The six types of patient knowledge: Focus on Medical Knowledge

In this third blog in my series focusing on the different types of patient knowledge, I will be focusing on medical knowledge: What is medical knowledge? How is this unique to patients? And how can we learn from it when educating healthcare professionals (HCPs). 

The inspiration for this blog is from the Springer Nature journal Social Theory & Health (ref: https://link.springer.com/article/10.1057/s41285-024-00208-3) where the authors classified six different types of patient knowledge.  In other words, six ways that patients’ lived experience are unique and essential for healthcare professionals.    

• Embodied knowledge  
• Monitoring knowledge
• Relational knowledge  
• Medical knowledge  
• Cultural knowledge  
• Navigational knowledge  

Medical knowledge for patients stems from two primary sources: 

1. Interactions with medical practitioners: Every appointment, consultation, and discussion with healthcare providers serves as an opportunity for patients to learn more about their conditions. Through these interactions, patients gain insights into the nature of their illness, treatment options, and the medical processes involved in their care. 
2. Independent information seeking: Beyond their visits to the doctor, many patients actively seek out additional information to deepen their understanding. Patients and carers are turning to a multitude of sources (including Google) to research their symptoms and condition. They explore the physiological causes of their symptoms, research potential treatments, investigate side effects, and learn about drug interactions. This self-directed learning is transforming the patient-practitioner dynamic and has significant implications for how care is delivered and received. 

Armed with medical knowledge from all sources, patients can engage in informed conversations about their health. It allows them to initiate discussions with healthcare providers about their treatment options and services. This understanding helps them question and even challenge treatment plans or medication choices, making them active participants in their healthcare decisions. 

Negotiating credibility and balance in care 

By demonstrating an understanding of their condition and the associated medical terminology, patients can help negotiate a more balanced relationship with their caregivers, where their voices and concerns are taken seriously. Medical knowledge allows patients to tell their own stories more effectively. By framing their experiences in medically accurate terms, they can communicate more clearly and be better. 

Potential pitfalls of patient independent information seeking 

As we have probably all experienced, Googling medical information can also lead to some challenges in the HCP-patient dynamic. Misinformation from the internet can lead to patients being unnecessarily worried, or to perhaps resist certain diagnostic procedures if they hear negative (untrue) things about them. For example, in our 2023 program to educate on shared decision-making in NSCLC*, we recorded a video conversation between Dr Alexander Drilon (Chief of Early Drug Development at MSKCC, New York) and Alex Miles (a police offer and NSCLC patient). In the video, Alex shared his experience of the diagnosis process and that his oncologist had explained the process of having a tissue biopsy to identify any oncogenic mutations to determine the right targeted therapy for him. However, after this explanation, Alex Googled the procedure and found a blog (containing false information) that claimed biopsies could potentially exacerbate the spread of cancer. This misinformation made Alex reluctant to have a biopsy. Alex did not share this fear with the clinical team at the hospital, because, luckily, he did not need a tissue biopsy to identify his specific gene mutations. However, if he had, this false information from the internet could have deterred him from pursuing the targeted treatment.

What does this mean for medical education? 

As patients become more knowledgeable, they gain the ability to advocate for themselves, negotiate their care, and balance the power dynamics that have traditionally favored healthcare providers. For medical education providers, embracing this shift means creating content that supports and respects the informed patient, ultimately contributing to better healthcare outcomes and more balanced relationships between patients and providers. 

However – as evidenced in our NSCLC example – not all patients are comfortable asking questions. Depending on a multitude of factors, patients may not feel confident, may be too anxious or overwhelmed, or think of questions after the fact. 

How can we incorporate these issues into medical education? 

• Consult your target patient population or patient advocacy groups (PAGs) when developing educational programs:

○   Where do you go for information? 

○   What do you want to be educated on for your condition? 

○   Are there questions that your providers have not been able to answer? 

○   What types of misinformation are encountered by patients? 

○   Which providers do you feel most comfortable asking questions of? 

• Consider the demographics of your patient population and their format/platform preferences.  Use this information to create education such as:

○   Education for patients, such as questions to ask your HCP during each stage of your diagnosis and treatment journey 

○   Educational handouts for HCPs, tailored for different patient types (such as newly diagnosed patients who may not yet be familiar with terminology, patients of different ages, social groups, or educational backgrounds) 

Consider patient-led formats such as patient panels or patient-physician interviews, where the patient can talk through their experience from symptom presentation, diagnosis, and treatment options. This will give HCPs a holistic understanding of how a patient makes sense of everything, where they go for information (good or bad), and where patients can end up becoming misinformed. This may vary per condition, and even within a patient population. Therefore, try to encourage a broad patient representation within the content.

Do you have other examples of how medical knowledge can be incorporated into medical education programs? Please comment or share – I would love to hear from you. 

Stay tuned for the next blog, which will speak on relational knowledge.

*Supported by an educational grant from Bayer HealthCare Pharmaceuticals Inc.