Content area
Aim
To determine what intervention strategies have been used in interventions aimed at improving the patient health education competence of nursing personnel.
BackgroundThere is a growing body of research on educational interventions for improving nursing personnel’s patient health education competence, but there are significant differences in the teaching objectives, content and methods of these studies, as well as a lack of standardized educational strategies.
DesignThe scoping review was based on the Joanna Briggs Institute methodology.
MethodsIn this study, six databases and the gray literature source, the Google search engine, were searched. A search strategy was developed based on the three-step search method recommended by the Joanna Briggs Institute. Two researchers independently performed study selection and data extraction.
Results22 articles reported on the specifics of educational interventions. The duration of these interventions ranged from a minimum of 1.5 hours to a maximum of 3 months. Most interventions employed face-to-face courses as the teaching model. The studies included a variety of teaching methods, with the most frequently mentioned being lectures, discussions, demonstrations, simulations and role-playing. However, most studies lacked specific teaching objectives and none described the educational content of the implementation process. Additionally, none of the studies developed educational content based on a competence framework for patient health education. Few studies reported on long-term effects.
ConclusionThe diverse intervention strategies demonstrated in these studies could serve as valuable evidence to guide the development of relevant educational programs and facilitate the design of future high-quality educational interventions.
Patient health education serves as a crucial tool in both health promotion and disease prevention, widely acknowledged as the most effective and cost-efficient approach to enhancing and sustaining patient well-being ( Croniger et al., 2023; Khazhymurat et al., 2023; Li et al., 2023). Several studies have shown that patient health education can enhance patients’ understanding of their health status and approaches to disease management, improve their ability to self-manage their disease and their compliance with treatment and care and reduce disease-related complications, thereby improving their health outcomes and quality of life ( Forbes et al., 2021; Khazhymurat et al., 2023; Thomas et al., 2022; Wilken et al., 2023). In addition, there is evidence that patient health education not only helps to reduce the cost of treating diseases, but also motivates patients to adopt preventive health behaviors, thereby reducing healthcare costs ( Jung and Roh, 2020; Pueyo-Garrigues et al., 2019; Watson and Ducheine, 2022).
Patient health education is an important part of high-quality nursing practice and also a primary responsibility of the nursing personnel ( Deakin et al., 2023; Khazhymurat et al., 2023; Watson and Ducheine, 2022). However, the performance of nursing personnel in patient health education was not satisfactory, with most nursing personnel reporting that they failed to provide effective patient health education ( Deakin et al., 2023; Pueyo-Garrigues et al., 2022; Wang et al., 2024). Several studies have shown that patient health education competence (PHEC) is an important influence in determining the quality of patient health education provided by nursing personnel, as well as a core professional competence that nursing personnel must possess ( Eskolin et al., 2023; Tian et al., 2024; Wang et al., 2024). Despite the consensus among nursing personnel that PHEC is critical to improving the quality of patient health education, there are deficiencies in their competence to provide patient health education ( Jung and Roh, 2020; Khazhymurat et al., 2023; Pueyo-Garrigues et al., 2022). Most nursing personnel have realized the need for enhanced training in PHEC ( Forbes et al., 2021; Jung and Roh, 2020; Pueyo-Garrigues et al., 2022). Therefore, it is important to provide nursing personnel with appropriate educational interventions targeting PHEC, to improve the quality of patient health education, which in turn improves patient health outcomes and quality of nursing.
There is a growing body of research on educational interventions for nursing personnel’s PHEC, but there are significant differences in teaching objectives, content and methods in these studies and a lack of standardized educational strategies. A comprehensive understanding of relevant educational interventions will identify the characteristics of interventions that are beneficial to nursing personnel’s PHEC. This will provide important information for the future development of standardized educational programs, thereby facilitating the development and optimization of standardized, high-quality educational programs to improve nursing personnel’s PHEC. Therefore, there is a need for a comprehensive and systematic review of existing relevant studies. However, there is a lack of reviews focusing on educational interventions for nursing personnel PHEC. In addition, the existing literature is fragmented. Therefore, we used a scoping review to determine what intervention strategies have been used in interventions aimed at improving the PHEC of nursing personnel, to provide an evidence-based foundation for the future development and optimization of educational programs.
1.1 Review questionWhat intervention strategies (e.g., teaching modalities, teaching objectives, teaching content, teaching methods, teaching duration and frequency, teaching media and teaching faculty) have been used in interventions aimed at improving the PHEC of nursing personnel?
2 MethodsWe used the Joanna Briggs Institute (JBI) methodology to guide this scoping review ( Peters et al., 2021). This scoping review was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist ( Tricco et al., 2018). The scoping review is registered on the Open Science Framework (Registration DOI: https://doi.org/10.17605/OSF.IO/Y38TZ).
2.1 Search strategyThe following six databases were searched between 1 April 2024 and 15 April 2024: the Cochrane Library, PubMed, EMBASE, CINAHL, MEDLINE and ERIC. In addition, the gray literature source, Google search engine, was also searched. The literature search consisted of both subject headings and free-form words involving search terms related to nursing, patient education, competence and training. A search strategy was developed based on the three-step search method recommended by the JBI ( Peters et al., 2021). Firstly, an initial search was conducted in PubMed to identify keywords and subject terms in articles related to the study topic. Then, the search strategy was developed in PubMed (see Table 1) and then adapted for other databases and searched across all six databases. The corresponding search strategies for the other databases can be found in the Supplementary file. Finally, we screened the reference lists of all literature that met the inclusion criteria to identify additional relevant studies. The timeframe for the search was from the creation date of each library to the date of the search, selecting articles written in English.
2.2 Inclusion and exclusion criteriaThe PCC (Population, Concept, Context) model guided the development of inclusion and exclusion criteria. Population: Any nursing personnel (e.g., clinical nurses, nursing supervisors, nurse managers and nursing students) in any clinical setting (e.g., hospital, community) were eligible. The literature was considered if the intervention was aimed at health professionals but included nursing personnel, with at least half of the participants being nursing personnel.
Concept: Any intervention designed to improve nursing personnel’s PHEC. Any intervention content, intervention method and intervention duration were included as concepts.
Context: Interventions provided in any setting by professional or non-professional providers were considered.
Literature type: This review considered different research methods (e.g., quantitative, qualitative and mixed methods study designs) for inclusion. If full-text versions of the studies were not available online, we contacted the authors of these articles and if we were unable to obtain valid information after contacting the authors, we excluded these articles.
2.3 Study selectionThe search results were imported into Endnote to facilitate article selection. Articles were selected in two steps: first, two researchers independently screened the titles and abstracts of the articles according to the developed inclusion and exclusion criteria. Then, studies that passed the first screening step were independently reviewed in full text by the same researchers. Any disagreements between two researchers were resolved by consensus, with a third researcher making the final decision on inclusion in this study. Because this scoping review was designed to provide an overview of the available evidence, we did not assess the risk of bias or quality of the included studies.
