“My doctor said the word cancer, and I didn’t hear anything he said after that.”—Mark, patient with cancer
A few months ago, I was interviewing a patient who had recently been diagnosed with cancer. HealthEd was conducting a needs assessment to better understand the educational needs that patients have with regard to their condition and treatment. That quote stuck with me, because it captures the magnitude of the impact that emotions can have on learning and retention.
Learning and emotion are intertwined
Educational neuroscience is an exciting new field that brings together researchers and practitioners from areas such as cognitive neuroscience, educational psychology, educational technology, and education theory to explore the connection between the mind, the body, and education. Traditional education has often been viewed as information sharing. Emotions have not typically been considered part of the traditional design process. But researchers and health educators are starting to embrace the fact that learning and emotion are intertwined. One can’t happen without the other.
Emotions can enhance or impede learning and retention
Tracey Shors, PhD, from the Center for Collaborative Neuroscience at Rutgers University, states, “Stressful life events can have profound effects on our cognitive abilities, and acute stressful experiences can impair our ability to learn and remember.” So, negative emotions, such as stress, anxiety, anger, and frustration, can impede learning and cause fatigue, a sense of helplessness, and even disinterest.
On the flip side, neuroscience research has also shown that positive emotions, such as calmness, confidence, and hopefulness, can create a positive learning environment, one that can enhance attention, learning, and retention.
Applying educational neuroscience to patient education
How we can apply educational neuroscience findings to patient education? It can help to consider the following questions: How might patients feel when they engage with the programs or materials you develop? For example, what emotions surface when your patients first read about the potential side effects of treatment, and how might these emotions impact learning? We know that receiving a new diagnosis or facing treatment decisions can create anxiety and fear for both patients and their care partners. As educators, we have an opportunity to incorporate emotional objectives into educational design to validate these emotions and help patients to overcome them.
Here are two examples of emotional objectives that capture both content and tone.
- Content objective: Patients and care partners will be able to identify the common emotions that surface when learning about their diagnosis and list three positive coping strategies for overcoming those emotions.
- Tone objective: This educational tool will help my patients to feel:
- Calmer and more relaxed as they learn about their condition or treatment
- Understood and validated
- Informed, empowered, and confident in their ability to act
- Part of a larger community of others "like me”
- Supported and hopeful
Here are some questions that might help educators to identify the most relevant emotional objectives for their patients and care partners.
- What are my patients feeling and experiencing before they engage with education?
- What emotions might arise during education? For example, how might a patient feel when he or she learns about a challenging prognosis?
- Are there aspects of education that might create negative emotions, such as confusion, fear, or anxiety? If so, how can I help my patients to understand and manage these emotions?
- Are there aspects of education that will create or promote positive emotions? If so, how can I incorporate these aspects into my design?
- How will patients feel after learning about their condition or treatment?
By focusing on patient emotions, we have an opportunity to expand on educational objectives and promote the most positive learning environment and outcomes for patients and their care partners.
Can you share a best practice?
In the sprit of collaboration, it would be great to hear other suggestions and best practices for ensuring that patient education meets both the educational and the emotional needs of patients and their care partners.
Shors TJ. Stressful experience and learning across the lifespan. Annu Rev Psychol. 2006;57:55–85. http://www.rci.rutgers.edu/~shors/pubs/index.htm. Published September 16, 2005. Accessed March 23, 2011.
Shors TJ. Learning during stressful times. Learn Mem. 2004;11:137-144. http://learnmem.cshlp.org/content/11/2/137.abstract. Accessed March 23, 2011.
Shuck B et al. Emotions and their effect on adult learning: a constructivist perspective. In: Nielsen SM, Plakhotnik MS, eds. Proceedings of the Sixth Annual College of Education Research Conference: Urban and International Education Section. Miami, FL: Florida International University; 2007:108-113. http://www.scribd.com/doc/35059133/Emotions-and-their-effect-on-Adult-Learning-a-Constructivist-perspective. Accessed March 23, 2011.
Christopher G. Kelly, M.Ed.
Director, Health Education