5 Patient Education and Health Literacy

Purpose and shared responsibility

Effective patient education helps people make informed decisions and carry out actions that support health. It is a two-way process: the clinician shares relevant information, learns what matters to the patient, and checks whether the plan is understandable and workable.

Health literacy is not simply a patient’s reading ability. It also depends on how clearly health professionals and systems communicate. Use health-literacy universal precautions by making information easier to understand and act on for everyone, since anyone may have difficulty understanding health information in a particular situation.

Communicate clearly

Before teaching, identify the patient’s main concern, what they already know, what they want to learn, and what they need to do next. Agree on one or two priorities, especially when time or attention is limited.

Use plain, direct language, explain unfamiliar terms, and focus on one idea at a time. Put the most important action first, use short sections and headings, and pair spoken explanations with useful written or visual materials. For example, say, “Take one pill in the morning and one in the evening,” rather than “administer the medication twice daily.”

Ask about access needs, such as vision, hearing, preferred language, or help using written or digital materials.

Respond to culture and language

Ask rather than assume. Beliefs, experiences, family roles, communication preferences, and personal circumstances can shape how patients understand health and make decisions. Invite patients to share what matters to them, then develop a plan that respects their preferences while clearly explaining relevant health information.

Use a qualified medical interpreter when needed. Speak directly to the patient in short segments and pause for interpretation; do not rely on children or untrained interpreters for clinical communication. Offer understandable materials in the patient’s preferred language when available, and include family or other support people when the patient wants them involved.

These practices reflect the National CLAS Standards’ emphasis on effective, understandable, respectful care and appropriate language assistance.

Support behavior change

Education alone may not be enough to change a behavior. Ask about the patient’s goals, readiness, confidence, and barriers without blame. Motivational interviewing uses a collaborative, respectful style to explore a person’s own reasons for change and support their autonomy.

The 5 A’s provide a practical counseling framework:

• Ask about the behavior.

• Advise with clear, personalized information.

• Assess willingness to change.

• Assist with a patient-chosen plan.

• Arrange follow-up.

Make plans specific and achievable. For example, a patient who wants to be more active might choose a brief walk after lunch three days this week. Discuss likely obstacles and possible supports, then revisit the plan at follow-up. Adjust the approach to the patient’s circumstances rather than treating difficulty following a plan as a lack of motivation.

Check understanding and skills

Do not rely on “Do you understand?” A patient may answer yes even when important details remain unclear. Use teach-back to check how well you explained the plan by asking the patient to describe, in their own words, what they will do. For example: “I want to be sure I explained this clearly. When you get home, how will you take this medicine?”

For a skill, use show-me: ask the patient to demonstrate it, such as how they will use an inhaler. Teach in small sections using chunk and check, and invite teach-back without judgment. If needed, clarify in a different way and check again. Teach-back evaluates the explanation and helps uncover misunderstandings; it is not a test of the patient.