The physicians' recognition and attitude about patient education in practice

Production and Provision of Context-Based Patient-Specific Educational Resources

BACKGROUND

Patient education is generally accompanied by instructive materials. The Korean government has recommended the provision of patient-specific educational materials (PEMs) via an electronic medical record (EMR) certification system. However, there are currently no clear standards or guidelines for including PEMs in current domestic educational materials. We investigated the benefits of integrating PEMs with the EMR certification system and the methods by which this integration can be achieved.

METHODS

We developed and administered three structured Delphi surveys to 26 healthcare providers in clinical settings based on data collected from separate semi-structured advisory interviews with five experts. The surveys included the following topics: 1) expected effects of patient-specific education and health-related notifications/alarms, 2) desirable methods for providing PEMs, and 3) appropriate fee-setting and government support. We distributed the Delphi surveys via e-mail and calculated the average and standard deviation of the survey responses.

RESULTS

PEMs are expected to have significant educational effects, such as the provision of surgery/intervention-related information, and will improve the understanding of various treatment processes/procedures. The preferred method for providing PEMs was via automatic request after receiving confirmation from healthcare providers. The provision of these materials was based on set fees and government support. The average fee per session was set at approximately USD 23 (as of October 2021, USD 1 = KRW 1,196).

CONCLUSION

In this study, we investigated the prerequisites, contents, methods, and fees related to the provision of effective and efficient PEMs. The study findings can facilitate the production and provision of PEMs.

Instruments to assess the perception of physicians in the decision-making process of specific clinical encounters: a systematic review

Background

The measurement of processes and outcomes that reflect the complexity of the decision-making process within specific clinical encounters is an important area of research to pursue. A systematic review was conducted to identify instruments that assess the perception physicians have of the decision-making process within specific clinical encounters.

Methods

For every year available up until April 2007, PubMed, PsycINFO, Current Contents, Dissertation Abstracts and Sociological Abstracts were searched for original studies in English or French. Reference lists from retrieved studies were also consulted. Studies were included if they reported a self-administered instrument evaluating physicians' perceptions of the decision-making process within specific clinical encounters, contained sufficient description to permit critical appraisal and presented quantitative results based on administering the instrument. Two individuals independently assessed the eligibility of the instruments and abstracted information on their conceptual underpinnings, main evaluation domain, development, format, reliability, validity and responsiveness. They also assessed the quality of the studies that reported on the development of the instruments with a modified version of STARD.

Results

Out of 3431 records identified and screened for evaluation, 26 potentially relevant instruments were assessed; 11 met the inclusion criteria. Five instruments were published before 1995. Among those published after 1995, five offered a corresponding patient version. Overall, the main evaluation domains were: satisfaction with the clinical encounter (n = 2), mutual understanding between health professional and patient (n = 2), mental workload (n = 1), frustration with the clinical encounter (n = 1), nurse-physician collaboration (n = 1), perceptions of communication competence (n = 2), degree of comfort with a decision (n = 1) and information on medication (n = 1). For most instruments (n = 10), some reliability and validity criteria were reported in French or English. Overall, the mean number of items on the modified version of STARD was 12.4 (range: 2 to 18).

Conclusion

This systematic review provides a critical appraisal and repository of instruments that assess the perception physicians have of the decision-making process within specific clinical encounters. More research is needed to pursue the validation of the existing instruments and the development of patient versions. This will help researchers capture the complexity of the decision-making process within specific clinical encounters.