Building Competency in Diabetes Education THE ESSENTIALS

FOUNDATIONS OF DIABETES SELF-MANAGEMENT EDUCATION AND SUPPORT| 2-51

Figure 7. Levels of diabetes self-management

Survival

Advanced

Intermediate

Adapted from Jones (154)

• Survival (basic): The knowledge, skills and motivation required for self-care to prevent acute, short-term complications of hyperglycemia or severe hypoglycemia. The patient may or may not wish, need or be able to progress beyond this level at this time. Education at this level generally does not require the ability for critical thinking. • Intermediate: The knowledge, skills and motivation required for self-care that achieves more stable and improved metabolic control than the survival level, reducing the risk of long-term complications and facilitating the adjustment to living with diabetes. It may be thought of as a transition between survival-level and advanced management. The patient must be able to apply guidelines to accomplish these objectives. This level of skill may be adequate during a remission phase or if the treatment plan is not complex. • Advanced: The knowledge, skills and motivation required for self-care that supports intensification of therapy for optimal metabolic control and full integration of care into individual life activities and goals. The ability for critical thinking is generally required to accomplish these objectives. Developing appropriate objectives is the first step in designing an educational program. While learning objectives give you guidance in deciding what needs to be learned, they do not tell you how people learn best, which objective will be chosen by the patient or why people make the decisions the way they do. Further chapters will deal more extensively with developing appropriate objectives.