Oral Instructions and Patient Literacy Response to Nursing Education

Literacy Relative to Oral Instructions

    The inability to understand the spoken word or oral instruction
above the level of understanding simple words, phrases, and slang words should
be considered an important element in the definition or assessment of literacy.
Most health information can be provided verbally, and many clients prefer to
learn in a face-to-face encounter (Morrow et al., 2007). However, oral
instruction alone is not a very successful method of teaching. “Written
information is better re-membered and leads to better treatment adherence”
(Kessels, 2003, p. 221).

    Doak, Doak, and Root (1985) address the fact that there is no
universally accepted way to test the degree of difficulty with oral language.
However, as these authors observe, “It is believed that some of the same
characteristics that are critical for written materials will also affect the
comprehensibility of spoken language” (p. 40). Much more research needs to be
done on “iloralacy,” or the inability to understand simple oral language, as a
generic concept of illiteracy (Hirsch, 2001; Zarcadoolas et al., 2006).

Literacy Relative to Computer Instructions

    The literacy issue has traditionally been examined from the
standpoint of readability and comprehension of printed materials. The use of
computer technology has emerged as an increasingly popular way to present
information, making it an important dimension of the literacy issue. To a much
greater extent, educators and consumers are relying on computers as educational
tools, transforming the way healthcare information is accessed and shared.
Clients who are well educated and career oriented are likely to own a computer
and be computer literate. 

    It is important to assess and accommodate those with
limited resources, literacy skills. and technological know-how so they are not
left behind (Merriam & Bierema, 2014; Zarcadoolas et al., 2006).Computers not only are used to convey instructional messages, but
they also serve as valuable tools for accessing a wide array of additional
sources of health information. However, clients may not have the skills
necessary to assess the quality and validity of the information they discover. 

    This new concern speaks not only to having skills to use the computer but
skills to know how to assess and use the information found (Landry, 2015). This
is called web or information literacy, which is “how well the client can assess
the accuracy, reliability, and validity of various web sources” (Merriam &
Bierema, 2014, p. 201).

Role of Telecommunication and Patient Instructions In Nursing Education

    The opportunity to expand clients’ knowledge base through
telecommunications and virtual resources requires nurse educators to attend to
computer literacy levels of their audiences. In the same way that they now
recognize the negative effects that illiteracy and low literacy have had on
restricting the information base of consumers of health care when printed
materials are relied upon, nurses must begin to advocate for computer literacy
in the public they serve (Doak et al., 1996; Moore, Bias, Prentice, Fletcher,
& Vaughn, 2009). 

Use of Computers and Software for Patient Instruction 

    Computer software programs can be made suitable for use by
low literate learners if these individuals have the basic capacity to access
and operate computers and the information is simplified for readability and
comprehension (Egbert & Nanna, 2009).The concept of e-health and informatics has grown globally to
encompass use of the Internet and other virtual resources, such as telehealth
and electronic health records, for the delivery and organization of care. 

Use of Smart Phone and Mobile Applications

    Patients also are using smartphone applications, text reminders, blogs or
online communities, and health websites to manage their health (Landry, 2015).
This innovative approach requires that patients have additional skills to
communicate with healthcare providers and understand their treatment plan. Thus,
electronic health literacy must be an additional concern to the nurse. 

    Norman
and Skinner (2006a) define e-health literacy as “the ability to seek, find,
understand, and appraise health information from electronic sources and apply
the knowledge gained to addressing or solving a health problem” (para. 6).These authors draw attention to the knowledge and complex skill set that is
often taken for granted when people interact with technology to access and
share information. 

    Nurses now must focus their attention on learning and
usability issues, whether it begins in an acute care setting or at the
population health level. E-health tools include digital resources designed to
help patients, consumers, and caregivers find health information, store and
manage their personal health information, make decisions, and manage their
health (CDC, 2009).

    The use of e-health tools and interventions by healthcare
professionals and patients appears to hold promise for increasing transparency
and expanding both parties’ knowledge base. Like health literacy, however,
e-health literacy levels are complex and can change based on technological
advances. 

    Therefore, undertaking an assessment of not only health literacy but
also e-health literacy is an important action the nurse can take to determine
whether the use of technology will be useful or detrimental to the client’s
understanding of health information (Brega et al., 2015 ; Collins, Currie,
Bakken, Vawdrey, & Stone, 2012; Neter & Brainin, 2012).