Building Competency in Diabetes Education THE ESSENTIALS

2-46 | CHAPTER 2

Understanding change as both a process and the desired outcome of learning can guide the educational or therapeutic processes. Patients with diabetes, their families and the systems that support them are continually changing. Change is generally progressive and helpful, but it can also be feared, resisted and slowly assimilated. One of the first theorists to study the phenomenon of change described it as occurring when the forces driving a system toward change exceed the forces that restrain the change from occurring (148). Change and stability are recurring phenomena; the key elements of the change process have been described as follows (148): • Change depends on the perception of the problem. • Change depends on the context of the problem. • Change depends on the educator’s and the patient’s mutual treatment goals. • Understanding alone does not lead to change. • Change does not occur equally in all components of a system. • Facilitating change toward the patient’s desired outcome is the function of the educator. • Change can have many causes. Principles of learning: Many educational texts have compiled lists of learning principles derived from the recommendations of various authors. The following list comes from one of these compilations (149): • Perception is necessary for learning. • Learning, because it is considered a change in behaviour, is threatening. Therefore, learning takes place more readily when threats are at a minimum. • Learning is more effective when it takes place in response to a felt need of the learner. • Learning is facilitated when the material to be learned is related to what the learner already knows. • Organization promotes retention and application of learning. • Learning is facilitated when the material to be learned is meaningful to the learner. • Active participation on the part of the learner is essential.