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Effective Patient Teaching (EPT), a course designed to improve health professionals' and health professions students' teaching skills, reliably produces gains in participants' skills when presented by its developers. The objective of this dissemination research study was to investigate whether, using a 'training of trainers' approach, seven nurses with staff development responsibilities in five different sites could teach EPT with similar effectiveness. The evaluation included pre- and post-course analysis of audiotaped patient education sessions conducted by 48 health professional participants who took EPT from one of the trainers in their home institutions. Post-course participant satisfaction surveys were also administered. EPT resulted in teaching skill improvements in four of five sites, and overall teaching skills scores improved significantly (P < 0.01). EPT can improve participants' teaching skills when taught by health professional trainers with staff development responsibilities who have recently received EPT training.

This study's hypotheses were that both shortly after instruction and after an 8-month follow-up, diabetic children taught via anchored instruction (AI), a format for problem solving, would outperform controls. Subjects were 8 1 9–15-year-old campers with insulin dependent diabetes who were randomly assigned to AI or control groups for two 45-min small group teaching sessions. AIs viewed a video about a girl who mismanages her diabetes during intercurrent illness, and they were challenged to identify, define and solve her errors. Controls learned sick-day management via conventional direct instruction. At the end of the 2-week camp, AI and control groups' scores on factual knowledge were equal. AIs were more likely than controls at the end of the camp (0.75 vs. 0.54, P < 0.05) and 8 months later (0.59 vs. 0.38, P < 0.02) to provide a rationale for the use of remembered guidelines. Across all campers, this ability to link guidelines and their rationales was significantly correlated (r = 0.55, P < 0.01) with the number of self-management practices employed by campers who suffered an illness between the end of camp and the 8-month follow-up. Only one long-term behavioral difference between groups emerged: AIs' parents shared in making most diabetes decisions on sick days, while controls' parents left more decision making to their children. AI appears at least as good as conventional teaching, and may better 'link' rules and reasons, perhaps aiding daily real-life problem solving.

Nutrition counseling is often not effective, I and one obstacle may be the quality of the patient education being offered. Specifically, many dietitians have not had formal instruction in teaching, and many do not routinely employ teaching skills known to enhance instructional effectiveness.3•4 There have been calls for teaching skills training for nutritionists, and many health professionals desire such instruction.4.5 Unfortunately, it has not been widely available or accessible. This article reports an evaluation of a course on skills for teaching patients when it was translated from the institution where it was developed to another academic setting. The course "Effective Patient Teaching" (EPT) has been offered both as an elective to health professions students and as a continuing education course for health professionals.79 Course time (30 hours) is equally divided between facultyled lecture-discussions and four to five videotaped "microteaching"IO exercises in which classmates serve as surrogate patients, and participants are able to practice 20 selected teaching skills (Table 1) and receive feedback on their effectiveness. The individual items form four subgroups. For example, Interpersonal Skills help build trust and rapport. Essential Teaching Functions are general strategies that should form a framework for most teaching. Presentation Skills help make instruction memorable (i.e., they improve efficiency). Finally, Adherence Promotion Skills are used to improve the likelihood that patients will apply what they learn. Evaluations show that EPT improves the patient teaching skills of undergraduate medical and nursing students8• and practicing health professionals. II •12 EPT may prove a helpful response to the need for teaching skills instruction for undergraduate nutrition stu

We developed a home study version of an established and successful workshop program called Effective Patient Teaching (EPT), making use of suggested guidelines for developing home study courses. The self-study modules we produced consisted of workbook materials, videotaped illustrations, and practice exercises, all of which focused on patient teaching and counseling skills. During a period of 2 years and 3 months, 28 participants enrolled in the home study course. Only one participant completed the entire course. Another participant completed the portion purchased. The barrier most commonly cited as preventing completion of the home study course was other work-related deadlines. We suspect that our requirement for a feedback procedure (either an audio- or n videotape of an instruction interview) may also have prevented submission of a completed course. The low, completion rate made quantitative evaluations impossible. Although the literature includes reported successes in the use of self-learning courses, few formal evaluations have been conducted and reported. The efficacy of home study courses, particularly when enhanced skill is the desired outcome rather than knowledge gain, is yet to be e published, and merits close examination and rigorous evaluations.