2.4 Data extractionTwo researchers extracted data from the final included articles using a data extraction form and a third researcher checked the data extraction form for consensus. The following were extracted for this study:(1) characteristics of all included studies (i.e., authors, year of publication, country, type/design of the study); (2) participants (i.e., target population, sample size, study setting); (3) purpose of the study; (4) key findings and conclusions; (5) intervention strategies (i.e., teaching modality, teaching objectives, teaching content, teaching methods, teaching duration and frequency, teaching media and teaching faculty); (6) measured outcomes; and (7) outcome assessment methods and measurement tools used.
2.5 Synthesis and presentation of the resultsAccording to the research aims of this scoping review, we used a narrative approach to collate and synthesize the findings of the review, supported by tables and flowcharts, combined with a thematic analysis of the research content to understand the diversity of educational interventions better.
3 Results3.1 Search results
A total of 11,687 articles were retrieved, with 8945 remaining after removal of duplicates. After title and abstract screening, 78 full-text articles were obtained for further screening. 56 of these articles were excluded after full-text screening and 22 studies were finally included in the review. No eligible literature was found through the Google search engine. A summary of the process is presented in the flowchart ( Fig. 1).
3.2 Study characteristicsThe included studies were published between 1990 and 2024 and originate from five countries. 10 of the studies were conducted in the USA, while the remaining studies were conducted in Iran, China, Turkey and the UK. The included studies were conducted in hospitals and universities, including 13 quasi-experimental studies, three case report studies, five randomized controlled trials and one mixed-methods study. The characteristics of the included studies are shown in Table 2. Details of the included studies are given in Table 3.
3.3 Teaching targets and teaching durationThe target population primarily comprised nursing students and nurses. Participant numbers in the interventions spanned from as few as eight to as many as 216 individuals. Teaching durations exhibited considerable variability, ranging from a minimum of 1.5 hours to a maximum of 3 months. Additionally, the frequency of teaching sessions differed across the studies examined.
3.4 Teaching modalities, teaching methods and teaching media18 studies implemented interventions in the form of face-to-face courses, while two studies used online courses ( Basak et al., 2019; Blazeck et al., 2016; Boswell et al., 1990, 1996; Burkhart, 2008; Carpenter and Bell, 2002; Dong et al., 2023; Dorri et al., 2019; Eaton-Spiva and Day, 2011; Ekong et al., 2016; Emrani et al., 2024; Ghaffari et al., 2019; Goldenberg et al., 2005; Lamiani and Furey, 2009; Little, 2006; Sezer and Orgun, 2019; Sherman, 2016; Sy, 2016; Torkshavand et al., 2020; Wang et al., 2023). Additionally, two studies employed both online and offline course formats ( Kao et al., 2013; Weiss et al., 2021). These interventions encompassed a variety of teaching methods, with lecture, discussion, demonstration, simulation and role-playing being the most frequently used ( Basak et al., 2019; Blazeck et al., 2016; Boswell et al., 1990, 1996; Burkhart, 2008; Carpenter and Bell, 2002; Dong et al., 2023; Dorri et al., 2019; Ekong et al., 2016; Emrani et al., 2024; Ghaffari et al., 2019; Goldenberg et al., 2005; Lamiani and Furey, 2009; Little, 2006; Sezer and Orgun, 2019; Sherman, 2016; Sy, 2016; Torkshavand et al., 2020; Wang et al., 2023; Weiss et al., 2021). Some studies also incorporated service-based learning, mind mapping, clinical practice, feedback and teach-back methods, as well as standardized patients ( Basak et al., 2019; Blazeck et al., 2016; Boswell et al., 1990; Ekong et al., 2016; Emrani et al., 2024; Lamiani and Furey, 2009; Sherman, 2016; Wang et al., 2023). Most the studies employed diversified teaching methods ( Basak et al., 2019; Blazeck et al., 2016; Boswell et al., 1990, 1996; Burkhart, 2008; Carpenter and Bell, 2002; Dong et al., 2023; Dorri et al., 2019; Ekong et al., 2016; Emrani et al., 2024; Ghaffari et al., 2019; Goldenberg et al., 2005; Hwang and Kuo, 2018; Kao et al., 2013; Lamiani and Furey, 2009; Little, 2006; Sezer and Orgun, 2019; Sherman, 2016; Sy, 2016; Torkshavand et al., 2020; Wang et al., 2023; Weiss et al., 2021). 17 studies provided details on teaching media, including slides, videos, computers, models and handouts ( Basak et al., 2019; Blazeck et al., 2016; Boswell et al., 1990, 1996; Burkhart, 2008; Dong et al., 2023; Eaton-Spiva and Day, 2011; Ekong et al., 2016; Ghaffari et al., 2019; Kao et al., 2013; Lamiani and Furey, 2009; Little, 2006; Sezer and Orgun, 2019; Sy, 2016; Torkshavand et al., 2020; Wang et al., 2023; Weiss et al., 2021).
3.5 Teaching objectivesIncluded among the 22 studies, only four delineated explicit teaching objectives ( Basak et al., 2019; Dong et al., 2023; Sherman, 2016; Wang et al., 2023). All four studies included a teaching objective of improving patient health education competence ( Basak et al., 2019; Dong et al., 2023; Sherman, 2016; Wang et al., 2023). Furthermore, two studies concentrated on augmenting nursing personnel’s knowledge within pertinent clinical domains, while an additional two studies emphasized the cultivation of professional thinking among nursing personnel ( Basak et al., 2019; Dong et al., 2023) ( Dong et al., 2023; Wang et al., 2023). Communication skills enhancement emerged as a teaching objective in three studies ( Basak et al., 2019; Dong et al., 2023; Wang et al., 2023). Notably, Dong et al.’s investigation extended the scope of teaching objectives by encompassing the cultivation of team awareness, enhancement of literature-searching competence, problem-solving aptitude and practical skills ( Dong et al., 2023).
3.6 Teaching content17 studies provided teaching content, which was divided into four main topics: (1) basic knowledge of patient health education, (2) patient health education process, (3) communication skills and (4) knowledge of health education for specific populations.
3.6.1 Basic knowledge of patient health educationThree studies addressed the teaching content related to the basic knowledge of patient health education, encompassing concepts of health and illness, interventions for modifying health-related behaviors and principles of patient health education ( Dong et al., 2023; Lamiani and Furey, 2009; Torkshavand et al., 2020). However, none of the studies provided specific details regarding this content.
3.6.2 Patient health education processNine studies addressed educational components related to the patient health education process, including assessment, planning, implementation and evaluation ( Blazeck et al., 2016; Burkhart, 2008; Carpenter and Bell, 2002; Ekong et al., 2016; Lamiani and Furey, 2009; Little, 2006; Sezer and Orgun, 2019; Sherman, 2016; Weiss et al., 2021). Four studies described specific assessment components, such as patient health literacy, educational needs assessment, readiness to learn, barriers to learning and preferred learning styles ( Burkhart, 2008; Carpenter and Bell, 2002; Ekong et al., 2016; Sherman, 2016). Eight studies shared planned educational details, such as the identification of teaching moments, selection of appropriate teaching methods and preparation of teaching resources ( Blazeck et al., 2016; Burkhart, 2008; Carpenter and Bell, 2002; Ekong et al., 2016; Little, 2006; Sherman, 2016; Wang et al., 2023; Weiss et al., 2021). Two studies focused on how to evaluate the outcomes of patient health education training ( Carpenter and Bell, 2002; Sherman, 2016). The study by Carpenter et al. addressed training in the implementation of patient health education but did not provide specific training details ( Carpenter and Bell, 2002).
