importance of education research paper

Editorial: Educational Research and Why It’s Important

• Published: 23 October 2017
• Volume 52 , pages 207–210, ( 2017 )

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• Roseanna Bourke 1 &
• Judith Loveridge 2  

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The New Zealand Journal of Educational Research (NZJES) is aptly named, because the distinction between ‘education’ research and ‘educational’ research is critical. As Lingard ( 2013 ) has argued, “When we use the descriptor ‘educational’ attached to research, we are arguing that such research has educational or educative purposes, that is, such research is progressive in the sense of seeking and desiring to improve both education policy and professional practice in education” (p. 115). For contributors and readers of this journal, the importance of demonstrating the potential to impact on policy and practice is important. Researchers working in education typically are also interested in addressing equity issues as political and social agendas, and seeking to explore positive change for others through educational research .

Educational research can challenge and change educational policy and practice, as evidenced in the articles within this issue. Equity and justice of educational experience are important to these researchers. This is consistent with previous NZJES issues, where authors have sought to enable the voice of participants to be heard, to foreground culture, and question the status quo. In other words, for these authors, being educational through research is a critical part of having impact.

Of the eight articles in this issue, five present evidence about educational experiences, issues and outcomes for Māori, Pacific Island and Indigenous students. The approaches taken to address these questions are diverse, ranging from examining the very way that ethnicity is defined and used in statistical analysis to exploring ‘the spiritual footsteps of teaching and learning’.

In the first article, Boereboom critiques the way that ethnicity is defined and then used for the purposes of analysing and reporting national educational outcomes and assessment data. Although New Zealand has moved to a view of ethnicity as a fluid social construct which allows for self-identification and the claiming of multiple ethnic identities, the rapid increase in ethnic diversity and the need for narrow and precise definitions of variables for the purposes of statistical analysis are creating a range of issues that to date have been largely ignored. Boereboom explores these issues by comparing an analysis of NCEA Level 1 results using (1) the status quo of rank ordering to assign a single ethnic identity, and (2) a weighted ethnicity proportional representation approach. Boereboom’s analysis and arguments show that there is the potential for current practices to mask and under report trends and thereby to strengthen a deficit approach to educational planning. He compellingly argues that there are strong ethical grounds and concerns related to validity to support a call to ‘re-examine the practice of ethnic priority ranking and explore alternative more culturally valid and inclusive approaches’.

Although positive outcomes have been achieved in Māori medium education over the past 40 years there are still very real concerns about the revitalisation of te reo Māori. Research is needed to support the revitalisation process. Hill’s research focuses on level 2 Māori medium programmes, that is programmes with 51–80% Maori language instruction. He explores the perceptions of students and their parents about the contribution these programmes make to the education of students. In Maged, Rosales-Anderson and Manuel’s article, they explore teaching and learning relationships that students attending a Wānanga (a Māori indigenous tertiary education organisation) identified as having had a positive impact on their learning and engagement in the past or currently. In particular Maged et al. are interested in exploring the spiritual element of the connection between the kaiako (teachers) and the tauira (students). They identify a range of ways in which tauira had felt a deep sense of connection through the wairua (spirit) within the classroom to the people, place and space around them and which had impacted positively on their learning and their well-being, both within and beyond the classroom.

Olsen and Andreassen explore how indigenous issues are articulated and instantiated in the Early Childhood Education Curricula (the official written documents) of Norway and Aotearoa/New Zealand. They argue that the purpose of comparing how indigenous issues are conceptualised within the respective curricula is ‘to bring something new to the analysis of one case by putting it next to another’. Their analysis focuses on the main tendencies of the indigenous issues in each country. While they conclude, ‘the curricula are expressions of indigenous knowledge and status being privileged’ they caution that if the curricular claims and statements are not enacted, then it would not be a surprise to find the indigenous silenced.

