II. Approach
- Patient Education effectiveness relies on the rapport and trust built from the patient-clinician relationship
- Sit down during the patient encounter
- Use open ended, non-judgmental questions and employ engaged, active listening
- Assist patients with reliable information they may use in making decisions based on their values
- Avoid prescriptive and paternalistic approach
- Provide information in small parts and reassess for understanding ("chunking")
- Employ anonymized patient stories and clinician experiences where appropriate
- Discuss both risks and benefits of recommended testing and treatment
III. Precautions: Health Misinformation and Disinformation
- Definitions
- Misinformation
- False information not delivered with malice
- Disinformation
- False information delivered as a deliberate attempt at deception
- Misinformation
- Patient Education remains an important strategy in primary, secondary and tertiary prevention
- As clinicians, we bring an added credibilty and patient trust to Patient Education
- U.S. medical certification boards and licensing organizations emphasize reliable information
- Clinician spread of misinformation counter to standard of care may result in loss of license, certification
- Health disinformation and misinformation risks serious outcomes and death
- Covid19 misinformation in 2020-2022 resulted in under-Vaccination and mask resistance
- Estimated 163,000 excess covid deaths preventable with Vaccination U.S. June to November 2021
- https://www.healthsystemtracker.org/brief/covid19-and-other-leading-causes-of-death-in-the-us/
- FAD Diets and supplements of the late 1900s-2000s
- Anti-Vaccination movements (from Smallpox to Measles)
- Medicine shows of the 1800s (e.g. snake oil)
- Covid19 misinformation in 2020-2022 resulted in under-Vaccination and mask resistance
- Approach: Follow the 3Cs (see Misinfo Rx Toolkit below)
- Compassionate Understanding
- Use open ended, non-judgmental questions (e.g. "what concerns you most")
- Employ engaged, active listening
- Understand the patient's framework (cultural, religious, community morals, values and approved behaviors)
- Connection
- Empathize with patient's concerns and acknowledge their initiative to seek health information
- Acknowledge true statements that the patient made as well as unknowns
- Ask permission to share information you feel is important and related to the topic
- Identify the most important key falsehoods and the evidence that dispells those ideas
- Ask the patient, their feelings and thoughts regarding this new information
- Share reliable resources in the form that the patient prefers to get their information
- Collaboration
- Identify common goals that you and the patient share regarding their own health
- Express your support for them to reach these health goals
- Express your strongest, most important recommendations
- Accept disagreement and the need to continue to readdress at future encounters
- Compassionate Understanding
- Precautions
- Avoid engaging with false information sources online
- Responding, resharing, commenting, correcting may amplify the misinformation due to search algorithms
- Expose internet users to accurate, reliable health information
- For those who have an online presence, consistently post accurate and reliable health information
- Recognize the power of trust in medical providers to provide accurate medical information
- Also be honest and straightforward when evidence is lacking, and expert opinion is the only guidance
- Avoid engaging with false information sources online
- Resources
- U.S. Surgeon General Statement regarding health misinformation
- Debunking Misinformation as "Science" (Hemmer, CNN)
- Misinfo Rx Toolkit
- References
IV. Resources
- Healthfinder
- Mayo Clinic
- JAMA Patient Page
- Family Doctor (AAFP)
- Medline Plus
V. References
- Barnes, Aust and Leaf (2022) Crit Dec Emerg Med 36(1): 21-25