Patient Education: Behavioral Change Or Clinician Monologue?

Health care is chock full of a lot of telling. Telling the patient to do this or that. Telling the patient to not do something. There is a lot of telling going on around the health care world.

Health care has its share of intelligent people doing the telling. And I have no doubt that there are many that are telling patients a lot of good things.

But one problem exists. We mistakenly focus on adherence and compliance with all the telling and immediately assume that behavioral change goes right along with it. A faulty assumption, indeed.

Bob Pike, author of the book “Creative Training Techniques Handbook”, has spoken extensively on the topic of adult learning. One of his "Laws Of Adult Learning" is this:

"Learning has not taken place unless behavior has changed"

When it comes to chronic conditions such as diabetes or obesity or osteoarthritis, long-term changes in behavior are critical. Go ahead and focus on the short-term stuff all you want. However, the true long-term impact in terms of health care costs and quality of life lies in lifestyle and behavioral changes. This requires an approach to care that has a strong cognitive and behavioral component, one that emphasizes independence, mentorship, and active strategies.

The same rules apply throughout musculoskeletal care as well. Frankly, there is no reason to think otherwise.

But our world of health care is full of telling - with little to no assessment of behavioral change or patient-focused value-added benefit. It amounts to a mentality of "just do it because I am the clinician with the degree". Clinical care becomes a series of monologues, first clinician then patient. It is one soapbox moment followed by another.

There is a difference between talking at someone and having a dialogue, between saying "patient-centered" and acting in accordance with it.

Effective adult learning involves the participant being active in their learning and in charge of it. This is well-established. So why does the majority of patient education run afoul of this core principle of adult learning?

Does your patient education take on the look of a lecture series? Or are you having a true dialogue with the patient and allowing them to be an active participant in not only their care but in their life-long learning as well?

Photo credits: garryknight

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