Towner, Taumoepeau, Lal and Pranish focus on the situation of Pasifika learners in the tertiary context. They conducted a case study, which evaluated the outcomes of current practices and support for Pasifika students at a New Zealand private tertiary education (PTE) provider in order to assess what practices and support systems are beneficial for Pasifika learners. Their findings emphasise the importance of a variety of support systems, many of which increased a sense of community connectedness for students, and a culturally sensitive environment for students’ academic success.

Van Rij explores how the New Zealand’s School Journal has reflected both shifting perceptions of childhood as well as acting as a mirror on the educational ideologies of the times, from the time it started (1907) through to 1918. Later, she introduces another period (1919–1938) where she identifies how the journal ‘led to the liberal spirited, revised syllabus of instruction in 1935. This in turn paved the way for the curriculum reforms from 1939 into the 1950s’. In this article van Rij traverses the complex terrain of the journal by presenting the historical and cultural analysis of the type of prose, subject content and inherent political messages within the journal.

In McPhail and Laurie’s article, they argue that social science research methods teaching needs to include the idea of realism. Given that interpretivism is commonly used in educational social science research, the authors were both faced with a dilemma when conducting their respective PhDs, looking for a methodological approach that could enable them ‘to explain the social meaning of events and provide a means of exploring causes and processes obscured within the phenomenon being investigated’. Using the case study of the second author who completed her PhD using realism, this article explores what this methodological approach has to offer, and how a realist rather than an interpretivist orientation can offer a different analysis of data.

Oldham’s article foregrounds the increase of non-state policy actors in public education systems. He explores the phenomenon of ‘enterprise education’ by using governance theory and methods to argue that this is replacing curriculum governance.

Finally Gerrard’s commentary, explores the impact of the Productivity Commission’s Report on New Models of Tertiary Education (2017) and how this may impact on the changing nature of the purpose and value of tertiary education.

This issue of the New Zealand Journal of Educational Studies is also our last one as Editors. Our tenure has included transitioning the journal from a print-based journal to its first online issue with Springer (Volume 50), and marking its 50th anniversary celebrations. The journal continues to be foundational to the New Zealand Association for Research in Education (NZARE) learned society, and the principal vehicle for researchers and educators to share and disseminate their published research.

Since 2014, we have edited 8 issues, which have included 65 published articles and 5 commentaries written by 112 authors (76% female; 24% male). We extend our thanks to the 138 reviewers who gave their time, expertise and collegial support to blind peer review the work. In addition, we have published 39 book reviews and we thank our Book Editor, Dr. Stephanie Doyle, Victoria University of Wellington, who liaised so successfully with the book reviewers that we were never without a well-articulated review of the latest work coming out. During this period there have been two special issues: Student Voice 49(2), and Equity and Diversity 51(2). Both these special issues included national and international contributions, with one collection arguing the importance of including student voice in learning, policy and practice, and acting on these views; and the other on ensuring equity through education enables, celebrates and includes all learners.

Across this period the contributing authors have collectively demonstrated a broad interest in educational research, policy and practice, which fully justifies the journal’s claim to be concerned with ‘educational studies’. The many contributors to this journal have documented change and progress, issues and tensions, and promises and visions. Given this depth and breadth of educational research, and the diversity of researcher-authors, it is not surprising that their own values and ideologies are embedded in the work. As Lingard ( 2013 ) reminds us, evidence-based policy is not all about research evidence. It includes in the mix values, ideology and professional knowledge of the researchers who conduct the research, and the practitioners and policy makers who read and interpret that research.

The areas of scholarship covered over this period (Volumes 49–52) are diverse, inclusive and representative of multi-voiced, cultural and social imperatives. These include Kura Kaupapa Māori research, cross-cultural practice, the achievement gap, tertiary education supervision and partnership practices, all education sectors, the history of education in New Zealand, student voice, education policy, equity in education, curriculum design, teacher initial education and professional development and the nature of education in the twenty-first century.