3.6.3 Communication skillsFive studies addressed teaching content related to communication skills, four of which delineated specific communication strategies ( Carpenter and Bell, 2002; Lamiani and Furey, 2009; Little, 2006; Wang et al., 2023; Weiss et al., 2021). These strategies included establishing a harmonious nurse-patient relationship, respecting patients’ personal beliefs and values and maintaining positive communication to foster good interactions with the patient.
3.6.4 Knowledge of health education for specific populations10 studies described components of health education knowledge teaching for specific populations, including elderly patients, patients with heart failure, diabetes, chronic diseases of the respiratory system, post-hysterectomy patients, gastroscopy patients and discharged patients ( Basak et al., 2019; Blazeck et al., 2016; Boswell et al., 1996; Burkhart, 2008; Eaton-Spiva and Day, 2011; Ekong et al., 2016; Emrani et al., 2024; Kao et al., 2013; Torkshavand et al., 2020; Weiss et al., 2021). Most studies offer educational interventions across several components: characteristics and risks of the disease, principles of symptom management and self-care and medication management.
3.7 Teaching faculty16 studies reported on the teaching faculty involved in the intervention ( Basak et al., 2019; Blazeck et al., 2016; Boswell et al., 1990, 1996; Burkhart, 2008; Carpenter and Bell, 2002; Dong et al., 2023; Dorri et al., 2019; Ghaffari et al., 2019; Lamiani and Furey, 2009; Little, 2006; Sezer and Orgun, 2019; Sherman, 2016; Sy, 2016; Wang et al., 2023; Weiss et al., 2021). Most the teaching faculty mentioned in the included studies were nursing educators, which encompassed college nursing faculty and clinical nurses. Additionally, three studies involved diverse teaching teams consisting of nursing faculty, clinical nurses, physicians, dietitians and psychologists ( Boswell et al., 1990; Burkhart, 2008; Dong et al., 2023).
3.8 OutcomesIn assessing teaching and learning outcomes, assessment methods include surveys, interviews, observations and feedback.
3.8.1 Patient health education-related knowledge12 studies assessed changes in nursing personnel’s knowledge related to patient health education ( Carpenter and Bell, 2002; Dorri et al., 2019; Eaton-Spiva and Day, 2011; Ekong et al., 2016; Ghaffari et al., 2019; Kao et al., 2013; Lamiani and Furey, 2009; Sezer and Orgun, 2019; Sherman, 2016; Sy, 2016; Torkshavand et al., 2020; Wang et al., 2023). Among these studies, 11 reported improvements in participants’ knowledge of patient health education ( Carpenter and Bell, 2002; Dorri et al., 2019; Eaton-Spiva and Day, 2011; Ekong et al., 2016; Kao et al., 2013; Lamiani and Furey, 2009; Sezer and Orgun, 2019; Sherman, 2016; Sy, 2016; Torkshavand et al., 2020; Wang et al., 2023). Nine studies used self-developed questionnaires for assessment ( Carpenter and Bell, 2002; Dorri et al., 2019; Ghaffari et al., 2019; Kao et al., 2013; Lamiani and Furey, 2009; Sezer and Orgun, 2019; Sherman, 2016; Torkshavand et al., 2020; Wang et al., 2023). Ekong et al. employed the Nurses’ Knowledge of Heart Failure Education Principles Questionnaire for measurement, while Eaton-Spiva et al. used the Diabetes Self-Report Tool ( Eaton-Spiva and Day, 2011; Ekong et al., 2016). Sy’s study analyzed participant feedback to ascertain the positive impact of education on patient knowledge of health education ( Sy, 2016).
3.8.2 Patient health education competence and performanceSix studies examined the impact of educational interventions on patient health education competencies, all demonstrating a significant increase in these competencies among nursing personnel ( Dong et al., 2023; Ekong et al., 2016; Emrani et al., 2024; Kao et al., 2013; Sy, 2016; Torkshavand et al., 2020)。Among these, two studies used validated survey instruments, such as the Scale of Health Education Competence for Nurses and the Health Education Competencies Questionnaire, for evaluation ( Dong et al., 2023; Emrani et al., 2024). Additionally, two studies employed self-administered questionnaires, while one study used observational methods for evaluation ( Ekong et al., 2016; Kao et al., 2013; Torkshavand et al., 2020). Another study was evaluated through a feedback method ( Sy, 2016). Notably, four studies assessed patient health education performance using observational methods, concluding that the educational interventions enhanced nursing personnel’s performance in patient health education ( Basak et al., 2019; Ghaffari et al., 2019; Sherman, 2016; Weiss et al., 2021).
3.8.3 Patient teaching skillsFive studies assessed the impact of educational interventions on the patient teaching skills of training participants, with results indicating improved patient teaching skills associated with these interventions ( Blazeck et al., 2016; Boswell et al., 1990, 1996; Burkhart, 2008; Little, 2006). Among these studies, two used the observation method, two employed the interview method and one used the feedback method.
3.8.4 Self-efficacy and self-confidence related to patient health educationTwo studies indicated that an educational intervention could increase nursing students’ self-efficacy related to patient health education ( Goldenberg et al., 2005; Wang et al., 2023). One study assessed this using the General Self-efficacy Scale, while the other used a self-administered questionnaire on self-efficacy in health education teaching ( Goldenberg et al., 2005; Wang et al., 2023). Additionally, two studies employed a self-developed questionnaire to measure changes in nursing personnel’s self-confidence in implementing patient health education before and after the intervention and one study used a feedback method to explore the effect of training on self-confidence ( Basak et al., 2019; Eaton-Spiva and Day, 2011; Little, 2006). The results of these three studies demonstrated that the educational intervention had a positive impact on caregivers’ self-confidence in delivering patient health education ( Basak et al., 2019; Eaton-Spiva and Day, 2011; Little, 2006)。
In addition, a study by Lamiani et al. found that educational intervention increased nurses’ awareness of their readiness for patient health education ( Lamiani and Furey, 2009). Another study by Torkshavand et al. demonstrated that intervention could improve nursing students’ attitudes toward patient health education ( Torkshavand et al., 2020). Furthermore, a study by Burkhart et al. revealed that intervention could enhance patient outcomes ( Burkhart, 2008).
4 DiscussionThis scoping review identified 22 published studies focused on enhancing nursing personnel’s competence in patient health education. Most these studies were conducted in developed countries, with 10 conducted in the USA. This is likely due to existing standards in the USA mandating training for nursing personnel to enhance their competence in patient health education ( Sy, 2016). There is a clear need for context-specific studies in developing countries. Most of the study designs were quasi-experimental, with five using randomized controlled design approaches. Further randomized controlled trials and longitudinal studies are necessary to thoroughly investigate the effectiveness of educational interventions. The intervention programs examined in the studies were heterogeneous, displaying wide variation in intervention strategies.
