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EDUCATION AND DEBATE: Noreen M Clark and Molly Gong Management of chronic disease by practitioners and patients: are we teaching the wrong things? BMJ 2000; 320: 572-575 [Full text]

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Are practitioners' teachers teaching the wrong things? The Spanish case

José Luis Turabián Fernández   (9 March 2000)

Are practitioners' teachers teaching the wrong things? The Spanish case 9 March 2000
José Luis Turabián Fernández Send response to journal: Re: Are practitioners' teachers teaching the wrong things? The Spanish case	EDITOR: Clark (1), and Holman (2) in their articles consider that practitioners who are trying to manage chronic disease are teaching the wrong things to patients, and they suggest that an approach that enhances the ability of patients with chronic disease is self management education, a "new" form of empowering practice in health care based on empowering patients to enhance their individual and community capacity (3). But, if professionals have to understand and work with an empowerment approach, they need opportunities to explore this process in their own professional development and training (4). Maybe, Spain is different from other countries, because there is a big gap between real primary health care and university, where students are taught yet within a biomedical model. In this context, we have had some experience about training courses in health education and clinical skills to primary health care professionals (general practitioners, nurses, social workers, pharmacists, veterinarians, psychologists) during the last ten years in the Health Public School of Castilla-La Mancha, a regional postgraduate school, which has as a core value education for empowerment through participation, open agenda, holistic learning, awareness about causes of disease, learning from each other more than from a teacher to students, and within strategic analysis of possibilities to perform empowerment patient education in everyday practice. Unfortunately, in our experience, doctors and nurses -the nearest professionals to patients - have more difficulties in understanding empowerment education, and they have more resistance in applying this strategy to manage patients with chronic disease, compared with other primary health care professionals. Perhaps, in many places, as in Spain, there is a long way go before teaching is understood as a communication process to lead to empowerment, and it can be used as a method of education, in order to facilitate practitioners teaching the right things to their patients. REFERENCES: 1.-Clark NM, Gong M. Management of chronic disease by practitioners and patients: are we teaching the wrong things? BMJ 2000;320:572-575. 2.-Holman H, Lorig K. Patients as partners in managing chronic disease. BMJ 200;320:526-527. 3.-Turabián JL, Pérez-Franco B. Utilidad y límites de la educación sanitaria. FMC-Formación Médica Continuada en Atención Primaria. 1998;5:419-421. 4.-Rivers K, Aggleton P, Whitty G. Professional preparation and development for health promotion: a review of literature. Health Education Journal 1998;57:254-262. José Luis Turabián and Benjamín Pérez-Franco general practitioners, tutors of family medicine and professors of health education Castilla-La Mancha Health Public School, Regional Centre of Public Health. Talavera de la Reina, Toledo, Spain. Address for correspondence :José Luis Turabián Fernández Calderón de la Barca, 24. 45313 Yepes (Toledo)