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Winners of the 2004 DESG Awards |
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Page 2 of 3
Best two abstracts on Therapeutic Patient Education presented during the 40th EASD Congress, Munich, 2004:
G. J. Schlömer, G. Meyer, J. Kasper, I. Mühlhauser: Evidence-Based Health Care (EBHC) for diabetes educators - knowledge gain in different course formats (Abstract No. 189)
Unit of Health Sciences, University of Hamburg, Germany.
Background: The recent paradigm shift in therapeutic counselling towards informed shared decision making (ISDM) requires new skills and competences of the therapeutic team. In chronic diseases such as diabetes with its multifaceted interventions ISDM may be particularly valuable. Diabetes educators already play a decisive role in the information process of patients with diabetes and as intermediators between patients and physicians. Therefore, they could take over important parts in evidence-based patient information. At present, diabetes educators are not trained to present and communicate evidence-based information. In this pilot study we tested various course formats on evidence-based diabetology for this target group within a given time frame.
Aims: Evaluation of 1 to 3-day course formats in EBHC for diabetes educators.
Methods: Since 2003 we collaborate with three institutions which run degree courses for diabetes educators in cooperation with the German Diabetes Society. Special curricula in defined areas of competence have been developed: a) systematic searching in internet-based databases for predefined questions b) critical appraisal of observational and experimental studies c) critical appraisal of presented data / communication with patients/consumers. Four courses with 97 participants have been evaluated with a test instrument in a pre-post-intervention manner. Two independent raters evaluated course results. The test comprises three main elements: 1. Ability to formulate relevant aspects of an intervention study (5 possible points). 2. Ability to calculate effect-sizes (3 points), and 3. Ability to turn numbers into meaningful objective patient oriented communication (1.5 points for criteria of patient information; 2 points for correct calculation; 2 for correct explanation).
Results: Trainees found courses very important and useful for their further work. 94 participants completed both tests. The mean score before the course (pretest) was 4.4 (range 0-11.5) and after the course (posttest) 6.9 (range 3-11.5) (p <0.01). Degree of knowledge gain depended on course duration, in favour of the three days format. Before and after the course participants were able to calculate data correctly. Most was learned in the third aspect of the test, concerning patient information (median pretest/posttest score: 0/2). Although, further analysis showed that participants while being able to understand basic requirements of patient communication, still lack competences in patient-orientated explanation of data.
Conclusion: The evaluation instrument is able to measure EBHC competences. For diabetes nurses, who are involved in direct patient consultations and shared decision making, more focus is to be put on communication and explanation of data. A three days course on EBHC seems the minimum to reach the learning objectives. More intensified course formats are necessary to meet the complex needs of diabetes educators.
Supported by: BMBF
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