This research labour has originated from within 29 institutions, including 21 universities, 1 wānanga, 2 polytechnics, independent researchers (2), and other tertiary, research or independent providers such as the New Zealand Council for Educational Research (NZCER), Kelston Deaf Education Centre, and SPELD. The research published within NZJES has demonstrated it is confidently located within the Aotearoa/New Zealand context. Locally, we have had contributors from University of Auckland, Auckland University of Technology (AUT), University of Waikato, Waikato Institute of Technology (Win Tec), Te Whare Wānanga o Awanuiārangi, Massey University, Victoria University of Wellington, Whitireia Polytechnic, University of Canterbury, and University of Otago. There has also been an international presence connected closely to the New Zealand research community, including contributions from researchers based in higher education organisations from the UK, Ireland, Sweden, Norway, USA, UAE, and Australia. The institutions represented include University of Dublin, University of Manchester, University of Uppsala, University of Tromsø, University of Melbourne, University of New South Wales, Monash University, Australian Catholic University, University of New England, University of Denver, Bryn Mawr College, North Carolina State University, University of Florida, Southern Cross University and Zayed University.

As co-editors, we are proud to have been part of this continuing educational research journey. We wish the incoming editors the rich experience we have been privileged to have. We thank the Editorial Board for the stimulating collegial discussions at our meetings and the NZARE Council for their ongoing support. A warm thank you to all contributors, reviewers, NZARE members, and staff at Springer for enabling this journal to take the next step in its trajectory of contributing to the betterment of education in Aotearoa/New Zealand.

Lingard, B. (2013). The impact of research on education policy in an era of evidence-based policy. Critical Studies in Education, 54 (2), 113–131.

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Bourke, R., Loveridge, J. Editorial: Educational Research and Why It’s Important. NZ J Educ Stud 52 , 207–210 (2017). https://doi.org/10.1007/s40841-017-0093-0

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Published : 23 October 2017

Issue Date : November 2017

DOI : https://doi.org/10.1007/s40841-017-0093-0

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The 10 Most Significant Education Studies of 2021

From reframing our notion of “good” schools to mining the magic of expert teachers, here’s a curated list of must-read research from 2021.

It was a year of unprecedented hardship for teachers and school leaders. We pored through hundreds of studies to see if we could follow the trail of exactly what happened: The research revealed a complex portrait of a grueling year during which persistent issues of burnout and mental and physical health impacted millions of educators. Meanwhile, many of the old debates continued: Does paper beat digital? Is project-based learning as effective as direct instruction? How do you define what a “good” school is?

Other studies grabbed our attention, and in a few cases, made headlines. Researchers from the University of Chicago and Columbia University turned artificial intelligence loose on some 1,130 award-winning children’s books in search of invisible patterns of bias. (Spoiler alert: They found some.) Another study revealed why many parents are reluctant to support social and emotional learning in schools—and provided hints about how educators can flip the script.

1. What Parents Fear About SEL (and How to Change Their Minds)

When researchers at the Fordham Institute asked parents to rank phrases associated with social and emotional learning , nothing seemed to add up. The term “social-emotional learning” was very unpopular; parents wanted to steer their kids clear of it. But when the researchers added a simple clause, forming a new phrase—”social-emotional & academic learning”—the program shot all the way up to No. 2 in the rankings.

What gives?

Parents were picking up subtle cues in the list of SEL-related terms that irked or worried them, the researchers suggest. Phrases like “soft skills” and “growth mindset” felt “nebulous” and devoid of academic content. For some, the language felt suspiciously like “code for liberal indoctrination.”

But the study suggests that parents might need the simplest of reassurances to break through the political noise. Removing the jargon, focusing on productive phrases like “life skills,” and relentlessly connecting SEL to academic progress puts parents at ease—and seems to save social and emotional learning in the process.

2. The Secret Management Techniques of Expert Teachers

In the hands of experienced teachers, classroom management can seem almost invisible: Subtle techniques are quietly at work behind the scenes, with students falling into orderly routines and engaging in rigorous academic tasks almost as if by magic. 

That’s no accident, according to new research . While outbursts are inevitable in school settings, expert teachers seed their classrooms with proactive, relationship-building strategies that often prevent misbehavior before it erupts. They also approach discipline more holistically than their less-experienced counterparts, consistently reframing misbehavior in the broader context of how lessons can be more engaging, or how clearly they communicate expectations.

