Beyond the Phone Call: How Hands-On Learning Improves Patient Outcomes

In my professional career, I have the privilege of witnessing the impact nurses make on health literacy every day. Regardless of mode, whether live, virtual, or telephonic, nurses empower patients and providers with the knowledge and confidence to navigate their treatment journeys and optimize their treatment pathways. While each patient and provider learn differently, there is something uniquely powerful about being physically present with the patient. This level of engagement not only deepens the patient's understanding but also expands the clinician’s ability to assess, adapt, and intervene—allowing us to round out the care plan in ways that traditional approaches have not fully captured, bridging gaps that virtual or telephonic interactions simply cannot address.

As nurses, we rely on all of our senses to drive patient-centered care, but one of the most essential—our sense of sight—is significantly diminished when we are not physically with the patient. Seeing their environment, their physical challenges and the unspoken struggles they may not even recognize themselves allows us to tailor our education and support to meet their true needs. It is often what is left unsaid, what is hidden from view, that poses the greatest risks to a patient’s success. And just like an iceberg, it’s what lies beneath the surface that can be the most dangerous. Because in healthcare, as in navigation, it's what you don’t see that can sink a ship.

Each mode of engagement offers unique advantages—live interactions provide critical visual and environmental assessments, virtual visits increase accessibility and convenience, and telephonic check-ins offer a quick and efficient touchpoint for ongoing support. By allowing patients to drive the mode of engagement, we empower them to receive education and support in the way that best suits their individual learning preferences, comfort level, and lifestyle needs. Some patients may thrive with face-to-face demonstrations, while others may prefer the flexibility of virtual sessions or the simplicity of a phone call. Providing multiple engagement options ensures that learning is not only delivered but also understood, retained, and applied—ultimately leading to better adherence, improved health outcomes, and a more personalized patient experience. A study in the Journal of Medical Internet Research found that face-to-face patient education led to a 25% greater improvement in knowledge retention compared to digital or phone-based education. Studies show that 36% of U.S. adults have limited digital health literacy, making virtual education less effective.

Yet, too often, we prioritize the "cost-effectiveness" of a telephonic or virtual engagement over the "literate effectiveness" of a live engagement, rendering the educational journey nearly useless in a subset of patients. According to the 2003 National Assessment of Adult Literacy (NAAL), approximately 14% of U.S. adults possess "below basic" health literacy skills, indicating significant challenges in understanding and using health-related information. This disparity suggests that educational efforts lacking in-person engagement would be far less effective for these groups, as they often benefit from the personalized interaction and tailored communication that face-to-face encounters provide.

An educational journey without the option for live engagements is like an iceberg without anything below the surface—it lacks the depth and stability needed to stay afloat. Clinicians without the ability to visualize critical gaps in understanding and care risk poor adherence and missed opportunities for intervention. A well-rounded approach to education that includes live interactions ensures the care plan is complete, keeping the patient’s journey on course and preventing unseen risks from pulling them under.

Additionally, live engagements influence the following:

1. The Power of Visual and Environmental Cues: clinicians can see the patient’s condition, home environment, and non-verbal cues, allowing for a more comprehensive assessment.

2. Environmental hazards: Issues such as black mold, poor lighting, trip hazards, or lack of necessary assistive devices can only be identified in person.

3. Medication adherence: Seeing unopened medication bottles or expired prescriptions provides insights into adherence challenges that a patient might not disclose.

4. Live engagements create a human connection that virtual or telephonic encounters often struggle to replicate.

5. Body language and eye contact enhance communication, making patients more likely to ask questions and express concerns.

6. In-person conversations feel less transactional, fostering trust and increasing patient adherence to medical recommendations.

7. Many patients—especially older adults and those with limited digital literacy—are more comfortable engaging in person than over a screen or phone.

8. Virtual and phone-based interactions rely heavily on patient self-reporting, which may be inaccurate due to misunderstanding, cognitive issues, or reluctance to disclose concerns.

9. In-person engagements remove technological barriers, ensuring all patients receive equitable, high-quality education and care.

While virtual and telephonic engagements are valuable for increasing access and convenience, they should complement—not replace—live interactions. In-person visits round out the care plan in ways that virtual models cannot, ensuring a deeper, more accurate, and personalized approach to patient education and support.