Academic journal article Journal, Physical Therapy Education

Patient Education: Past and Present

Academic journal article Journal, Physical Therapy Education

Patient Education: Past and Present

Article excerpt

ABSTRACT: Patient education has been a part of health care since the first healer gave the first patient advice about treating his (or her) ailments. This paper provides a brief look at some of the major historical developments of patient education, from telling patients and families what to do, to the involvement of patients and caregivers in individually designed educational expariences. The concept of complaince and the effect of health beliefs are exploded, and current regulatory policies are outlined. Current research in educational methodology is presented.

INTRODUCTION

Patient education has been a part of health care since the first heater gave the first patient advice about treating his (or her) ailments. Although early references are limited. there is evidence that the first Civil Chamber of the Court of Cassation in France in 1315 required surgeons to inform patients of the risks involved before performing a surgical procedure.1 What is patient education? How has it evolved over the years? Is there more to patient education than just telling a patient what to do?

HISTORICAL DEVELOPMENTS

It can be assumed that education of some sort has been a part of the caring process through the centuries; however, there was essentially no supporting documentation until recent times. Through the centuries, health care was fragmented. based in the home and family, and dependent on local resources and the knowledge of local healers. In the middle and late 1800s, health care became more formalized and health education became an important part of the work of health care providers, who were mostly nurses and physicians. Nurses taught family members proper sanitary precautions, disease prevention, and how to care for the sick.2 The National League of Nursing Education commented that the preventive and educational activities of public health nurses were "essential elements"2(p2) of public health work. A 1937 curriculum guide in nursing emphasized that nurses were essentially teachers.3 Following the Second World War, as longevity increased and the survival of individuals with chronic disabilities increased. education began to focus on management of chronic problems and the term "patient education" began to appear in the literature.4 The nursing literature is replete with references on patient education, and much of the research in methodology and outcomes has been done by nurses.

There is little documented data to help trace the role of patient education in the evolution of physical therapy practice. An outline of the early curriculum developed by Mary McMillan at Reed College does not specifically mention education; however, it may be assumed that at least some of the 66 hours of remedial exercises or 163 hours of clinical practice may have included the concept of teaching patients. This assumption is supported by evidence that, during World War I, the heavy patient load necessitated that reconstruction aides teach the injured to selfadminister exercises.5 Early criteria for physical therapy education outlined the number of clock hours required in major subject areas such as exercise, medicine, and clinical experience. Education was not separately identified as a criterion until the American Physical Therapy Association (APTA) assumed responsibility for accreditation of educational programs; however, there is evidence that teaching was an integral part of the role of the physical therapist from the early days of the profession,6 In the 1950s and 1960s, as physical therapists rather than physicians assumed primarily responsibility for the direction of educational programs, course titles began to reflect increased autonomy of the profession, and there was greater emphasis in the curriculum on administration, education, and professional issues.6 As accreditation criteria changed from a focus on subject matter hours of instruction to the competencies expected of the graduate, the role of the physical therapist (and later the physical therapist assistant) as a teacher became better defined. …

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