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This study describes the demographic and occupational patterns of the health care educator in the 1990s. A sample of ASHET members formed the study frame. The data obtained were compared with previous demographic and occupational pattern studies. Trend lines over the past 20 years seem to indicate relative stability in the health care educator's characteristics. Although better educated than in the past, the health care educator tends to be female, middle-aged, working in an acute care urban setting, occupying an administrative rather than instructional role, residing in a department of hospitalwide education and training, and reporting to a vice presidential level. This study also forecasts future patterns for the 21st Century.

While patient education has been an integral part of health care for centuries, the management of this process is a relatively new concept for US hospitals. Beginning in the late 1960s, documentation of patient education coordinator positions, policies, committee mandates, and other management structures began to appear. National surveys and projects documented the growth of these structures and provided some evidence that their existence positively impacted the number of programs and their effectiveness. Financial pressures on hospitals including the advent of the prospective pricing system, other actions by government and business to control health care costs, and changes in technology have resulted in budget cuts, staff reductions, and reorganizations that have posed new challenges for the development of patient education management. This paper discusses these developments and their impact on management of patient education programs in hospitals.

In this article a description is given of the development of the function of patient education coordinator in the Netherlands. In general, these developments have been successful. The differences in emphasis between the work of Dutch coordinators and those in the United States are discussed, set against the background of the Dutch health care system and its prevailing attitudes. Besides sketching the common elements which have proven to be successful ways of inducing organizational change, a description is given of a particularly successful project involving feedback from patients to medical specialists. This project succeeded in combining aspects of organizational change and the education of members of the medical staff in communication with patients; it might be useful for emulation by others. The article concludes by sketching changes in general political and cultural ideology and the way these changes affect the developments in patient education.

The world of health care education has been changing. This article has documented some of that change reflected in a recent survey. It has also provided some suggestions for the health care educator in making decisions regarding the structure of education, programs of education, and the marketing of education. Change frequently brings frustration, confusion, and stress. For health care educators, it brings all of that. However, this is a very exciting time to be part of health care education. Transitions enable us to develop health care education in new ways that are rewarding for the organization and for those involved.