Focusing on the underlying dynamics of classroom behavior—and not on surface-level disruptions—means that expert teachers often look the other way at all the right times, too. Rather than rise to the bait of a minor breach in etiquette, a common mistake of new teachers, they tend to play the long game, asking questions about the origins of misbehavior, deftly navigating the terrain between discipline and student autonomy, and opting to confront misconduct privately when possible.

3. The Surprising Power of Pretesting

Asking students to take a practice test before they’ve even encountered the material may seem like a waste of time—after all, they’d just be guessing.

But new research concludes that the approach, called pretesting, is actually more effective than other typical study strategies. Surprisingly, pretesting even beat out taking practice tests after learning the material, a proven strategy endorsed by cognitive scientists and educators alike. In the study, students who took a practice test before learning the material outperformed their peers who studied more traditionally by 49 percent on a follow-up test, while outperforming students who took practice tests after studying the material by 27 percent.

The researchers hypothesize that the “generation of errors” was a key to the strategy’s success, spurring student curiosity and priming them to “search for the correct answers” when they finally explored the new material—and adding grist to a 2018 study that found that making educated guesses helped students connect background knowledge to new material.

Learning is more durable when students do the hard work of correcting misconceptions, the research suggests, reminding us yet again that being wrong is an important milestone on the road to being right.

4. Confronting an Old Myth About Immigrant Students

Immigrant students are sometimes portrayed as a costly expense to the education system, but new research is systematically dismantling that myth.

In a 2021 study , researchers analyzed over 1.3 million academic and birth records for students in Florida communities, and concluded that the presence of immigrant students actually has “a positive effect on the academic achievement of U.S.-born students,” raising test scores as the size of the immigrant school population increases. The benefits were especially powerful for low-income students.

While immigrants initially “face challenges in assimilation that may require additional school resources,” the researchers concluded, hard work and resilience may allow them to excel and thus “positively affect exposed U.S.-born students’ attitudes and behavior.” But according to teacher Larry Ferlazzo, the improvements might stem from the fact that having English language learners in classes improves pedagogy , pushing teachers to consider “issues like prior knowledge, scaffolding, and maximizing accessibility.”

5. A Fuller Picture of What a ‘Good’ School Is

It’s time to rethink our definition of what a “good school” is, researchers assert in a study published in late 2020.⁣ That’s because typical measures of school quality like test scores often provide an incomplete and misleading picture, the researchers found.

The study looked at over 150,000 ninth-grade students who attended Chicago public schools and concluded that emphasizing the social and emotional dimensions of learning—relationship-building, a sense of belonging, and resilience, for example—improves high school graduation and college matriculation rates for both high- and low-income students, beating out schools that focus primarily on improving test scores.⁣

“Schools that promote socio-emotional development actually have a really big positive impact on kids,” said lead researcher C. Kirabo Jackson in an interview with Edutopia . “And these impacts are particularly large for vulnerable student populations who don’t tend to do very well in the education system.”

The findings reinforce the importance of a holistic approach to measuring student progress, and are a reminder that schools—and teachers—can influence students in ways that are difficult to measure, and may only materialize well into the future.⁣

6. Teaching Is Learning

One of the best ways to learn a concept is to teach it to someone else. But do you actually have to step into the shoes of a teacher, or does the mere expectation of teaching do the trick?

In a 2021 study , researchers split students into two groups and gave them each a science passage about the Doppler effect—a phenomenon associated with sound and light waves that explains the gradual change in tone and pitch as a car races off into the distance, for example. One group studied the text as preparation for a test; the other was told that they’d be teaching the material to another student.

The researchers never carried out the second half of the activity—students read the passages but never taught the lesson. All of the participants were then tested on their factual recall of the Doppler effect, and their ability to draw deeper conclusions from the reading.

The upshot? Students who prepared to teach outperformed their counterparts in both duration and depth of learning, scoring 9 percent higher on factual recall a week after the lessons concluded, and 24 percent higher on their ability to make inferences. The research suggests that asking students to prepare to teach something—or encouraging them to think “could I teach this to someone else?”—can significantly alter their learning trajectories.

