Insights From Nursing Students About Patient Teaching: Are We Getting a Passing Grade?

The purpose of this focused ethnography study is to determine students ‘perceptions of their preparation to engage in patient teaching and factors related to its implementation. The general aim of professional education is to be leaders within the profession. A key nursing entry to practice competency identified by many professional nursing practice organizations and undergraduate nursing programs relates to ensuring that patients have the knowledge and skill to achieve optimal health (Canadian Nurses Association, 2015; American Nurses Association, 2010). Patient teaching is recognized as a key component of nursing practice and yet patient teaching has been described as haphazard ((Kendal, Deacon-Crouch, & Raymond, 2007). If patients do not understand what is being taught, the risk of complications and readmission can increase (Kornburger et al., 2013). As well, students view clinical faculty as leaders and their perceptions of the importance of patient teaching have a profound effect on students (Lenz, 2013). The literature also supports rethinking health education in the nursing curriculum to support interprofessional educational initiatives in order to make connections to the social determinants of health (Zancheta, et al., 2013).

A focused ethnographic approach was chosen because it is a time limited exploratory study focused on a select behavior or area of belief among a specific group of people (Speziale & Carpenter, 2011). Focus groups are advantageous because they are flexible and cost effective, assist in recall, and create a cumulative free exchange of ideas that can be explored within a group setting.  The synergistic effects of the interactions within the focus groups was evident. The second form of data collection was shorter individual interviews which were effective in providing more in-depth data and confirming the emerging themes.

Results from the study show that although students realize the importance of patient teaching that there is disconnect between the perceived importance and the implementation of patient teaching in clinical settings.  When there is a strong commitment for patient teaching in the clinical culture and from the course instructor, patient teaching is easily engaged. Students’ internal factors facilitating patient teaching include: confidence, feeling prepared, knowing the material, and experience teaching. External factors facilitating patient teaching include: receptivity of patients to teaching and the complexity of the patient, consistency between staff members on what is to be taught, time and resources to do the teaching, more exposure to teaching opportunities, and the unit and teacher identifying patient teaching as a priority. Leaders in nursing practice and education can further identify teaching facilitators and barriers in the clinical setting and the dynamics around patient teaching to facilitate positive health outcomes. Clinical and education implications are identified by the students to enhance their patient teaching experiences including: accessibility to resources, role modelling, valuing patient education, and incorporating patient teaching in the evaluation of clinical practice. Other research has supported the findings of this study in the areas of clinical settings that do not support patient teaching, absence of role models, and lack of preparation for health teaching (Zancheta, et al., 2013). Research has shown that the issues related to effective patient teaching are not unique to this study and that further study is required to understand interventions that would be most effective to enhance student competence in engaging in patient teaching.