Objective: Informal patient education is a common practice used by nurses in the healthcare setting. Informal methods use quick delivery instruction, and often promote self-directed learning and focus on specific tasks, based on the needs of the patient. While there are effective models for more structured patient education programs, they are not typically applicable to informal instructional situations, such as at a patient's bedside, or upon discharge. The purpose of this paper is to: a) define how informal patient education manifests itself in healthcare settings, b) identify, through a review of literature, potential issues arising from informal patient education practices, and c) suggest ways nurses can further support and enhance informal patient education to help overcome these issues. Methods: This review of literature explores research and findings relevant to informal patient education in healthcare settings, including an examination of potential issues related to this often spontaneous, less-structured approach. Also, this review reveals findings that inform practitioners and researchers in this field with further ways to improve informal patient education practices. Results: While informal patient education holds a valuable place in healthcare settings, it also presents issues related to areas such as quality control, assessment, and curriculum. Without addressing these issues, research shows that healthcare providers, including nurses, risk a myriad of negative outcomes affecting both the patient and the organization. An analysis of the literature informed recommendations of strategies to support and enhance informal patient education, guided by four areas: desire to learn, learning by doing, feedback, and reflection. Discussion: While patient education is frequently informal, it can be supported and enhanced to help overcome challenges brought about by this type of delivery. The discussion provides specific ways nurses can help enhance informal instruction in practice. Conclusions: Informal patient education remains prevalent in patient care, but it has drawbacks. By incorporating new strategies in practice, nurses can work towards enhancing and improving instances of informal instruction to make it more effective and productive.

Health literacy is the ability to understand and act on health information and is linked to health outcomes. It is unclear how health literacy skills are developed in patients with complex conditions, such as cardiovascular disease and diabetes. The purpose of this grounded theory study was to gain perspectives of both patients and healthcare professionals on how health literacy skills were developed in patients with cardiovascular disease or diabetes. The research questions addressed how knowledge and skills were acquired, the role of digital tools, instructional strategies used by healthcare professionals, and how the instructional strategies of the healthcare professionals matched the learning preferences and needs of the patients. A social ecological framework was used, which underscored the importance of understanding health literacy from multiple sources. Semistructured interviews were conducted on 19 healthcare professionals and 16 patients. Emergent key themes included: (a) social support plays an important role as a learning opportunity; (b) many patients get their information from internet searches; (c) instructional strategies should be personalized, interactive, social, and relevant; and (d) patients are self-directed learners. Linking of these themes led to the development of the health literacy instructional model, which is a 3-step approach, including an emotional support, behavioral approach, and instructional strategy. Social support was the common element in all 3 phases and was perceived to be key to developing health literacy skills, resulting in the key implication for social change. Recommendations are to consider social support in the development of health literacy instructional strategies.