7. A Disturbing Strain of Bias in Kids’ Books

Some of the most popular and well-regarded children’s books—Caldecott and Newbery honorees among them—persistently depict Black, Asian, and Hispanic characters with lighter skin, according to new research .

Using artificial intelligence, researchers combed through 1,130 children’s books written in the last century, comparing two sets of diverse children’s books—one a collection of popular books that garnered major literary awards, the other favored by identity-based awards. The software analyzed data on skin tone, race, age, and gender.

Among the findings: While more characters with darker skin color begin to appear over time, the most popular books—those most frequently checked out of libraries and lining classroom bookshelves—continue to depict people of color in lighter skin tones. More insidiously, when adult characters are “moral or upstanding,” their skin color tends to appear lighter, the study’s lead author, Anjali Aduki,  told The 74 , with some books converting “Martin Luther King Jr.’s chocolate complexion to a light brown or beige.” Female characters, meanwhile, are often seen but not heard.

Cultural representations are a reflection of our values, the researchers conclude: “Inequality in representation, therefore, constitutes an explicit statement of inequality of value.”

8. The Never-Ending ‘Paper Versus Digital’ War

The argument goes like this: Digital screens turn reading into a cold and impersonal task; they’re good for information foraging, and not much more. “Real” books, meanwhile, have a heft and “tactility”  that make them intimate, enchanting—and irreplaceable.

But researchers have often found weak or equivocal evidence for the superiority of reading on paper. While a recent study concluded that paper books yielded better comprehension than e-books when many of the digital tools had been removed, the effect sizes were small. A 2021 meta-analysis further muddies the water: When digital and paper books are “mostly similar,” kids comprehend the print version more readily—but when enhancements like motion and sound “target the story content,” e-books generally have the edge.

Nostalgia is a force that every new technology must eventually confront. There’s plenty of evidence that writing with pen and paper encodes learning more deeply than typing. But new digital book formats come preloaded with powerful tools that allow readers to annotate, look up words, answer embedded questions, and share their thinking with other readers.

We may not be ready to admit it, but these are precisely the kinds of activities that drive deeper engagement, enhance comprehension, and leave us with a lasting memory of what we’ve read. The future of e-reading, despite the naysayers, remains promising.

9. New Research Makes a Powerful Case for PBL

Many classrooms today still look like they did 100 years ago, when students were preparing for factory jobs. But the world’s moved on: Modern careers demand a more sophisticated set of skills—collaboration, advanced problem-solving, and creativity, for example—and those can be difficult to teach in classrooms that rarely give students the time and space to develop those competencies.

Project-based learning (PBL) would seem like an ideal solution. But critics say PBL places too much responsibility on novice learners, ignoring the evidence about the effectiveness of direct instruction and ultimately undermining subject fluency. Advocates counter that student-centered learning and direct instruction can and should coexist in classrooms.

Now two new large-scale studies —encompassing over 6,000 students in 114 diverse schools across the nation—provide evidence that a well-structured, project-based approach boosts learning for a wide range of students.

In the studies, which were funded by Lucas Education Research, a sister division of Edutopia , elementary and high school students engaged in challenging projects that had them designing water systems for local farms, or creating toys using simple household objects to learn about gravity, friction, and force. Subsequent testing revealed notable learning gains—well above those experienced by students in traditional classrooms—and those gains seemed to raise all boats, persisting across socioeconomic class, race, and reading levels.

10. Tracking a Tumultuous Year for Teachers

The Covid-19 pandemic cast a long shadow over the lives of educators in 2021, according to a year’s worth of research.

The average teacher’s workload suddenly “spiked last spring,” wrote the Center for Reinventing Public Education in its January 2021 report, and then—in defiance of the laws of motion—simply never let up. By the fall, a RAND study recorded an astonishing shift in work habits: 24 percent of teachers reported that they were working 56 hours or more per week, compared to 5 percent pre-pandemic.

