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Putting diabetes conversation maps into practice
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Over the years, there has been a trend in moving from the traditional didactic approach to diabetes self-management education to more of an empowerment model. In adopting the philosophy of empowerment, the educator’s role is not to change our patients’ behaviors, but to inspire, inform, support, and facilitate their efforts to identify and attain their own goals.
As diabetes educators, we struggle constantly to find new and interesting ways to facilitate learning that leads to effective behavior change.
When managing a chronic disease such as diabetes, successful attempts at changing behaviors as a result of acquiring the knowledge and skills needed to do so ultimately leads to clinical improvement and improved health status, as outlined in the American Association of Diabetes Educators position statement, “Standards for Outcomes Measurement of Diabetes Self-Management Education.”
Tool to facilitate empowerment
The U.S. Diabetes Conversation Maps, developed in collaboration with Healthy Interactions and the American Diabetes Association, offer a unique approach to facilitate empowerment in diabetes group education settings. The maps are a 3-ft. by 5-ft. graphic offering information, with an accompanying facilitator’s guide providing leading questions to facilitate discussion as well as a number of activities cards that engage the group in more discussion.
 Janice Koshinsky |
The process also includes exercises in developing an action plan where post-session follow-up activities can be addressed and reinforced. The more interaction one has in an education session, the more they take away with them. It has been cited that we remember 10% of what we read, 20% of what we hear, 30% of what we see (graphically), 50% of what we see and hear, 70% of what we discuss with others, 80% of what we experience personally, and 90% of what we teach to others.
In using the maps, one has the opportunity to practice all of these. The participants share their own unique experiences and learn from one another. With proper facilitation, the maps engage the participants in a learning process that is informational, meaningful, and supports discovery learning.
There are five Diabetes Conversation Maps:
- On the Road to Better Managing My Diabetes,
- Diabetes and Healthy Eating,
- Monitoring Your Blood Glucose,
- Continuing Your Journey with Diabetes,
- Caring for Gestational Diabetes.
They include all of the content areas necessary for ADA recognized diabetes education programs and can serve as a delivery method for the curriculum. They also address the AADE 7 Self-Care Behaviors. Certainly, the maps are just one of the many educational tools that can be used and can easily be integrated into any diabetes program.
At the Lions Diabetes Center, the conversation maps have been extremely well received. The participants find it to be an enjoyable rewarding encounter. They learn from each other and are very willing to share their own personal experiences of living with diabetes. It is refreshing as an educator to see the participants bonding and developing a real concern for the well-being of one another. The process allows them to learn so much more about each individual; their personal interests and concerns, the degree of understanding about diabetes and its’ management, and their confidence levels in achieving their goals. In contrast to the typical didactic approach to education, using the maps enables the facilitator to better identify the individualized needs of each participant in a group setting; a task that can be difficult to do without a timely one on one encounter.
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The maps offer the flexibility to be used in a variety of settings. They are best used with groups of three to 10 participants and are designed to take about two hours to complete each map. However, the delivery can be customized to each individual program and can be used in part or in its entirety. The maps can be used in any sequence, though. The “On the Road to Better Managing My Diabetes” map serves as a general overview and can set the stage for what is to come in subsequent classes. The other maps have more of a focus on particular content. For larger groups, it is ideal to have more than one set of maps so that all of the participants can be seated around the table(s), close enough to see the visual images on the map. This helps engage the group and fosters the discussion. Additionally, it is recommended to follow the facilitator guide. This helps to assure that all of the content areas are addressed and keeps the group on track.
The U.S. Diabetes Conversation Maps are an exciting tool to deliver diabetes education. They help to create a memorable experience for the participants and provide the educator with a fresh approach to the empowerment model of learning. Optimistically, future research will demonstrate the effectiveness of this tool in improving long term behavioral outcomes of our patients. For more information, log on to www.healthyi.com.
Janice Koshinsky, RN, MS, CDE, is a Program Manager at the Lions Diabetes Center, University of Pittsburgh Medical Center in McKeesport, Penn.
For more information:
- K Mulcahy, M Maryniuk, M Peeple, et al. AADE Position Statement: Standards for Outcomes Measurement of Diabetes Self-management Education. Diabetes Educ. 2003; 29:804-816.
- Funnell MM, Anderson RM. Patient Empowerment: A Look Back, A Look Ahead. Diabetes Educ. 2003; 29:454-4