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My Ins and Outs for Patient Education in 2025

My Ins and Outs for Patient Education in 2025

For my digital health peeps and clinicians alike!

Erika del Pozo MOT, OTR
January 07, 2025

One of my biggest flexes in 2024 was stupid simple:

I learned to spit and not rinse.

After 30-something years on this planet, I would hope to be a toothbrushing expert by now. However, I was living a big fat lie.

I originally learned of this once-believed factoid on TikTok. I chose to ignore it because I assumed a) it couldn’t be accurate, b) it feels barbaric, and c) ‘my sensory issues could never.’

Unfortunately, to my great dismay, rinsing immediately after brushing erases much of the benefit of applying fluoride to your teeth. (1, 2) I pushed this information away until I confirmed it with my real-life dentist and through a handful of dentist personalities on TikTok. sigh.

I finally gave in and began rinsing my toothpaste immediately after brushing my teeth. I don’t think twice about rinsing now.

Nevertheless, the whole situation was frustrating—I had been doing something wrong my entire life.

This knowledge could have saved me plenty of cavities (especially in adulthood); I mean, who knows?? It may have been communicated to me at some point, but there inevitably was a breakdown in communication and education.

Why could this have been missed? Dental providers may assume this foundational knowledge is de facto household knowledge, or perhaps their objectives and workflows do not permit the luxury of such patient education.

This is a small, low-stakes example of what occurs en masse globally every single day.

From pre- and post-op care to chronic condition management, not having all the pieces of knowledge together in a comprehensive, sequential, and person-first way can yield devastating consequences, greater than a few cavities.

Where and how patient education began and evolved

Systematic patient education is a relatively new discipline. The scientific journal of Patient Education and Counseling was only established in 1976. (3) Over time, patient education morphed from bare-bones knowledge transfer to incorporating health promotion and theory-based frameworks. (4)

Patient care has undergone considerable changes. Generally, patients have upgraded their status from passive care recipients to active care participants. The provider-patient relationship typically operated as such: providers are the ultimate authority, and patients are to conform to that authority.

It was a one-sided, my-way-or-the-highway relationship, which reminds me of that scene in Maltida, where Harry Wormwood scours at Malitda: “I'm smart, you're dumb; I'm big, you're little; I'm right, you're wrong, and there's nothing you can do about it.”

From the 1960s onward, those dynamics shifted. Patients’ rights advocacy organizations took off in the 1970s. In the 1980s, patient education developed parallel to a growing societal focus on patients’ rights. Several countries had established legislation regarding patients’ legal rights to information about their health condition and treatment options. (4)

From the 1990s to today, patients have become increasingly responsible for managing their health, symptoms, and conditions. The playing field between providers and patients has evened, with patient-centered care leading the way.

This approach allows patients to become actively involved in decisions regarding their care. The patient’s broader ecosystem, such as social networks and access to resources, is often included in treatment decisions.

Is patient education really worth it?

Health professionals can educate patients through interpersonal communication and other means, such as educational materials. Fortunately, the good old-fashioned printout has gotten a glow-up—patient education now comes in digital multimedia formats optimized for patient engagement and behavior change.

In a 2021 second order meta-analysis study, researchers found three comforting insights: (5)

The overall effect of patient education on health outcomes is statistically significant and positive.

Patient education has proven cost-efficient. It can be standardized to become an integral aspect of care, not a side thing or by-chance phenomenon.

The impact of patient education is generalized across different health issues.

This study found that patient education is effective for a wide range of diseases, including diabetes, diseases of the circulatory system, and surgery. Lifestyle changes play a significant role in health outcomes regarding these diseases and are commonly addressed via patient education interventions.

Patient education can improve various health outcomes, including physiological, physical, and psychological outcomes.

Patient education can impact several parameters. Take fall prevention, for example. Education can help patients learn medication management, home modifications to reduce their fall risk, and how to realistically integrate exercise into their daily routines.

Medication as a treatment option, on the other hand, yields fewer parameters (medication to control dizziness). Thus, patient education enhances knowledge and health behaviors, potentially serving as mediators for improving health outcomes.

What I’ve learned works and doesn’t work with patient education

As a senior clinical program manager and former clinician who has managed the creation of thousands of digital patient education materials from concept to launch, I’ve seen what works and what doesn’t.

Following are my patient education ins and outs for 2025. ✨

Ins:

Health literacy is GOAT
Build trust before you yap
Edutainment or bust

Outs:

Toxic positivity
Missing the plot
Overloading the noggin

Let’s look at each of these with some practical explanations and examples.

INS

Health literacy is GOAT 🐐

Erika’s Laws of Behavior Change #1: You can’t engage if you don’t understand.

Health literacy is defined as the capacity to seek, understand, and act on health information (7). In a randomized controlled trial study on interventions enhanced by the Theory of Planned Behavior (TPB) on health literacy and self-care behaviors of type 2 diabetic patients, researchers found the following strategies to be effective in providing education: (6)

simple and understandable communication
gradual presentation of information and an emphasis on information curtailment
limiting information provided at each patient referral
repeating information in various ways
repeatedly receiving feedback and refining the education process
encouraging patients to be curious
focusing on simple media utilization

There are several strategies to make information more digestible. When I’m preparing patient education content—especially text-based—it must meet an 8th-grade or below reading level. I also only include the need-to-know anatomical terms of a bodily system or region if it’s imperative to understanding one’s condition, and cut the rest out.