Many health professionals lack important teaching skills, perhaps adding to patient difficulties in understanding and adopting therapeutic diets. Research suggests that teaching skills improved after dietitians took a continuing education course entitled "Effective Patient Teaching." Our study tested whether dietitians' new skills would persist in the field and whether selected patient outcomes would differ as a result. Thirty staff dietitians from six urban hospitals were videotaped teaching patients, then randomly assigned to take the Effective Patient Teaching course or not (control group). Follow-up videotapes were made after 1 week, 1 month, and 3 months. After each teaching session, patient satisfaction and recall were assessed. Two judges rated 20 teaching skills, which were divided into four subsets for analysis. Repeated measures analyses of variance showed overall gains only for the group that took the Effective Patient Teaching course, which scored higher than the control group at 1 week and 1 month, but not at baseline or 3 months. Gains occurred in presentation skills and essential teaching functions. Throughout the study, interpersonal skills were high and adherence promotion skills were low for dietitians in both groups. Groups did not differ on patient satisfaction or recall. Improvements in dietitians' teaching skills translated to the field immediately after they completed the continuing education program, but not all gains were sustained after 3 months. We recommend that dietitians assess their teaching and adherence promotion skills, obtain training where warranted, and periodically reassess the application of those skills during patient teaching sessions.

Effective Patient Teaching (EPT), a health professions continuing education course, improves educators' teaching skills when presented by its developers. This study aimed to determine whether others could teach EPT with similar effectiveness. Four nurse mnagers who provide stafftraining and supervision for multiple hospital diabetes care units presented EPT to health care professionals at seven such sites; another seven served as controls. The evaluation included observations of trainers conducting EPT programs in thefiel4 teaching shills ratings of health professionals in both groups, and bowledge tests administered to patients. Six months ter training, teaching skills scores of health professional EPT participants were better (p < .05) than controls. The EPT program improves participants' teaching skills and maintains these effects infield settings, when presented byfaculty not involved in its development.

Even following education sessions, dietary adherence among medical patients is generally poor. One contributor to this problem may be the quality of teaching and adherence promotion skills employed by Registered Dietitians, whose behavior during routine patient interactions was evaluated in this observational study. Thirty dietitians were videotaped with one of their patients. Twenty operationally defined skills were rated on a scale from 0 (skill absent) to 3 (excellent). Dietitians' interpersonal skills were good (mean = 2.1, S.D. = 0.35), but all other skills were performed significantly less well (mean scores less than 1.0). Adherence promotion skills were rarely observed. Dietitians need supplemental training to improve teaching and adherence promotion skills.

Medical educators increasingly recognize patient education skills as an important component of professional curricula. Previous studies have suggested that a 30‐hr course, “Effective Patient Teaching,”; improves health professionals’ instructional skills. This study was designed to further evaluate program impact on students’ teaching skills and on their patients’ recall. Course participants and untrained matched volunteers were asked to provide instruction based on standard content material. College students served as surrogate patients. After instruction, surrogate patients completed a recall questionnaire on the standard content. Course participants exceeded controls on 10 of 16 selected teaching skills. Trained students also taught more content (p < .01), and their patients recalled more of what was taught (p < .05). Time spent teaching was not a significant covariate. Extent of use of teaching skills correlated significantly with patients'recall (r = .57, p < .01). The results suggest that training t...

Patient education is an increasingly important part of modern health care. Health professionals' ability to effectively teach their patients is therefore an important concern for medical educators. This report describes a program designed to improve health professionals' teaching skills. Effective Patient Teaching is a 30-hour course which targets 20 specific teaching skills. Course time is approximately equally divided between lectures/demonstrations by faculty, and practice teaching by participants, followed by individual feedback. Comparison of first and last practice teaching sessions to operational definitions of teaching skills showed signifiant improvement in most teaching skills. This study suggests that rapid improvement in health professionals' patient teaching skills can be achieved in a program that includes modeling of effective skills, supervised practice, and appropriate feedback.