The vaccine was the promised land, but when it arrived nothing seemed to change. In an April 2021 survey  conducted four months after the first vaccine was administered in New York City, 92 percent of teachers said their jobs were more stressful than prior to the pandemic, up from 81 percent in an earlier survey.

It wasn’t just the length of the work days; a close look at the research reveals that the school system’s failure to adjust expectations was ruinous. It seemed to start with the obligations of hybrid teaching, which surfaced in Edutopia ’s coverage of overseas school reopenings. In June 2020, well before many U.S. schools reopened, we reported that hybrid teaching was an emerging problem internationally, and warned that if the “model is to work well for any period of time,” schools must “recognize and seek to reduce the workload for teachers.” Almost eight months later, a 2021 RAND study identified hybrid teaching as a primary source of teacher stress in the U.S., easily outpacing factors like the health of a high-risk loved one.

New and ever-increasing demands for tech solutions put teachers on a knife’s edge. In several important 2021 studies, researchers concluded that teachers were being pushed to adopt new technology without the “resources and equipment necessary for its correct didactic use.” Consequently, they were spending more than 20 hours a week adapting lessons for online use, and experiencing an unprecedented erosion of the boundaries between their work and home lives, leading to an unsustainable “always on” mentality. When it seemed like nothing more could be piled on—when all of the lights were blinking red—the federal government restarted standardized testing .

Change will be hard; many of the pathologies that exist in the system now predate the pandemic. But creating strict school policies that separate work from rest, eliminating the adoption of new tech tools without proper supports, distributing surveys regularly to gauge teacher well-being, and above all listening to educators to identify and confront emerging problems might be a good place to start, if the research can be believed.

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Empowering Patients: Promoting Patient Education and Health Literacy

Pradnya brijmohan bhattad.

1 Cardiovascular Medicine, Saint Vincent Hospital, University of Massachusetts Chan Medical School, Worcester, USA

Luigi Pacifico

Patients are generally keen to understand and obtain more information about their medical conditions. There exists a need to develop updated and thorough yet concise patient education handouts and to encourage healthcare providers (HCPs) to use uniform patient education methods.

A thorough review of literature on patient education material was performed prior to starting the study. A comparison with different resources regarding the appropriateness of patient education was done. Educating HCPs to effectively use patient educational materials incorporated into the electronic health record system, including electronic methods, such as the use of a patient portal, to help educate patients. 

Strategies were formulated to reduce the amount of processing and attending time required for fetching appropriate materials and lead to fast, efficient, and effective patient education. To improve the physical and psychosocial wellbeing of a patient, personalized patient education handouts, in addition to verbal education by the HCPs, augment the betterment of patient care via shared decision making and by improving patient satisfaction and health literacy.

Introduction

Patients are often eager to understand and know more about their medical conditions and health situation, and educating them with the most relevant, current, consistent, and updated information helps patients and their families significantly in the medical care and decision-making process [ 1 ]. 

Patients need formal education on the disease condition; they need to know their ailment, understand their symptoms, be educated on the diagnostics, appropriate medication use, and should be taught when to call for help. Several patient education handouts for various conditions are available, and there exists a need to assess which one is better suited for a particular disease/condition encountered and provides concise information. Patient education materials help educate the patients on their health conditions, improves their health literacy, and enhances and promotes informed decision-making based on the most current and updated medical and clinical evidence as well as patient preference [ 2 ].

The aim of this study was to develop updated patient education handouts and materials in addition to verbal counseling of the patients to help them understand the disease condition, diagnostic studies, proper advice on medications, and when to call for help. And to encourage healthcare providers (HCPs) to use uniform patient education materials.

The objectives of this study are 1) the implementation of quality improvement techniques of Plan-Do-Study-Act (PDSA) cycles on patient education in clinical settings; 2) to enhance the delivery of patient education and create awareness amongst the HCPs regarding the importance of patient education and improved health literacy; 3) to verify if patient education handouts have the minimum necessary information that patient should know; 4) to compare patient education handouts from databases integrated in the electronic health record (EHR) with standard patient education database websites like the Centers for Disease Control and Prevention website, and MedlinePlus® site to make sure that they have the minimum necessary information; and 5) to educate and encourage HCPs on the use of appropriate patient education articles in the EHR and utilize an electronic patient portal for patient education, help transition the patient education to an electronic form, and increase efficacy and consistent patient education.

