Michelle Litchman, PhD, FNP-BC, FAANP, is a research scientist and nurse practitioner specializing in diabetes at the University of Utah. Her research is focused on how individuals manage their diabetes in the context of technology (social media, mobile apps, RT-CGM) and peer health support. You can find her on Twitter at @MichLitch.
The traditional hierarchy of medicine has been a top-down approach, with the clinician being at the top and the patient being at the bottom. With more focus on patient-centered care, the hierarchy is flattening. Not only are patients encouraged to be decision-makers in their care, we are starting to see patients become involved in advisory boards for medical centers and contribute to meaningful research and design of new products through co-design (AKA participatory design). But how can patients be used to educate clinicians about real-life challenges with a health condition? Especially with chronic conditions, such as diabetes, where individuals become patient experts based on experience? We should be capitalizing on this experiential knowledge to augment how clinicians are trained.
Education in healthcare
There are three typical education patterns seen in healthcare.
Clinician to patient. The traditional model of care. The clinician educates the patient about their diagnosis and/or treatment plan based on research and/or clinical experience.
Clinician to clinician. Clinicians educate student clinicians through formal education and each other through curbside consults.
Patient to patient. Patients educate peers based on their experience living with a condition, such as diabetes, in both online (e.g., communities such as Diabetic Connect) and offline settings (e.g., Diabetes Mixers, meet ups).
But what about education occurring from patient to clinician? This is where things could get really interesting considering how many years of patient expertise exists compared to traditional clinical expertise.
Expert patients as teachers
Taking the concept of the gynecological/genitourinary examinations patient teaching associate (individuals who let students practice histories and physicals focused on sensitive areas of the body) used in clinician student programs, I developed the Fakebetes Challenge. The Fakebetes Challenge is a high-fidelity simulation of living with diabetes. Not only do clinicians go through the motions of living with diabetes—testing, carb counting, taking “fake” insulin (saline)—they are also paired with an individual who actually lives with diabetes, who can create learning opportunities. Such as the time it takes to address a hypoglycemia reaction and how that might impact other responsibilities. Or how easy it is to forget to test or take medications at the right time because life gets in the way. This project focused on patient experts educating clinicians, allowing healthcare providers to learn the critical thinking skills necessary to troubleshoot daily life with diabetes. Overall, participating clinicians felt they could better relate, understand, and empathize with those who have diabetes. Further, clinicians who participated in the challenge were able to learn tips and tricks related to managing diabetes.
Invest in educating your healthcare providers
I have personally gained better insight about living with diabetes from my patients (who have taught me both in clinic and online) and the individuals with diabetes I have encountered through the diabetes online community. The diabetes hacks and various tips and tricks I have learned go into my “toolbox” to be used to educate other patients as appropriate. In a sense, a patient educates me, and I pay it forward by educating a different patient in need.
What will be the next thing you educate your healthcare providers about? Just remember, it might be the very thing their next patient needs.
Have you had teaching moments with your healthcare providers? How did they respond? Share your experience by commenting below.