Building Competency in Diabetes Education THE ESSENTIALS

11-6 | CHAPTER 11

In the beginning: Shared philosophy

When engaging in any collaborative project, there needs to be a philosophical consensus among the developers. In Chapter 2: Foundations for Diabetes Self-management Education and Support, we explored the premise of the need and nature of SME and SMS. This foundation, as well as our guidelines mentioned previously, provide us with our basic beliefs (3,5,6): • Diabetes education and support should be interactive, solution focused and based on experiences of the learner. • We believe diabetes education is a planned, individualized and evaluated process. • We respect, value and promote self-management. • We believe diabetes support is an integral component to sustain self-management behaviours. Evidence based Our professional standards of practice are informed by the research which provides evidence for practice. While great progress has been made in developing an evidence base for the practice of diabetes SME and SMS, we still have many unanswered questions (7). Research efforts remain limited by a lack of human and financial resources dedicated to this field, as well as the problems inherent in studying human behaviour. When attempting to analyze the effective components of SME and SMS, researchers have had difficulty comparing studies due to the lack of consistency in reporting variables, such as the length of the programs, the level of the content included in the programs, the presenters themselves and the techniques used in the educational process (7-9). Also, the heterogeneity of populations, cultural influences, environmental factors and variability in the social determinants of health all contribute to the problem of generalizing the results of the SME and SMS research. However, with the growing epidemic of type 2 diabetes, it is becoming more imperative that our SME and SMS programs are effective, sustainable and accountable (7). We need to intensify our efforts to evaluate our programs in an effort to determine the successful elements which can be considered “best practice” contributing to the best outcomes. As educational and psychological professionals try to identify the most essential and effective components of SME and SMS programs, the discussion can become confusing. For example, a systematic analysis, a meta-analysis, and experts suggest (8,10,11):