The duration of educational interventions ranged from a minimum of 1.5 hours to a maximum of 3 months, with relatively longer durations observed for nursing students. This could be attributed to nursing students’ limited theoretical knowledge and practical skills prior to their clinical placements ( Emrani et al., 2024). However, there is no conclusive research suggesting the optimal duration of educational interventions for nurses and nursing students. A study by Dong et al. demonstrated that collaborative efforts between college nursing faculty and clinical nurses in designing and implementing educational programs resulted in high-quality interventions ( Dong et al., 2023). Additionally, three studies suggested that involving a diverse teaching team could enhance teaching effectiveness ( Boswell et al., 1990; Burkhart, 2008; Dong et al., 2023). This finding aligns with the conclusions drawn by Kristjansdottir et al. ( Kristjansdottir et al., 2021). Therefore, fostering collaboration between academic and clinical staff could facilitate the formation of diverse teaching teams, ultimately contributing to the delivery of high-quality nursing education.
Most interventions employed face-to-face courses as the teaching model. Although face-to-face courses provide immediate interaction and practical opportunities, they are often constrained by geographical location and time, lacking a certain degree of flexibility ( Schwarz et al., 2024). Some studies have suggested that incorporating online courses enhances the continuity and flexibility of educational interventions, meeting the diverse needs of teaching audiences and ultimately improving educational outcomes ( Eaton-Spiva and Day, 2011; Kao et al., 2013; Weiss et al., 2021). Future research should actively explore the usation of online platforms to promote the development of patient health education competence among nursing personnel. The hybrid teaching model can leverage the immediacy and interactivity of face-to-face courses while combining the flexibility and scalability of online courses, thereby saving nursing education resources ( Müller and Mildenberger, 2021). Therefore, future research should explore how to further optimize educational resources and improve teaching quality through a hybrid learning environment to better adapt to changing educational needs and technological advances.
The studies included a variety of teaching methods, with the most frequently mentioned ones being lecture, discussion, demonstration, simulation and role-playing, all of which have been demonstrated to be effective in numerous studies ( Basak et al., 2019; Blazeck et al., 2016; Boswell et al., 1990, 1996; Burkhart, 2008; Carpenter and Bell, 2002; Dong et al., 2023; Dorri et al., 2019; Ekong et al., 2016; Emrani et al., 2024; Ghaffari et al., 2019; Goldenberg et al., 2005; Lamiani and Furey, 2009; Little, 2006; Sezer and Orgun, 2019; Sherman, 2016; Sy, 2016; Torkshavand et al., 2020; Wang et al., 2023; Weiss et al., 2021). Although lecture, discussion and demonstration can convey theoretical knowledge, they tend to focus on details in teaching practice and lack overall systematic instruction ( Li et al., 2022; Xu et al., 2022). While simulations and role-playing can promote interaction and emotional involvement, the lack of professional training among participants may prevent them from realistically reproducing patient responses, resulting in limited authenticity, insufficient feedback mechanisms and excessive subjectivity ( Koukourikos et al., 2021). Additionally, some studies introduced novel teaching methods such as service-based learning, mind mapping, clinical practice, feedback, teach-back methods and standardized patients ( Basak et al., 2019; Blazeck et al., 2016; Boswell et al., 1990; Ekong et al., 2016; Emrani et al., 2024; Lamiani and Furey, 2009; Sherman, 2016; Wang et al., 2023). As a teaching method, standardized patients provide a highly realistic reproduction of clinical scenarios and offer immediate and targeted feedback, compensating for the lack of authenticity in traditional simulations and role-playing while stimulating participants’ interest in learning in an intuitive and engaging way ( Wang et al., 2023). Service-based learning and clinical practice engage nursing students in experiential activities, thereby increasing motivation and self-confidence ( Basak et al., 2019; Emrani et al., 2024). These methods not only promote the integration of theory and practice but also enhance professionalism and responsibility by applying skills in real-world settings ( Emrani et al., 2024). Mind mapping facilitates the extraction and integration of knowledge and information from nursing students, deepening their understanding of educational content ( Wang et al., 2023). It helps participants build a clear knowledge system, master relevant knowledge at a holistic level, promote the integration of multi-level and multi-professional knowledge and cultivate comprehensive thinking ( Wang et al., 2023). Teach-back and feedback methods enhance students’ absorption of knowledge through phased delivery and review of content ( Blazeck et al., 2016; Boswell et al., 1990; Ekong et al., 2016; Lamiani and Furey, 2009). They not only ensure the effective delivery of learning content but also help educators promptly identify and address participants’ misunderstandings, thus promoting teaching effectiveness and learning quality ( Eloi, 2021). However, these novel teaching methods have limitations in large-scale implementation. Most of the studies used a diversified teaching methodology to enhance learning motivation and teaching effectiveness among educational targets ( Basak et al., 2019; Blazeck et al., 2016; Boswell et al., 1990, 1996; Burkhart, 2008; Carpenter and Bell, 2002; Dong et al., 2023; Dorri et al., 2019; Ekong et al., 2016; Emrani et al., 2024; Ghaffari et al., 2019; Goldenberg et al., 2005; Hwang and Kuo, 2018; Kao et al., 2013; Lamiani and Furey, 2009; Little, 2006; Sezer and Orgun, 2019; Sherman, 2016; Sy, 2016; Torkshavand et al., 2020; Wang et al., 2023; Weiss et al., 2021). These findings are consistent with results from other studies, suggesting that diversified teaching methods can indeed improve the quality of education and training ( Ragland et al., 2023; Tao and Wu, 2024; Yang et al., 2022). Diversified teaching methods can combine the advantages of various teaching methods, significantly enhance participants’ initiative and enthusiasm for learning, ensuring the improvement of teaching outcomes. Therefore, in education and training, traditional teaching and learning approaches can be combined with innovative strategies to maximize the learning experience and enhance educational effectiveness. A growing body of research has sought to integrate traditional and modern teaching media to enhance the effectiveness of interventions ( Basak et al., 2019; Boswell et al., 1996; Ekong et al., 2016; Kao et al., 2013). Educators should carefully select and use instructional media to maximize the quality of educational interventions.
