Checking readiness to learn
Even when we believe patient education is necessary, the timing has to be right. Readiness to learn is a dynamic, context-sensitive state that reflects whether a person is emotionally, cognitively, and practically able to take in and apply new information. Many factors, including pain levels, stress, cultural beliefs, and previous healthcare experiences can all impact how receptive a patient is to learn at any given moment. Patients must be ready not only to absorb information, but also to engage with it, especially when that information is new, unfamiliar, or challenges their existing beliefs. Research in adult learning highlights that readiness to learn is a key predictor of skill acquisition and use, making it a vital consideration in effective patient education (Smith et al., 2015).
Let’s start with a clinical parallel: Would you deliver high-intensity rehabilitation to someone in acute pain, high distress, or without clear goals? Probably not. The same principle applies to education. Trying to teach a patient who isn’t ready can create frustration, resistance, or misunderstanding, and may reduce trust in you as their clinician.
Why this matters
- If a patient isn’t ready to learn, forcing education can be counterproductive.
- Patients with strong pre-existing beliefs that have been held for a long time (for example, “my back is fragile”) may need a gradual approach to accepting new perspectives. Trying to challenge these beliefs too quickly can create resistance and distrust.
- Recognising when to pause, simplify, or delay education can help our outcomes.
Readiness to learn can be influenced by:
- Emotional state: Anxiety, fear, or distress may make learning difficult. In these cases, reassurance and small, manageable information chunks are key.
- Cognitive load. Patients who are trying to process multiple pieces of information at once, especially after a new diagnosis or a life event, may feel overwhelmed. In these cases, small chunks of information, summarised clearly, can be more effective than in-depth explanations.
- Confidence levels. Patients with low confidence may avoid asking questions or feel unsure about trying new approaches. Boosting confidence through small wins and positive reinforcement can gradually increase their engagement with learning.
- Life transitions and context. Situational “triggering factors”, such as changes in health, relationships, employment, or daily responsibilities often drive adults to engage with learning. These moments can provide “teachable moments,” especially when patients are actively seeking change or direction (Tonseth, 2015).
Key questions to assess readiness to learn
- “Would you like more information about this now, or would another time be better?”
- “How are you feeling about what we’ve discussed so far?”
- “Does this feel like the right time for us to go through some strategies together?”
- “Would you be open to exploring a different way of thinking about this?”
- “Has anything changed in your life recently that’s made this feel more important to you?”
What if they’re not ready?
That’s okay. Readiness can develop with time and the right support. In the meantime:
- Provide small, digestible take-home materials tailored to their current concerns.
- Normalise uncertainty, it’s okay for patients to need time to absorb new ideas.
- Revisit the topic later, especially after a change in symptoms, life events, or confidence.
A case example
A readiness-based approach would not overwhelm Joseph with too much information as the physiotherapist recognises Joseph’s readiness to learn and focuses on small, achievable steps while still prioritising mobilisation.
Instead of leading with education, the physiotherapist reassures him, “I can see you’re feeling tired, let’s take it step by step. Even a little movement can help with your breathing and energy levels.”
Rather than asking Joseph to sit out of bed immediately, the physiotherapist first adjusts his position, helping him into a more upright posture. Joseph finds it easier to breathe in this position and is more engaged in the treatment as he can see that it is working.
To build confidence and keep the patient engaged, the physiotherapist keeps instructions simple: “Let’s start by taking a few comfortable breaths in your own time before we move.”
Once Joseph feels slightly more settled, the physiotherapist guides him into sitting out of bed and eventually standing with simple explanations, allowing him to focus on the movements rather than processing too much information at once.
Instead of delivering a full education session on airway clearance, the physiotherapist keeps it brief: “We’ll take a short walk to help loosen things up. I will check in later and if you are feeling up to it, we can go through some other strategies together.”
By keeping instructions simple, supportive, and focused on immediate priorities and goals of mobilisation, the physiotherapist avoids overwhelming Joseph. Joseph successfully stands, takes a few steps to a chair, and reports that his breathing feels slightly easier. At his next session, he is more open to learning about other airway clearance techniques and ways to manage his breathlessness.
