Navigating misinformation in patient education
Patients often develop unhelpful beliefs about their condition due to misinformation, especially misinformation they may see online. As a physiotherapist, our role is to guide them toward more accurate, evidence-based understandings while maintaining empathy and trust. However, simply providing correct information isn’t always enough, patients may be deeply attached to their beliefs. Addressing misinformation requires effective communication strategies that foster open discussion rather than confrontation.
Why might someone be affected by misinformation?
- Confirmation bias. Patients are more likely to believe information that aligns with their existing fears or expectations (for example “wear and tear”= joint damage).
- Emotional influence. Fear, anxiety, or frustration about their condition can make people more receptive to alarming or simplistic explanations.
- Social proof. If many people are saying something online (or even in their community), it can feel true, even if it isn’t.
- Repetition effect (Illusory truth effect). The more patients see the same misinformation, the more familiar and believable it feels.
- Source credibility bias. A claim from a trusted influencer, friend, or another healthcare professional can override actual evidence in their decision-making.
Strategies for navigating misinformation
To effectively counter misinformation, we can use evidence-based communication strategies rather than relying on blunt corrections or overwhelming the patients with facts.
The “Three C” Approach
A helpful framework for responding to misinformation is the Three C Approach (Pasquetto et al., 2021).
- Compassion. Validate the patient’s concerns and recognise why the misinformation makes sense to them.
- Curiosity. Ask open-ended questions to understand their beliefs and how they came across the misinformation.
- Clarification. Gently introduce more accurate information while respecting their readiness to engage.
Applying the “Three C” Approach in Physiotherapy
What NOT to say:
“That’s just not true.”
Why it fails: This shuts down the conversation and may make the patient defensive.
A better response:
“I can see why that might be concerning. What have you heard about it?”
Why it works: Opens the conversation, making the patient more receptive to discussion.
Avoid information overload:
“There is overwhelming research that proves this is true. Here’s what the research says…”
Why it fails: Dumping facts can feel overwhelming and for some people, this might double down on their existing beliefs.
Instead, try:
“There’s a lot of information out there, some of it conflicting. Would you be open to exploring what the latest research says?”
Why it works: Invites collaboration, making the patient an active participant in their learning.
What to do vs. what not to do
| What To Do |
What NOT To Do |
|---|---|
| Acknowledge the patient’s concerns. | Dismiss their beliefs outright. |
| Show curiosity by asking how they found the information. | Ignore misinformation and hope it changes on its own. |
| Acknowledge the mixed quality of online information. | Overwhelm them with facts and research. |
| Ask about their readiness to explore other explanations. | Make them feel judged for believing misinformation. |
| Use metaphors or relatable explanations to gradually shift beliefs. | Confirm misinformation or propagate further myths. |
Helen’s case
Let’s look at Helen’s case from a previous chapter.
Read the potential responses to Helen below.
Which do you think is more effective? Why?
Response A:
“Yeah, that is true. But we’ll see if physio can help.”
Why it fails: This reinforces the misinformation instead of correcting it.
Response B:
“That’s not true, Helen. Patellofemoral pain isn’t caused by wear and tear, and your knee isn’t bone-on-bone. You don’t need to worry about damaging it more.”
Why it fails: While technically accurate, it dismisses her fears without addressing them.
Response C:
“I can see why that would be concerning. There’s a lot of mixed information about knee pain, especially online. Some of it is accurate, some not so accurate. It makes sense that you’d want to protect your knee. What we actually know from research is that pain doesn’t always mean damage. In fact, movement and strengthening can help reduce pain and improve your knee condition over time. Would you be open to talking more about what is going on with your knee and the best ways to manage it?”
Why it works:
- Acknowledges Helen’s concerns instead of dismissing them.
- Keeps the discussion open, inviting collaboration.
- Provides gentle, evidence-based education in a non-confrontational way.
Misinformation is widespread, and we must consider how we can address it without alienating patients.
- Building trust is key. Patients are more likely to accept new information from someone they feel understands them.
- Using empathy and open-ended discussions helps reduce defensiveness and create space for learning.
- Applying the “Three C” Approach can turn misinformation into a learning opportunity rather than a conflict.
