them first.
Individualize the information. Focus on the particular needs and knowledge gaps identified during the conversation.
Prioritize essential points. Ask yourself: what is the one thing they really need to know? Avoid giving a pathophysiology lecture.
Give digestible amounts of new information. Rather than presenting everything all at once, break up the content and thread relevant bits throughout the conversation.
Follow each bit of information with a question. The process of thinking about and answering a question requiressomeone to integrate information in order to give a rational answer.
Give one piece of information sandwiched between two questions
Visual and Tactile Aids
People learn and integrate information in different ways. Many patients are visual and tactile learners. To facilitate this type of learning, providers should have these types of tools to present information:
Samples of contraceptive methods to hand patients
Videos to demonstrate method use
Handouts to take home
Pay close attention to what patients say about reproductive goals, contraception preferences or other life circumstances. In addition to listening to the words, pay attention to tone of voice (happy, fearful, negative, concerned), body language (leaning forward, open stance or arms crossed indicating they are closed off), and facial expression. For example, does the person seem to be excited about the idea of being a parent someday (or having another child) or do they seem put off by the idea?
Reflective listening is not repeating verbatim what was said. Re-phrase what the person has said using different words to capture the essence of what was meant. If you are not clear on a point, use reflective listening to clarify. You can gather pieces of information your patient has mentioned throughout the conversation when you use reflective listening as a way to summarize.
Begin with an introduction like the following: “So I’m hearing you say…”
Then, after you have shared your reflection, say something like, “Did I get that right?” Throughout the visit, it helps to intermittently clarify, repeat, or summarize the attitudes and decisions that a patient has made.
Health literacy considerations are paramount. As health care providers, we are comfortable with use of percentages, relative risk, and absolute risk. Some patients have less understanding of these concepts and may not be able to use the “data” to help inform their decisions if they don’t have appropriate context or background. When describing relative risk; comparing characteristics such as effectiveness or risk of a particular outcome, use common denominators:
“If 100 people have unprotected sex for a year, 85 of them will get pregnant as compared with maybe 1 or none using an IUD.”
“If a person switches from the pill to an implant, the chance of pregnancy decreases from 7 in 100 to less than 1 in 100.”
Examples of Plain Language:
the place where a baby grows
through your whole body
how well it works
true, right, correct
your ability to get pregnant (...goes back to what ever is normal for you)
Return to fertility
ability to get pregnant
bleeding that goes on for a long time and can be annoying
Frequent or prolonged bleeding
(changes) the way your period comes
Menstrual Changes, bleeding profile