Standards of Oncology Education:1 Patient/Significant ...

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1 Standards of Oncology Education: Patient/Significant 2 Other and Public (4th Edition)

3 Carol S. Blecher, MS, RN, AOCN?, APNC, CBCN 4 Anne M. Ireland, MSN, RN, AOCN? CENP 5 Joni L. Watson, MBA, MSN, RN, OCN?

6 Introduction

7

In 2013 the Oncology Nursing Society published a Statement on the Scope and Standards of

8 Oncology Nursing Practice ? Generalist and Advanced Practice. Like the previous versions, it

9 defines the roles of oncology nurses and reflects ONS's mission statement (Brandt, and

10 Wickham). The scope of oncology nursing care includes assessment, diagnosis, outcome

11 identification, planning, implementation and evaluation (Brandt, and Wickham). This mirrors the

12 ANA Standards of Professional Nursing Practice 2nd edition (2010). In Standard 5

13 (Implementation) of both the ANA and ONS documents it indicates that the registered nurse

14 provides education to promote health.

15

ONS believes that oncology nurses have the responsibility of developing, assessing,

16 implementing and evaluating educational programs for patients, their significant others, and the

17 public. The nurse should provide teaching and anticipatory guidance regarding cancer and its

18 treatment, including symptoms and side effects (APHON, 2009). Joint Commission (1992-2000)

19 in the section on Education Standards identifies the facts that the patient's learning needs,

20 abilities, preferences and readiness to learn must be identified. They also emphasize the fact that

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21 patient education is interactive, meaning that we must include the patient, significant other, and

22 the public and assure their interest in the programs. An important method of achieving this is by

23 incorporating "teach back" techniques into the educational process. In short the educator role is a

24 nursing responsibility (APHON, 2009; ANA, 2010; ONS, 2013; Home Health Nursing

25 Standards, 2007; Joint Commission 1992-2000) and a necessity for patients, their significant

26 others, and the public.

27

The Outcome Standards for Cancer Patient Education was first published by ONS in 1982,

28 followed by the Outcome Standards for Public Cancer Education in 1983. In 1989, the standards

29 were revised and consolidated into one document. These were again updated and revised in 1995

30 and 2004.

31

The purpose of this document is to provide comprehensive guidelines for nurses to:

32 Develop, implement, and evaluate formal and informal patient/significant other education

33

programs.

34 Develop, implement, and evaluate formal and informal public education programs.

35

The intended outcomes of the Standards of Oncology Education: Patient/Significant Other

36 and Public are to:

37 Enhance the quality of patient teaching.

38 Exemplify the scope of teaching in all phases of cancer care, including prevention, early

39

detection, rehabilitation, survivorship, and supportive care.

40 Improve health promotion and care for the public. 41 The standards in this document are descriptive statements designed to guide the achievement of 42 quality education for the patient, their significant others, and the public. The format is consistent

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43 with the American Nurses Association (ANA) Standards for Nursing Professional Development

44 and includes the following categories:

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I. Oncology Nurse

46

II. Resources

47

III. Curriculum

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IV. Teaching-Learning Process

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V. Learner: The Patient/Significant Others and the Public

50

The following assumptions were made in the development of the Standards of Oncology

51 Education:

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1. All people are at risk for cancer.

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2. All people have the right to information related to cancer and oncology care presented at

54 the individual's level of learning/comprehension.

55

3. Education is a component of the comprehensive nursing care of the patient/significant

56 others experiencing cancer as well as the public.

57

4. Inappropriate responses to the potential or actual threat of cancer may be modified by

58 enhancing knowledge, skills, and attitudes of the patient/significant others and the public.

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5. Application of principles of adult education theory enhances learning.

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6. Professional oncology nurses are role models in cancer education.

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7. All educational activities reflect sensitivity to and respect for diverse cultural

62 backgrounds and health belief systems of the patient and significant others experiencing cancer.

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8. Professional oncology nurses provide care in a variety of settings, including hospitals,

64 ambulatory settings, private practices, homes, and hospices.

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65

This edition of Standards of Oncology Education: Patient/Significant Other and Public is

66 designed to affirm nursing's role as educator (ANA, 2015) and be reflective of current practice

67 trends and evidence-based practice. Updated references are provided for practitioners to use in

68 their role of educator for patients, significant others, and the public.

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69 Changing Methods and Technology in Education

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Lecture, verbal instruction, discussion, written materials both in hardcopy or digital format

71 through short message system (SMS) text messaging and email, demonstration, teach-back,

72 audio and visual (AV) aids ? either hardcopy through discs or digitally through online audio and

73 video files, "edutainment through gamification" (e.g. the use of games), and role-playing either

74 in-person or virtually through programs such as Second Life ? all of these are methods of current

75 patient and public education. As technology has rapidly changed and continues to morph, so do

76 the tools in which we use to fulfill the static principles of learning, utilizing the foundational

77 nursing process. The Internet now provides instant evidence, resources, and tools, often well

78 ahead of traditionally printed versions. In addition, mobile and televideo education methods are

79 commonplace in today's teaching environment with far-reaching effects (O'Connor & Andrews,

80 2015; Raman, 2015).

81

Teaching methods and "strategies [are only as] effective as their audience's access to the

82 necessary tools to use them" (Friedman, Cosby, Boyko, Hatton-Bauer, & Turnbull, 2011, p. 18).

83 Demonstration and the teach-back method are most effective followed by written materials and

84 AV tools, with verbal teaching and discussions least effective. While multiple education methods

85 exist, there is no "one size fits all" to educate patients, families, or the public. A combination of

86 education methods is preferred and proven to be more successful in producing enhanced patient

87 outcomes (Friedman, et al., 2011).

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The rise of the digital age has changed the way we teach and learn. Digital natives ? those

89 born after 1980 ? are generally well-versed and comfortable with learning via digital methods; it

90 is a natural language for Generation Y'ers and Generation Z'ers, a population currently totaling

91 approximately 94 million people who will grow to surpass all prior generations combined

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