How Medical Writers Can Boost Patient Engagement in Continuing Medical Education
If you’ve been working in continuing medical education (CME) for a hot minute, you’ll know that patient cases are a core deliverable.
But did you know that many education providers also tether clinician and patient education, or at least include patient components in their clinical-directed activities? This trend has been growing for at least a decade, as you’ll see from these white papers (here and here) and in a study I co-authored on patient education outcomes.
Patient-directed education is about more than just providing information—it’s about creating a bridge that connects individuals to their healthcare in a way that feels personal and meaningful. We foster respect, dignity, and understanding by meeting patients where they are. Whether through standalone activities, integrated curricula, or tools and resources for patients, this tailored approach through CME empowers patients to actively engage in their care, setting the stage for better outcomes.
But despite the progress on patient-directed education we’ve made in CME, there’s still work to do. Not every patient experiences the equitable and effective care they deserve. That’s where frameworks like PREP come in—a simple, four-step guide designed to enhance patient-provider communication and address these gaps.
As CME professionals—planners, strategists, analysts, and medical writers—we have a powerful role in this process. Through the materials we create, we can encourage collaboration and empathy, showing providers and patients alike that meaningful connections and shared understanding are at the heart of better healthcare. Together, we can help make these strategies a natural part of everyday practice.
The landscape of health care has undergone significant change in recent years, with patients transitioning from passive recipients of care to active participants in their own health management … as a result, patient education has become an increasingly important aspect of CME, creating new opportunities for medical writers. - WriteCME Roadmap
What is PREP? A Framework for Effective Communication
PREP, introduced during the SARS-CoV-2 pandemic by Richard Frankel and Howard Beckmann, emphasizes co-produced care, where patients and providers share responsibility for healthcare interactions. Published in The Journal of Patient Experiences, this framework highlights the importance of effective patient-provider communication in improving health outcomes and patient confidence. Each pillar of PREP—Prepare, Rehearse, Engage, Persist—offers strategies for empowering both parties.
The Four Pillars of PREP
Prepare
Preparation ensures patients’ priorities are heard and addressed during medical appointments. Physicians often follow a narrow diagnostic framework, which may leave unprepared patients feeling dissatisfied.
Encouraging patients to write down questions, research symptoms, and clarify goals beforehand can create more productive and satisfying interactions. CME writers can normalize preparation by creating patient narratives and case studies highlighting the benefits of preparation.
For instance, a story showcasing a patient who brings a detailed list of questions to their appointment can help other patients understand the value of preparation. In fact, this tactic was one of the features that patients valued in an education activity on managing non-Hodgkins B-cell lymphoma. When I interviewed them for the outcomes evaluation, they said how much they appreciated the questions the education activity modeled for patients to ask healthcare providers. Similarly, illustrating providers' positive responses to prepared patients reinforces the collaborative potential of this approach.
Rehearse
Many patients feel anxious or deferential during medical visits, hindering effective patient-provider communication. Rehearsing questions and concerns beforehand can boost confidence and ensure patients prioritize their needs during appointments. Role-playing with friends or family, or even bringing a trusted companion to the visit, can further alleviate pressure.
Patient narratives comparing scenarios—one where a patient rehearses and another where they don’t—can effectively demonstrate the benefits of this step. Such storytelling validates patients' experiences and provides actionable advice for engaging with healthcare providers.
Engage
Building trust and fostering psychological safety are central to the "Engage" step. Research shows active patient participation leads to better health outcomes, reduced anxiety, and improved adherence to treatment plans. Providers, in turn, can strengthen these relationships by practicing active listening, empathy, and open-mindedness—skills often undervalued in medical training.
CME professionals are crucial in promoting these "soft skills" for health professionals alongside clinical expertise. By creating materials that prioritize patient narratives and emphasize the value of shared decision-making, writers can help bridge the gap between technical knowledge and meaningful patient-provider relationships.
Persist
Even with preparation, rehearsal, and engagement, patients may leave appointments feeling unclear about their care instructions. The teach-back method, which asks patients to rephrase medical advice in their own words, can address this issue by ensuring understanding before patients leave the office. As CME professionals, we can also design content to support the teach-back method via reflective questions or pause moments, escape rooms, and virtual patients. We could consider interactive video clips or text-based scenarios demonstrating teach-back techniques followed by self-reflection or immediate application exercises. Or Choose Your Own Adventure style decision trees where different teach-back approaches yield varied patient understanding outcomes.
Persistence also involves encouraging patients to seek clarity until they feel confident in their understanding. CME writers can promote this behavior by highlighting examples of patients overcoming knowledge gaps through continued inquiry. However, it’s important to acknowledge and address systemic barriers, such as medical gaslighting, that can hinder persistence.
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Overcoming Roadblocks to PREP for Better Patient Engagement
While PREP offers a robust framework for improving communication, barriers remain that CME writers can help address.
Health Literacy and Access to Trusted Information
People may struggle to find reliable healthcare information. This challenge may be pronounced for people new to preparing for doctor’s visits or patient populations who have a deep mistrust of medical institutions. CME companies like PlatformQ Health and MedIQ have worked to bridge this gap by creating interactive online patient education activities, and as a CME writer, you can support this effort.
Diverse Patient Needs and Experiences
Cultural perspectives on medicine vary widely, influencing how patients engage with the PREP framework. Some patients may be unfamiliar with preparation or uncomfortable leading medical conversations due to past experiences or cultural norms. CME writers can address this by incorporating diverse patient narratives and actionable advice for both patients and providers.
Psychological Barriers
Nearly half of Americans report anxiety before medical visits, often stemming from fears of bad news or costs. Encouraging mindfulness techniques, like deep breathing or short meditations, can help patients manage pre-visit anxiety.
Of course, a little rehearsal goes a long way too! CME writers can raise awareness among providers about the emotional challenges patients face and offer strategies for creating a supportive environment.
Systemic Challenges
Time constraints and administrative burdens often limit providers’ ability to engage meaningfully with patients. While systemic reforms are necessary, CME writers can advocate for small, practical changes—such as integrating teach-back methods or emphasizing patient-centered care in CME materials—that make a tangible difference.
Outcomes Measurement of the PREP Approach for Patient-Provider Communication
As the focus continues to shift toward patient-directed care, the ability to measure patient-reported outcomes (as opposed to clinician-reported, system-reported, or disease-based outcomes) is vital.
For medical writers crafting patient cases, here are three invaluable tools to be aware of:
PROMIS (Patient Reported Outcomes Measurement Information System) is a resource offering validated tools to evaluate physical, mental, and social aspects of patient-reported health outcomes.
eProvide is a digital platform designed to streamline the collection, analysis, and management of patient-reported outcomes, supporting more informed, patient-centered healthcare decisions.
International Consortium for Health Outcomes Measurement (ICHOM) is an organization that creates standardized outcome sets that benchmark and compare healthcare effectiveness globally, always prioritizing outcomes that matter most to patients.
These tools are excellent starting points for exploring how we assess the impact of frameworks like PREP. They highlight the importance of quantitative measures, such as health outcomes and patient engagement scores, and qualitative insights, like behavioral shifts, provider testimonials, and strengthened patient-provider relationships.
CME professionals can also measure PREP’s success through knowledge assessments and observing how its principles are implemented in clinical practice. With these strategies, we can ensure the PREP framework drives meaningful improvements in patient-provider communication and patient care