Materials and methods

A comprehensive review of the patient education materials on the most common medical ailments in various clinical settings was performed. We compared the existing patient education database integrated in the EHR with the standard resources such as the CDC, MedlinePlus via retrospective chart study format to ensure the minimum necessary information is available. 

A comparison of existing educational material was completed by analyzing other patient education materials from resources such as UpToDate (the basics/beyond the basics), MedlinePlus, US National Library of Medicine of NIH, CDC, and the US Department of Health and Human Services to ensure that effective, most updated, current, and evidence-based information is provided to the patients from the educational materials.

Search words were incorporated to help search for the educational articles in the existing EHR by the title of the article. Educational materials studied were relevant to the common medical ailments in various clinical settings. The patient handouts were made available in such a way that these should be able to be sent either through an electronic patient portal or printed out.

HCPs were educated in a session with pre- and post-lecture survey qualitative and quantitative questionnaires. The impact of these interventions was further assessed by pre- and post-intervention surveys after educating the HCPs.

Uniform updated patient education handouts were created after comparing them with standard resources. A pre-test survey questionnaire was obtained to discuss with HCPs regarding the current knowledge and practices of the usage of patient education handouts and the understanding of EHR to utilize uniform and standardized patient education handouts. After educating the HCPs, their knowledge regarding the use of EHR to effectively use patient education handouts was tested in a post-test survey questionnaire. After completion of the pre and post-test survey questionnaire by HCPs, analysis of the data performed (Figures ​ (Figures1 1 - ​ -20 20 ).

HCPs - healthcare providers

"Do you feel that attending and processing times required for fetching appropriate educational articles will be reduced if standard materials are outlined?"

“Do you think that efficient patient education is effective in creating and improving adherence to treatment, medication compliance, and for improving overall patient health?”

Quality improvement (QI), problem-solving, and gap analysis

QI techniques, including PDSA cycles, to improve patient education implemented in various clinical settings [ 1 ].

Reasons for Action

There is a need for updated and uniform patient education materials in addition to verbal counseling of the patient to help them understand the disease condition, diagnostic studies, proper advice on medications, and when to call for help, thereby enhancing health literacy. There exists several patient education materials for various ailments, and the need to assess which one is better suited for a disease condition and contains concise information.

Initial State

We reviewed the available patient education material from the patient education database integrated in the EHR, and compared it with current standardized resources such as MedlinePlus, US National Library of Medicine of NIH, CDC, and the US Department of Health and Human Services. A thorough review of literature on patient education material was performed prior to starting the study.

We compared more than one source regarding the appropriateness of patient education, most specifically, how to use the medications and when to call for help. The quality of educational materials regarding disease education, diagnostics education, education on medication use, and education on when to call for help was assessed. The resources described above were utilized for comparison.

Gap Analysis

A graph of the gap analysis is displayed in Figure ​ Figure21 21 below.

Solution Approach

It was noticed that the educational materials were available only in printed format. Enrolling patients on the electronic patient portal helps send educational materials to the patient as a soft copy in a faster and more efficient electronic format. 

Higher attending and processing time is required for fetching appropriate materials due to the unavailability of exact materials and using non-updated educational materials. Therefore, creating an index of educational articles on commonly encountered medical situations and ensuring that these articles are current and updated might make the process more efficient. 

There is a very limited time availability to impart specific educational elements with the limited appointment times. Appropriately detailed educational materials can be sent to the patient via a patient portal even after the patient encounter has ended. For patients with limited technology/computer use, educational materials can be mailed if they're missed during the encounter. 

Inadequate educational methods were utilized; thus, incorporating educational articles from resources other than the databases in the existing EHR, and using the index of educational articles on commonly encountered medical situations were applied.

