Wednesday, September 19, 2012

The flipped classroom model for patient education

The world of education is being reinvented, thanks to the Khan Academy ! Flipped classrooms have become an extremely popular way of educating students , instead of the traditional method where students would be locked up in a classroom , and forced to listen to a teacher who would drone on and on using the chalk and talk method , in order to transmit facts which experts had decided were required to create educated adults. The teacher would then assign homework , to make sure that the students had learned these facts , so that they could regurgitate them at the time of the examination. This was the traditional model, which most of us were brought up on . It was not a very successful or a useful model,  because it never respected the learner. While some of us are good at cramming facts and passing exams, most of us probably forget everything we were taught the moment the exam was over , because a lot of the material taught in school was completely irrelevant to our daily lives .

Patient education can learn a lot from this flipped classroom model as well. What happens today is that the patient comes to the doctor , and then within the 10- 15 minute consultation, not only does the doctor have to take a history, do an examination , make a diagnosis and order tests, he also has to educate the patient about his illness and his treatment options . Obviously this is an extremely tall order , which is why it is hardly surprising that it fails so miserably ! This is  why most doctors often do such a bad job at patient education.

Just like students are not blank slates , waiting to be written on by the teacher ( or empty vessels , waiting to be filled up with knowledge hoarded by the teacher), patients are no longer are ignorant illiterates who come to the doctor for his expert advice and knowledge . Most patients these days are well informed ; and capable of finding information for themselves. While this does create its own set of problems , because they often end up with erroneous information, which confuses them, the fact still remains that patients have preconceived notions and ideas about their illness . We need to take advantage of the fact that when patients come to a doctor , they have already done a certain amount of homework for themselves . Smart doctors can actually use this as an opportunity to make sure that patients are armed with the right information , before they come to the doctor .

While it’s not always possible to use this method ( for example, during an emergency ), this works very well for most patients – for example, those with  chronic diseases . When the patient calls the clinic for an appointment , the receptionist can guide the patient to the clinic website . Here, the clinic can use products such as the Healthwise Knowledgebase to deliver information therapy to the patient, which is tailored and targeted to the patient's needs ! With this approach, the patient comes prepared with appropriate information by the time he comes to the doctor’s clinic. Not only does he know quite a lot about his problem , possible diagnoses , and possible treatment options , he can engage the doctor in a much more highly evolved conversation , which is likely to be more professionally satisfying for the doctor as well ! The doctor does not need to repeat the basics , as the website has already provided this information to the patient. This way the patient has done a lot of his homework before coming to the doctor - and even after the consultation is over , the doctor can continue to refer the patient to the website,  so that he has ongoing access to information as his problem evolves and his needs change.

This is a much more sophisticated model , because the doctor no longer serves as a bottleneck , either because of a shortage of time or energy or inability or lack of inclination to teach patients. Rather , it is the patient who is made to do the homework , and the role of the doctor is to act as a facilitator and coach to guide the patient to the right sources of information ; and help them apply this information to their particular specific problem. This is the kind of win-win situation, which the flipped classroom model has already succeeded in doing in schools, and which we can use to improve patient education as well.

Some of these patients will end up becoming expert patients ; and the doctor can then tap into their skill sets and use their knowledge, ability and experience to engage and educate other patients as well, thus creating a positive virtuous cycle, in which the patients do most of the work !
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