Talking the patient's language: The role of instructional design
Christopher Kelly, MEd
Jan 19, 2018

The aim of instructional design is to use the best practices in communication and design to create practical tools and techniques that will help healthcare professionals to get the message across to patients and their caregivers

Patients who are engaged with their own health, whether to prevent ill health or manage disease, are more likely to change their behavior, adhere to their treatment, and follow the regular care that they need. Higher levels of patient activation and engagement are shown to be beneficial to all stakeholders. For example, improved outcomes for patients could mean less need for hospitalization and emergency care, taking the pressure off healthcare professionals and lowering healthcare costs for payers.

Encouraging patient engagement can be difficult, with as many as 56% of people showing little or no engagement in their healthcare. The goal of patient engagement is to support and encourage healthcare professionals to educate, engage and activate their patients, helping them to understand why it is important to change behavior and adhere to treatment. 

Building patient engagement and activation

Patient communication and support are built around 3 pillars:

Instructional design

Health literacy guidelines

Behavior change models

Each of these components alone plays an important role, but together they create a powerful combination. 

Using instructional design

The aim of instructional design is to use best practices in communication and design to create practical tools and techniques that will help healthcare professionals effectively educate patients and their caregivers. These tools, which can be in print or digital formats, can include images, analogies and stories to improve patient understanding of their condition and its treatment. 

Patients can sometimes feel lost and vulnerable in the treatment pathway, not knowing what is going to happen next. Instructional design can be used to create action plans and checklists, and teach patients skills, such as how to get the most out of a consultation with a healthcare professional or how to use an unfamiliar drug delivery device.

What the evidence says

Instructional design as a strategy to support engagement and behavior change is supported by research. In an approach known as Brief Action Planning, designed to be used by individual providers and healthcare teams, patients and healthcare professionals worked on patient-centered goal setting to create an action plan for self-management. Between half and three-quarters of the patients who were ready to start self-management planning went on to develop an action plan. A total of 53% of the patients who made action plans went on to complete them in a 3-week follow-up. In a study of an online self-management support program, around half of the patients fully completed their action plans.

What the professionals say

In a recent webinar poll, our audience was asked: "How can we improve patient engagement?"

Around 50% of the audience said they thought that the inclusion of patient tools and resources was the most important approach. To meet this need, multimodal and interactive tools need to be developed to work with all learning styles and have an impact on all stakeholders, including patients, caregivers and families, and healthcare professionals across the spectrum.

From the patient's perspective

During the webinar, Keith and Judy, both caregivers of immediate family over several years, reinforced the importance of developing tools and techniques that touch all stakeholders and work with all learning styles. While talking about their experience of patient engagement, they expressed that they felt a lot more engaged when healthcare professionals took the time to listen to them, explain the process with action plans and outline what to expect next. Each time Keith and Judy found out more information, for example through seminars, they integrated this into their action plan, and found that this was really useful as they continued caring.

There can be a lot for patients and caregivers to take in, especially at first diagnosis or when treatments change. Large quantities of text may not be useful. Designers and developers need to step back and try to see the patient or caregiver point of view. This may be as simple as using a large font and lots of white space, or remembering to use lay language. It can also be about structuring information differently, using bullet points and checklists, and keeping things clear, concise and simple. It is also important for designers involved in instructional design to have a clear understanding of a patient's level of health literacy and to follow the health literacy guidelines.

To learn more about how to speak the patients' language, please watch the on-demand webinar (registration required).

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