Most studies lacked specific teaching objectives and only four studies reported specific teaching objectives without providing criteria for effective teaching objectives. The development of well-defined teaching objectives is crucial for educators to organize educational content and design effective teaching strategies, thereby enhancing the effectiveness of educational interventions ( Orr et al., 2022). Some scholars have suggested using competency performance as a criterion for setting teaching objectives to ensure alignment between teaching objectives and teaching activities, thus improving teaching quality ( Lewis et al., 2022; Robinson et al., 2024). Future research should consider formulating teaching objectives based on competency frameworks to promote coherence between teaching and learning. Four educational content themes were identified in this review. Given that the patient health education process is central to patient health education, most studies focused on training related to this process. However, none of the studies described the educational content of the implementation process. Conversely, the other three educational content themes received less attention. We observed that none of the studies developed educational content based on a competence framework for patient health education. Additionally, the educational content included in the studies was not comprehensive and failed to address the needs of nursing personnel. Hwang et al. and Pueyo-Garrigues et al. concluded that a structured competence framework could serve as effective criteria for addressing nursing personnel’s competence in patient health education, meeting their educational needs and substantially improving the effectiveness of educational interventions ( Hwang and Kuo, 2018; Pueyo-Garrigues et al., 2021). Therefore, systematic and comprehensive educational content should be developed based on the competency framework to more effectively enhance nursing personnel’s competence in patient health education.
All studies assessed learning outcomes, with the majority focusing on outcomes related to knowledge, skills and self-efficacy. The results suggested positive short-term effects of interventions on these learning outcomes. However, few studies reported long-term effects, such as patient outcomes ( Burkhart, 2008). Longitudinal studies are crucial for understanding developmental stages and long-term changes, highlighting the need for such studies to provide a more comprehensive assessment of the impact on learning outcomes ( Burkhart, 2008; Dall'Ora et al., 2022). Additionally, only a limited number of studies used validated instruments and there is a general lack of information regarding psychometric properties. Therefore, it is recommended that future studies employ well-established instruments to assess learning outcomes and provide detailed information on relevant psychometric properties.
4.1 Strengths and limitationsThis is the first scoping review of intervention studies focusing on patient health education competence for nursing personnel. The review adheres to recognized methodological guidance and is reported by the PRISMA-ScR guidelines, aiming to enhance rigor and transparency. Additionally, this study meticulously extracted specific details of relevant educational interventions, including teaching models, content, methods and staff, to assist educators in developing effective educational programs. However, there are some limitations to consider. First, this study only included articles published in English, which may have led to the omission of other relevant studies, thus affecting the comprehensiveness of the results. Second, due to the significant differences in measurement methods and measurement tools in various studies, it is impossible to compare the effectiveness of various teaching models and methods.
5 ConclusionsThis study encompassed 22 studies investigating interventions aimed at enhancing nursing personnel’s patient health education competence. The diverse intervention strategies demonstrated in these studies could serve as valuable evidence to guide the development of relevant educational programs and facilitate the design of future high-quality educational interventions. However, due to the wide variation in intervention strategies and the inadequate addressing of nursing personnel’s needs, there is a pressing need for future educational interventions to develop higher quality and standardized educational programs based on the patient health education competence framework.
While there is consensus that relevant educational interventions contribute to improving nursing personnel’s knowledge, skills, attitudes and self-efficacy, there is a dearth of corresponding longitudinal studies examining the long-term impact of these interventions. Therefore, additional longitudinal studies are warranted to assess the enduring impact of educational interventions.
Funding statementThis work was supported by the National Natural Science Foundation of China (No. 72104250) and the Natural Science Foundation of Hunan Province (No. 2022JJ40642).
CRediT authorship contribution statementGuiyun Wang: Data curation. Yanxia Qi: Writing – original draft. Qirong Chen: Writing – review & editing, Supervision, Methodology, Data curation, Conceptualization. Shuyi Wang: Writing – original draft, Methodology, Data curation, Conceptualization. Ke Liu: Writing – original draft, Data curation. Siyuan Tang: Writing – review & editing, Supervision, Conceptualization.
Declaration of Competing InterestThe authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
AcknowledgmentsWe appreciate the funding supported by the National Natural Science Foundation of China and the Natural Science Foundation of Hunan Province.
Registration numberThe scoping review is registered on the Open Science Framework ( http://osf.io/dapq7).
Appendix A Supporting informationSupplementary data associated with this article can be found in the online version at doi:10.1016/j.nepr.2025.104258.
Appendix B Supplementary materialSupplementary material Supplementary material
| 1 | #1 | (Nurses[MeSH Terms] OR Students, Nursing[MeSH Terms]) OR (nurs*[tiab] OR nursing student*[tiab]) |
| 2 | #2 | (((Health Education[MeSH Terms] OR Patient Education as Topic[MeSH Terms]) OR (health education[tiab] OR education, health[tiab] OR patient education[tiab] OR education, patient*[tiab] OR education of patient*[tiab] OR patient teaching[tiab] OR patient training[tiab])) OR (hospital education[tiab] OR clinical education[tiab])) OR (((((((“educate individual”[tiab:∼2]) OR (“inform individual”[tiab:∼2])) OR (“teach individual”[tiab:∼2])) OR (“train individual”[tiab:∼2])) OR (“learn individual”[tiab:∼2])) OR (((((“educate consumer”[tiab:∼2]) OR (“inform consumer”[tiab:∼2])) OR (“teach consumer”[tiab:∼2])) OR (“train consumer”[tiab:∼2])) OR (“learn consumer”[tiab:∼2]))) OR (((“educate patient”[tiab:∼2]) OR (“inform patient”[tiab:∼2])) OR (((“teach patient”[tiab:∼2]) OR (“train patient”[tiab:∼2])) OR (“learn patient”[tiab:∼2])))) |
| 3 | #3 | ((professional competence[MeSH Terms]) OR (competenc*[tiab] OR capabilit*[tiab] OR capacit*[tiab] OR abilit*[tiab])) OR ((knowledge[tiab]) AND (skill*[tiab])) |
| 4 | #4 | (education, nursing[MeSH Terms] OR nursing education research[MeSH Terms] OR Education, Nursing, Baccalaureate[MeSH Terms] OR Education, Nursing, Continuing[MeSH Terms] OR curriculum[MeSH Terms]) OR (educat*[tiab] OR teach*[tiab] OR learn*[tiab] OR course*[tiab] OR class*[tiab] OR train*[tiab] OR lecture*[tiab] OR intervene*[tiab] OR workshop[tiab]) |
| 5 | #5 | #1 AND #2 AND #3 AND #4 |
| Author(s)/year developed | Country | Type of study | Participants | Study aims | Key findings and conclusions | ||
| Target population | Sample size | Setting | |||||
| Dong et al. (2023) | China | Quasi-experimental with pre- and post-test design | Nursing students | 87
Intervention groups: 42 Control groups: 45 | A university | The study aims to evaluate the delivery and effectiveness of online cardiovascular health behavior modification training based on the CDIO model to improve nursing students’ health education competency and perceptions of clinical decision-making. | A CDIO-based cardiovascular health behavior modification program for nursing students enhances their health education skills, increases their perception of clinical decision-making and optimizes their ability to conduct behavior change counseling. |
| Sy et al. (2016) | USA | Case report | Pediatric RNs | 15 | - | This article details the CNS’s approach to supporting the bedside nurses who would serve as the primary educators for pediatric patients with type 1 diabetes and their caregivers. | This initiative resulted in an increase in nursing confidence and expertise related to diabetes care as demonstrated by competencies met by nurses and anecdotal evidence from nurses and patients’ caregivers. |
| Goldenberg et al. (2005) | Canada | Quasi-experimental with pre- and post-test design | Third-year BScN students | 66 | A university | This study investigated the effect of classroom simulation on third-year BScN students’ confidence related to health teaching. | Simulation as a teaching method to increase students’ perceptions of self-efficacy related to health teaching was supported. |
| Burkhart et al. (2008) | USA | Quasi-experimental with pre- and post-test design | Medical and surgical unit nurses | - | Silverton Hospital | The intent of this study was to explore current practices of inpatient education at Silverton Hospital and determine if an individualized approach to discharge education could improve patient outcomes. | Teaching and retention can be changed and improved through standardized methods of teaching on the part of nurses. |