Whether you’re in digital health or a clinician providing direct patient care (or both!), you are no stranger to changing modes. For example, you talk differently with patients than when communicating with fellow providers, colleagues, or insurance companies.

Remember that what may be another day of explaining osteoarthritis or congestive heart failure is someone’s lived experience that may have limited knowledge about their condition before they arrive to you.

Build trust before you yap

Erika’s Laws of Behavior Change #2: You can’t engage if you don’t trust.

Patient education is a part of treatment interventions, not just nice-to-have. After all, we are asking patients to make decisions about their health or change something about their lives to improve their health. It’s personal, which is why you need trust and empathy.

Trust does not only come from flashing one’s credentials. Authority may be a deterrent for some. (Shocker). The “you think you know what’s best for me” and “you think you’re better than me” don’t bode well in gaining people’s trust.

One way of earning people’s trust is when you talk about what matters to them. Learn what matters to your patients (or users) by listening before you assume you know what they care about. Listening is not just in what they say—it’s also in their behaviors.

Edutainment or bust

Erika’s Laws of Behavior Change #3: You can’t learn if you’re not engaged.

We live in an era of quick wins and gamified streaks. Although the information landscape is perpetually in motion, we can agree that people expect concise, compelling, and engaging content.

Why should we expect patients to engage with faded, outdated handouts filled with dreadful walls of text? Who says that patient education has to be dry and basic?

Thankfully, healthcare is catching up. This is where digital health comes in! Digital health 🤝patient education. I get to work on content innovation for patient education, which transcends the passive handout into a dynamic, evolving process that primes patients for behavior change.

OUTS

Toxic positivity

Erika’s Laws of Behavior Change #4: You can’t apply if you don’t buy (in).

I’m a sucker for adages, laws, and the like. Hanlon’s razor states: never attribute to malice that which can be adequately explained by neglect, ignorance, or incompetence.

I believe that most toxic positivity comes from a good place, not a place of malice. Unbeknownst to me, I have worked on patient education scripts with passages that our external reviewers flagged as toxic positivity.

I was mortified that I didn’t catch it myself. However, my blind spots on the topic prevented me from proper discernment. (which is why it’s important to get feedback often and early on in the creation process!)

One’s toxic positivity can be another person’s saving grace. However, there are tried and true practices I stay away from, such as anything that starts with “at least,” minimizing a patient’s symptoms or perceptions, and catastrophizing symptoms.

I usually like to include something along the lines of “we know how busy you are” and “you have a life to live, so let’s help you achieve XYZ” in my patient education content.

Missing the plot

Erika’s Laws of Behavior Change #5: You can’t learn if you don’t practice.

Talk is cheap. Telling your patients what they need to do and leaving it there doesn’t get them very far.

The key is to help patients build practices that will build their self-efficacy. One's sense of self-efficacy plays a major role in how one approaches goals, tasks, and challenges regarding one's health. (7).

We must not be passive information givers, but rather our patients’ proactive partners—easier said than done, especially in a digital environment. Asking questions (quizzing) and carving out practice sessions can help your patients absorb and integrate knowledge and master specific skills.

What are the most important things they need to know about said topic, and what’s not important? Identify those messages that support the key learning objectives for your patients.

Give patients those key objectives early on within the patient education so they know why they’re learning what they’re learning.

Overloading the noggin

Erika’s Laws of Behavior Change #6: You can’t learn if you’re overwhelmed.

It happens to the best of us—we’ll throw the kitchen sink at patients. We may assume that patients want the kitchen sink (maybe some of them do!).

Pictured: Me overwhelmed, which is every day

Regardless, we have to make sure that they receive the most important information first. That could be acute symptom management, and medication or device management. However, we must also be flexible, as human behavior is not predictable, and patient needs, preferences, and recovery are not linear.

We also have to “chunk and check.” (8). Consolidate and make information memorable and sticky to reduce cognitive overload.

That is why I am an advocate of pushing the most “health urgent” content to patients first, followed by the important (but not as urgent) education.

🧠 Unhinged: Thoughts🌲

As I write this, a winter storm is brewing outside, which brought up a legitimate thought I’ve been having. I think we need to normalize “winter” decor. There isn’t a place for it after Christmas.

I believe you can have winter elements- perhaps more minimally done than Christmas decor, throughout January and February. I am keeping up my faux pine tree garland with dried oranges on my mantle for a while because it’s GIVING COZY.

📰✨Noteworthy

My research team and I recently got published in the American Journal of Occupational Therapy!! I am so proud of our paper, Feel the Burn, Heal the Burn: Job Crafting and Burnout Among Occupational Therapy Professionals.

This study was a true labor of love and took over four years to complete. I should dedicate a whole newsletter to this journey alone!

Take care, and see you next week!

Erika

References