Inefficient usage of the operational capacity of EHR for patient education, using database integrated in the EHR, and lack of training were identified. As a result, HCPs were trained on using educational materials for their patients in an efficient manner, and patient education was prioritized.

Rapid Experiment: Plan-Do-Study-Act Cycle

Plan: Plan to use appropriate patient education material from several sources made available in the index of the educational articles.

Do: Counsel and verbally educate the patients, along with providing educational materials. Obtain a verbal read-back from the patients about how to use medications and when to call for help.

Study: Use the teach-back method to make patients explain back the information provided in their own words to see if they understood the disease, diagnostics, medication use, and when to call for help to improve health literacy.

Act: If a patient has questions, address them appropriately and if need be, set up a follow-up appointment. 

Actions Taken

An index of educational materials relevant to the common medical ailments in various clinical settings was created. This index of educational materials was to guide HCPs in choosing appropriate and relevant articles in an efficient, quick, and timely manner for patients in various clinical settings. Effective use of patient educational materials in the database incorporated into the EHR, including electronic methods such as the use of the patient portal to help educate patients, was promoted. Alternate resources other than those from the database in the existing EHR were utilized. Educational materials in printed format were made available for patients with limited technology access. The amount of time required for fetching appropriate materials was reduced by creating and referencing to an index for commonly encountered medical situations.

Efficient and faster patient education was imparted with reduced processing and attending time required. Prioritized health education to improve health literacy. Efficient usage of operational capacity of database integrated in the EHR was undertaken to improve health literacy. HCPs were trained to use patient education materials efficiently. 

What Helped

Fast, efficient, and effective patient education helped patients and their families significantly in medical care and shared decision-making based on the most current and updated clinical evidence and patient preference. Creating an index of educational materials relevant to the medical conditions commonly encountered thereby reduced the amount of processing and attending time required for fetching appropriate materials. Effectively using patient educational materials in the database incorporated into the EHR, including electronic methods such as the use of a patient portal to help educate patients, using soft copy (electronic-copy) reduced requirement of printed materials. Correction of misconceptions that patients may have helped improve health literacy. 

What Went Well

Helping engage, encourage, and empower the patients in participating in their own health care and treatment decisions. Enhanced patient satisfaction and better outcomes (for instance, educating a patient on osteopenia encouraged them to continue/start the vitamin D supplementation, participate in regular exercise, healthy diet preferences, and health promotion). 

What Hindered

High HCP turnover rate with changing schedules hindered consistent use of patient education materials. Insufficient number of HCPs trained for patient education.

What Could Improve

Incorporating educational materials in the video format for patients who do not wish to read or talk about their health situations. Enhanced training of all the HCPs for effective and efficient use of patient education resources to allow consistency in effective patient education.

Personalized patient education engages, encourages, and empowers patients in participating in their own health care and treatment decisions and leading to better outcomes, decreased need for excess diagnostic testing, and enhanced patient satisfaction [ 3 , 4 , 5 ]. This needs motivation on the part of the resident doctors, nurse practitioners, physician assistants, physicians, and the allied staff. 

The Advisory Committee on Training in Primary Care Medicine (ACTPCMD) recommends that Health Resources & Services Administration’s (HRSA) Title VII, Part C, Section 747 and 748 education and training programs should prepare students, faculty, and practitioners to involve patients and caretakers in shared medical decision-making which can happen well with better patient education process [ 6 ].

We as HCPs should cultivate good habits amongst ourselves to ensure patients know about their condition and treatment well. This will help increase medication and treatment compliance amongst patients and enhance the physician-patient relationship to a higher level.

Conclusions

To improve the physical and psychosocial well-being of a patient, personalized patient education materials, in addition to verbal education by the HCPs, augment the betterment of patient care via shared decision making and by improving patient satisfaction. There is a need to reiterate that HCPs understand patients' concerns and provide effective patient education and counseling for effective health care delivery.

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The authors have declared that no competing interests exist.

Human Ethics

Consent was obtained or waived by all participants in this study

Animal Ethics

Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue.