Table 1.

Overview of the Representational Approach to Patient Education: Key Elements and Goals

Element	Goals of Each Element
1. Representational assessment	Patient is encouraged to describe their representations of their health problem (e.g. symptoms or illness) along the five dimensions of representations: identity, cause, timeline, consequences, and cure/control. Goal is to get a clear picture of the patient’s understanding of their problem and to identify any gaps, error, and/or confusions.
2. Identifying and Exploring Gaps, Errors, and Confusions	Patient is encouraged to think and talk about what experiences led to the development of any misconceptions or confusions. The goal is to understand how any identified misconceptions or confusions developed and how committed the patient is to those beliefs/ideas.
3. Creating conditions for conceptual change	The goal is to help the patient recognize the limitations of his/her current conceptions -- i.e., ways in which gaps or confusions may be having negative effects on his/her life. Such recognitions often occur spontaneously as the patient has the opportunity to reflect on his/her experiences. When such recognitions do not occur spontaneously, they can be facilitated by making direct links between current representations, coping strategies, and any consequences that the patient has identified.
4. Introducing replacement information	Present credible information to fill in gaps in knowledge, clarify confusions, and replace current misconceptions.
5. Summary	Discuss benefits associated with acting on new information.
6. Goal Setting and Planning	Work with patient to develop goals related to improving his/her health problem and specific strategies for reaching those goals.
7. Follow-up contact: goal & strategy review	Discuss whether patient was able to implement strategies, what problems were encountered, any concerns patient has, how well strategies worked, and whether goal was reached. Discuss continuing with same strategies or making modifications. Encourage patient to continue same pattern of implementing, evaluating, and modifying strategies to manage health problems.