| Carpenter et al. (2002) | USA | Quasi-experimental with pre- and post-test design | RNs | 44 | - | To ascertain what nurses know about teaching patients and whether a planned education offering could increase the knowledge nurses have about the teaching process in patient education. | Nurse educators should instruct staff on the teaching process, giving nurses the necessary skills to deliver effective patient education. |
| Emrani et al. (2024) | Iran | Randomized controlled trial | Final-year nursing students | 72
Intervention groups: 36 Control groups: 36 | Two health centers | The present study aimed to investigate the effect of service-based learning on the health education competencies of students in community health nursing internships. | Service-based learning positively affects the health education competencies of the nursing students in the intervention group. |
| Weiss et al. (2021) | USA | Quasi-experimental with pre- and post-test design | Nursing students | - | A private university | This study’s purpose was to evaluate the effectiveness of a combined simulation with online learning module for improving discharge teaching skills in a sample of US nursing students. | The simulation combined with online learning approach effectively improved discharge teaching content and teaching skills of the nursing students. |
| Little et al. (2006) | Canada | Case report | Second-year nursing students | 8 | - | This article describes an innovative praxis strategy that used videotaped performances, learner feedback and self-reflection to encourage personal knowing in relation to the experience of nursing students learning to teach groups of clients. | The workshop format and subsequent written analysis of the performance and feedback process were effective in developing their personal knowledge of and confidence and competence in, the educator role. |
| Basak et al. (2019) | Turkey | Randomized controlled trial | Second-year nursing students | 71
Intervention groups: 35 Control groups: 36 | Hospital | The aim of the study is to compare the effectiveness of SP and theoretical lecture in terms of improving the patient teaching skills of nursing students. | The use of SPs may be a valuable method for increasing pre-graduate nurses’ competence related to patient teaching skills for inhaler technique and transferring their theoretical knowledge to clinical practice. |
| Wang et al. (2023) | China | Quasi-experimental with pre- and post-test design | Postgraduate nursing students | 74 | Affiliated hospital of Zunyi Medical University | This study examined the effects of a mind mapping based on standardized patient program in the patient education knowledge and communication competence of postgraduate nursing students in clinical setting. | The mind mapping based on standardized patient program is an effective way to improve postgraduate nursing students’ knowledge and communication competence in patient education during clinical practice. |
| Ekong et al. (2016) | USA | Quasi-experimental with pre- and post-test design | RNs and LVNs | 33 | Home healthcare agency | This article describes a change project involving an educational intervention designed to address this gap in home healthcare nurses’ knowledge. | This project can improve a nurse’s ability to provide adequate patient education on HF self-care. |
| Blazeck et al. (2016) | USA | Case report | Sophomore nursing students | 216 | University | This article describes the development, implementation and evaluation of interactive video modules that presented examples of effective and ineffective patient education for patients with complex chronic conditions who were preparing for their transition to self-care at home. | Interactive video modules can be used to foster patient teaching skills early in the nursing curriculum. |
| Sezer et al. (2019) | Turkey | Randomized controlled trial | Second-year nursing students | 66
Intervention groups: 32 Control groups: 34 | Nursing Faculty of Ege University | The current study was planned to determine the effectiveness of the simulation method and the use of a standardised patient in facilitating the ability of nursing students to gain patient education skills. | The simulation method and explanation method in facilitating the ability of nursing students to gain patient education skills are successful. |
| Boswell et al. (1990) | USA | Quasi-experimental with pre- and post-test design | RNs and other healthcare professionals | 66
RNs: 50 Other healthcare professionals: 16 | Vanderbilt School | The purpose of this article is to describe a program designed to enhance the teaching skills of healthcare professionals. | Course participants’ teaching skills improved from the beginning to the end of the course. |
| Sherman (2016) | England | Quasi-experimental with pre- and post-test design | Clinical nurses | 85 | Academic institute | The focus of the project described in this article was to promote a standard of practice that would improve nurses’ ability as effective, efficient patient educators. | The curriculum used in this project promotes increased knowledge and confidence in clinical nurses as they contribute to improved health outcomes through patient education. |
| Dorri et al. (2019) | Iran | Randomized controlled trial | Nursing students | 74
Intervention groups: 39 Control groups: 35 | Firouzgar and Hazrat Rasoul educational hospitals | The present study is an attempt to determine the effects of role-playing education on the learning outcomes in nursing students based on the Kirkpatrick’s evaluation model. | The evaluation by the Kirkpatrick’s model showed that use of role-playing method improved learning outcome of nursing students. |
| Kao et al. (2013) | China | Quasi-experimental with pre- and post-test design | Gastrointestinal nurses | 65
Intervention groups: 25 Control groups: 40 | Hospitals | The study was to compare the effects of two different educational interventions on knowledge and competence of nurses regarding conveying gastroscopy-related information to patients. | Both educational interventions improved nurses’ knowledge and competence in gastroscopy-related information. However, the CD-ROM-based intervention had long-term effects on knowledge and had short-term and long-term effects on competence. |
| Lamiani et al. (2009) | USA | Mixed-methods study | Nurses and health educator | 14
Nurses: 13 Health educator: 1 | Academic hospital | To evaluate the effects of a patient education workshop on nurses: (1) communication skills; (2) Knowledge of patient-centered model, patient education process and sense of preparedness to provide patient education. | Our findings demonstrate that a 2-day workshop on patient education, based on a patient-centered approach, improved nurses’ communication skills and knowledge and their sense of preparedness. |
| Eaton-Spiva and Day (2011) | USA | Quasi-experimental with pre- and post-test design | RNs | 933 | A community acute care hospital | To assess perceptions of nurses’ knowledge in diabetes care and confidence in teaching diabetes education and to examine the effectiveness of a computer-based learning educational module on nurses’ knowledge and confidence related to diabetes. | Nurses had a slight improvement in knowledge, skill and confidence related to diabetes after the computer-based learning intervention, but no statistically significant differences were found. |
| Ghaffari et al. (2019) | Iran | Quasi-experimental with pre- and post-test design | Second-semester bachelorette nursing students | 154
Intervention groups: 77 Control groups: 77 | Tehran University of Medical Sciences | This study compared the effects of multiple teaching methods and conventional methods on the knowledge, satisfaction and performance of bachelorette nursing students. | Teaching with multiple methods (role-playing, simulation and the use of multimedia) facilitates students’ satisfaction and performance through their engagement in the educational process. |
| Boswell et al. (1996) | USA | Quasi-experimental with pre- and post-test design | RNs and other health professionals | 60
RNs: 47 Other health professionals: 13 | - | The objective of this dissemination research study was to investigate whether, using a ‘training of trainers’ approach, seven nurses with staff development responsibilities in five different sites could teach EPT with similar effectiveness. | EPT can improve participants’ teaching skills when taught by health professional trainers with staff development responsibilities who have recently received EPT training. |
| Torkshavand et al. (2020) | Iran | Randomized controlled trial | Undergraduate nursing students | 70
Intervention groups: 35 Control groups: 35 | Hamadan University of Medical Sciences | The purpose of this study was to determine the effects of simulation-based learning on students’ skills in providing education to older patients. | Simulation-based learning is a promising instructional method, with long-term benefits in improving students’ skills. |
| Author(s)/year developed | Intervention strategies | Outcomes measured | Outcome assessment methods/ Measurement instruments | ||||||
| Teaching modalities | Teaching objectives | Teaching content | Teaching methods | Teaching duration and frequency | Teaching media | Teaching faculty | |||
| Dong et al. (2023) | Online Course | 1. Develop specialized thinking in cardiovascular disease.
