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Volume 22 (2)

Volume 22, Issue 2, Spring 2002 line
J Contin Educ Health Prof 2002; 22(2):94-102
ORIGINAL ARTICLES

Improving the skills of health professionals in engaging patients in diabetes-related problem solving
King EB
Schlundt DG
Pichert JW
Kinzer CK
Backer BA

A b s t r a c t

INTRODUCTION: Despite instruction, many patients do not employ diabetes-related self-management skills recommended by health professionals. One problem suggested by research is that many health professionals do not often use teaching and counseling skills widely considered to be effective. Among these are specific skills that help health professionals conduct adherence-related assessments, brainstorm workable solutions to obstacles, collaborate during long-term follow-up, and provide effective direct instruction.
METHODS: "Effective Patient Teaching and Problem Solving" was developed and taught in a block of 24 hours over 3 days to groups of health professionals. Course content emphasized 13 operationally defined skills in four major categories: (A) assessment, (B) brainstorming, (C) collaboration, and (D) direct instruction skills. To evaluate participants' (n = 33) use of the various skills, a standardized patient teaching exercise was videotaped at both the beginning and end of the course.
RESULTS: Total mean scores increased significantly (t = 7.7, p < .001) from 1.8 to 2.5 on a scale that ranged from 1 to 5. Skills improved in all four major categories (p < .003). The length of teaching sessions did not change, lasting 13.2 minutes before the course and 13.6 minutes after the intervention.
DISCUSSION: Health professionals play a crucial role in patient education but rarely receive training in effective teaching and counseling techniques. The "Effective Patient Teaching and Problem Solving" course improved several kinds of important skills. As standards of diabetes care for improved glycemic control become more widespread, and as health providers attempt not just to teach but also to help patients overcome considerable obstacles to consistent diabetes self-management, a premium will be placed on the ability of health professionals to counsel efficiently and effectively.

Lessons for Practice
  • Health professionals who take the course “Effective Patient Teaching and Problem Solving” show improvements in four counseling skills categories: assessment, brainstorming, collaboration, and direct instruction skills.
  • Health professionals can increase their use of teaching and problem-solving skills without increasing the length of time spent in patient education sessions.
  • More research is needed to address satisfactory gains in diabetes-related problem solving.
MeSH Terms: Diabetes Mellitus; Education, Continuing; Patient Education; Problem Solving; Self Care; Support, U.S. Gov't, P.H.S.

Publication Type: Evaluation Studies
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