2. Improve students’ literature search skills. 3. Enhance students’ basic professional knowledge. 4. Improve health education competency. 5. To enhance perceptions of clinical decision-making. 6. Training participants’ communication and coordination skills. 7. Enhance the team consciousness of the participants 8. Improve their problem-solving skills 9. Improve their practical ability under the guidance of the Standardised Patient (SP). | Conceive:
1. Provide cardiovascular health behavior modification cases and questions before the training. 2. Students conduct a literature search and have group discussions. 3. Behavior modification plan is developed based on the discussion. Design: 1. Students use slides to report on the behavior modification plan for the case briefly. 2. Teachers provide professional health behavior modification curriculum in five aspects: exercise, diet/weight management, smoking cessation, medication adherence and psychological support. 3. The teacher answered the students’ questions after the theoretical course. Implement: 1. Through role play, students practice health behavior change education and counseling. 2. The teacher gives suggestions and comments Operate: 1. Students work in groups to complete an individualized health education plan for the given case. 2. Communicate with SP and conduct education and counseling for health behavior modification. 3. The teacher provides comments throughout the process and summarizes the lesson. | 1. Case study
2. Participatory teaching and learning 3. Role-playing 4. Scenario simulation 5. Lecture | 9 class period | Slides | Professors of Fudan University, cardiovascular education nurses, chief physician of the cardiology department and the chief instructor of the nursing department | Health education competency | Survey/ Scale of Health Education Competence for Nurses |
| Sy et al. (2016) | Face-to-face Course | - | - | 1. Discussion
2. Simulation-based training | 8-hour in 1 day | | A certified diabetes nurse educator and a certified nutritionist | Patient health education knowledge and competence | Feedback/ NA |
| Goldenberg et al. (2005) | Face-to-face Course | - | - | 1. Case study
2. Role-play simulations | 2 half-day | - | - | Self-efficacy in health teaching | Survey/ Baccalaureate Nursing Student Teaching-Learning Self-Efficacy Questionnaire |
| Burkhart et al. (2008) | Face-to-face Course | - | 1. Assessment of the patient’s educational needs.
2. Barriers to learning. 3. Hysterectomy-specific content. 4. Teaching methods | 1. Lecture
2. Discussion | 4 hours | Handout | The assistant director of nursing services and researchers | Patient teaching skills | Telephone interviews/ NA |
| Carpenter et al. (2002) | Face-to-face Course | - | Teaching process:Assessment:Establishing a rapport to promote effective communication.
Readiness to learn. Literacy level. Learning style. Age-specific and cultural considerations. Barriers to learning.Planning:The tools the educator would use to teach the patient.Implementing:Interactive teaching.Evaluating:Documentation of the teaching session. | 1. Interactive lecture
2. Lecture 3. Case study discussion | 1.5 hours | - | Patient education department personnel | Knowledge level nurses possessed about the teaching process and its application to case study situations along with elements of content and retention issues | Survey/ Self-developed questionnaire on teaching process and its application to knowledge |
| Emrani et al. (2024) | Face-to-face Course | - | 1. Introducing the health system.
2. Introducing the integrated health system. 3. Happy children program (healthy child, monitoring the child’s growth and nutrition and promoting breastfeeding). 4. Supplemental assistance to 2–5-year-old children. 5. Varnish (fluoride therapy) for children aged 3–13 years. 6. Risk assessment in terms of blood pressure, blood sugar, blood lipids and BMI. 7. Screening cervix, breasts, intestine, AIDS, hepatitis, tuberculosis, cholera and lice. 8. Universal neonatal screening (G6PD enzyme deficiency, phenylketonuria, hypothyroidism and hearing). 9. Prevention of disasters and accidents 10. Vaccination, cold chain, child development and health. 11. Maternal healthcare program. Adolescent, youth and student health program. 12. Middle-aged health program. 13.Elderly health program. 14. Infectious and non-infectious disease control program. 15. Introducing the activities of the nutrition and service delivery unit. Introducing the activities of the mental health and service delivery unit. 16. Introducing the activities of the oral health and service delivery unit. 17. Introducing the activities of the environmental health and service delivery unit. | 1. Service-based learning
2. Discussion | 8 sessions in 20 days | - | - | Health education competency | Survey/ Health education competencies questionnaire |
| Weiss et al. (2021) | Both Online and Face-to-face Courses | - | 1. Discharge teaching core content:
Information about self-care at home. Knowledge about medical care treatments and medications. Practice with medical care treatments and medications. Knowledge about when to call the provider. Expected emotions during the discharge transition. Learning needs of other family members. 2. Patient/family teaching delivery skills. | 1. Simulation
2. Online learning module | - | Computer | Clinical instructor | Discharge teaching performance | Observation/ Quality of Discharge Teaching Scale – Evaluation form |
| Little (2006) | Face-to-face Course | - | 1. The need for a purposeful approach.
2. Interactive relationship between the teacher and learner in the education process. | 1. Lecture
2. Role-play simulations 3. Demonstration | 1 day | Video | College faculty | Patient teaching skills, self-confidence in patient health education | Feedback/ NA |
| Basak et al. (2019) | Face-to-face Course | 1. Maintain appropriate communication during patient teaching.
2. Use a clear and understandable language when communicating with the patient. 3. Explain to the patient how to use the inhaler device. 4. Demonstrate how to use the inhaler device correctly to the patient. 5. Pay attention to patient teaching principles regarding inhaler drug use. 6. Request feedback from the patient for the teaching. | 1. The use of inhaler drugs.
2. The principles of patient teaching on the use of inhaler drugs. | 1. Demonstration and video display techniques
2. Simulation 3. Clinical practice | 2 hours theoretical and 2 hours practical teaching and 4–5 days clinical teaching | 1. Model
2. Video | Clinical instructor | Self-confidence in patient training, student satisfaction, clinical performance for patient teaching, visual analogue scale | Survey and observation/ Visual analogue scale, Student Satisfaction and Self-Confidence in Learning Scale, Evaluation performance checklist of patient teaching skills of the students, |
| Wang et al. (2023) | Face-to-face Course | 1. Culture the students’ ability to summarize the knowledge of patient education.
2. Culture the students ability to communicate in patient education. | In the first phase:
1. The basic knowledge, charting method of mind mapping and mind mapping software (XMind). 2. Demonstrations of XMind in patient educational content design. 3. Choose a disease to complete a design for patient educational content based on mind mapping through XMind software for 40 minutes. In the second phase: Practice health education for COPD patient and Orthopaedic surgery patient. | 1. Mind mapping
2. Standardized patient 3. Demonstration | In the first phase: four sessions of 6 hours in one week,
In the second phase： one week | XMind software | Nursing educators | Patient education knowledge, patient education communication competence, self-efficacy, patient satisfaction | Survey/ Self-developed students’ patient education knowledge questionnaire, Nurse-Patient Communication Competency Rating Scale, General Self-efficacy Scale, Self-developed Patients’ satisfaction questionnaire |
| Ekong et al. (2016) | Face-to-face Course | - | 1. Overview of HF.
2. Pathophysiology and incidence. 3. Definition of self-care. 4. Application of HF self-care model. 5. Overview of health literacy. 6. How to assess health illiteracy in patients. 7. The use of the teach-back method to instruct patients on evidence-based HF self-care principles. | 1. Role-play simulations
2. Teach-back method | 2 90-minute sessions delivered over two days | 1.PowerPoint
2. Handout 3. Video | - | Patient education knowledge, patient education skills | Survey and observation/ Nurses’ Knowledge of HF Education Principles questionnaire, Institute for Healthcare Improvement’s teach-back observation tool. |
| Blazeck et al. (2016) | Face-to-face Course | - | 1. Evidence-based guidelines for discharge management.
2. Teaching strategies. 3. Common reasons for readmission. | 1. Teach-back method
2. Discussion | - | Video | College faculty | Patient teaching skills | Focus group interviews/ NA |
| Sezer et al. (2019) | Face-to-face Course | - | Patient Education Process | 1. Simulation,
2. Lecture 3. Discussion | - | Video | Researchers | Patient education process knowledge, patient education prepared and implemented | Survey/ Self-developed Knowledge Test, Self-developed Patient Education Evaluation Form |
| Boswell et al. (1990) | Face-to-face Course | - | - | 1. Simulations
2. Demonstration 3. Feedback | 15 2-hour sessions | Video | A nurse, educational psychologist, physician and clinical psychologist | Teaching skills | Observation / Teaching-skill rating scale |
| Sherman (2016) | Face-to-face Course | 1. Demonstrate the ability to assess the patient’s preferred learning style.
2. Validate with the patient the topic/goals/objectives of the educational session. 3. Use appropriate teaching modalities based on the learning needs assessment. 4. Use teach-back method/questioning to evaluate the patient’s understanding of educational content. | 1. Assessing the learner.
2. Setting mutual learning goals and objectives. 3. Using appropriate teaching modalities.Evaluating with teach-back. | 1. Demonstration
2. Standardized patient simulation | - | - | Nurse educators | Patient education knowledge, patient education performance | Survey and observation / Self-developed Pretest-Posttest Questions, Pre-post simulation performance checklist |
| Dorri et al. (2019) | Face-to-face Course | - | - | 1. Lecture,
2. Role-play | 8 2-hour sessions | - | Researcher, College faculty | Patient education knowledge, patients’ satisfaction | Survey/ Self-developed Knowledge evaluation questionnaire, Patients’ satisfaction scale with education performance of nurses |
| Kao et al. (2013) | Both Online and Face-to-face Courses | - | 1. The indications, contraindications and complications of gastroscopy, the procedure and patient sensations during the procedure and the need for gastroscopy patient education.
2. A gastrointestinal hepatologist used actual photographs to explain related treatment. 3. Standardized patients presented the experience of clinical gastroscopy and senior nurses demonstrated the provision of gastroscopy-related patient education to new nurses. | CD-ROM teaching method | - | 1. Video
2. Instruction pocket booklet | - | Gastroscopy nursing instruction knowledge, gastroscopy nursing instruction competence, gastroscopy nursing instruction curriculum learning satisfaction | Survey/ Knowledge Test Gastroscopy Nursing Instruction Scale, the Self-Evaluation Gastroscopy Nursing Instruction Scale and Gastroscopy Nursing Instruction Learning Satisfaction Scale |
| Lamiani et al. (2009) | Face-to-face Course | - | 1.The Patient-Centered Model and Patient-Centered Education.
2. The Communication Process. 3. The Patient Education Process 4. How to Document Patient Education. | 1. Lecture
2. Role Play 3. Discussion 4. Feedback | 2 6-hour sessions | Video | A nurse and a health educator | Baseline sense of preparedness in patient education, self-reported knowledge about the patient-centered model and the patient education process | Survey / - |
| Eaton-Spiva and Day (2011) | Online Course | - | 1. Pathophysiology of diabetes.
2. Natural progression of diabetes and its effects on mortality and morbidity. 3. The need for tight glycemic control to prevent complications. 4. Current treatment recommendations consistent with the ADA guidelines. | Computer-based educational | - | PowerPoint | - | Knowledge of and skills in diabetic care, nurses’ perceived confidence in their ability to teach patients | Survey/ Self-Report Diabetes Tool, Self-developed Confidence in Teaching Diabetes Education Scale |
| Ghaffari et al. (2019) | Face-to-face Course | - | - | 1. Role-play
2. Simulation | 12 sessions of an hour and a half in 3 months | Video | University faculty | Patient education knowledge, satisfaction, patient education performance | Survey and observation / Self-developed knowledge and satisfaction questionnaires, Patient education performance questionnaire |
| Boswell et al. (1996) | Face-to-face Course | - | 1. Medication administration.
2. Elements of diabetes self-care. 3. Heart disease. 4. Pre- and post-operative care. 5. The therapeutic exercise. 6. Maternal-infant care. 7. Specialized meal planning. 8. Family planning. | 1. Lecture
2. Demonstration | Course duration and frequency differed from site to site | 1. Video
2. Audiotape | RNs | Teaching skills | Observation / - |
| Torkshavand et al. (2020) | Face-to-face Course | - | 1. The principles of patient education.
2. Aging. 3. Common age-related physical and cognitive changes. 4. Strategies for educating older patients with COPD. | 1. Lecture
2. Demonstration 3. Simulation-based learning | 90 minutes | PowerPoint | - | Patient education knowledge, patient education attitude, patient education skills | Survey/ Self-developed Knowledge Assessment Questionnaire on COPD Elderly Patient Education, The Los Angeles Geriatric Attitudes Scale, Self-developed Checklist of Student’s Skills in COPD Elderly Patient Education |
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