The Need for Professional Educational Competences in Diabetes Management by Prof. Morsi Arab

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The Need for Professional EducationalCompetences
in Diabetes Management byProf. Morsi Arab
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Causes of Failure of Patients Education 1-
unqualified educators 2- pour
resourses 3- patient uncompliance
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The Education Triangle
Objectives Evaluation
Strategy ( Test )
( Methods of
teaching )
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Teaching and Education Teaching competence
an art
or a science ? Only
by an inborn talent,
or a science with rules to be
learned and skills
to be
acquired.?.
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Adjusting the Education to the Community Needs
Steps1. The needs of the community for
certain jobs.2. job description ,by defining
the tasks needed .3. Set objectives
( acquiring certain knowledge, skills
and attitudes)
4. Design curriculum 5. Evaluate
achievement of objectives.
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Task Analysis Each task requires
(i) Specific knowledge (ii)
Specific skills. (iii) Specific attitudes
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Example of task selection needed for the job
of Podologist 1- Examine feet 2-
Diagnose problems 3- Manage 4- Educate patients
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Task analysis requirements for Podologist)
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Objectives
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Objective Domains 1- Cognitive (
knowledge) 2- Skills -
psychomotor - communication
- cognition 3- Attitudes
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The selection of
objectives depends on what the learner needs
and is going to do (tasks) during the job
, and at which level of competence
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In an Education Course N.B. You can not
teach everything, So stick to
selected priorities
1- obligatory to learn2- useful to learn3-
if possible to learn
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ObjectivesGeneral
Considerations 1- Set clear-cut objectives. 2-
in behavioral terms( i.e. describing what the
learner ultimately can do) e.g.
1- If
cognitive e.g. describe, enumerate
2- In skills e.g.
inject , do blood testing etc.
3- In attitudes e.g. demonstrate punctuality
, sympathy ,
etc.-
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Objectives ( cont.)3- The education Faculty
(team work) ( to avoid
contradictions )4- Different objectives to
different learners 5- Different teaching
methods to suit different
objectives.
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Objectives ( cont.)6- Different objectives at
different stages of the disease.
7- Overloading leads to confusion ,
depression and hopelessness.8-
Only achievable objectives .
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Some variables that define different patient
objectives1- Their existing Knowledge about
DM.2- Their general educational competence
(eg. if illiterate?).3- Their belief,
perception of their illness,
mis-conceptions., etc.4- Psychological stage and
readiness to learn 5- State of illness
controlled ? complicated, ?
handicapped.?,etc.5- Socioeconomics cost
feasibility , etc.
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• STRATEGY

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To prepare for an educational
presentation 1- identify the need of
the learners for the set objectives.
2- identify their background (what they already
know). Repetition (as revision) may be
useful as enforcement. 3- select the
content never tell all (only the
useful and appropriate) 4- focus objectives
to the outcome (what they can do,
think , believe and know, at the end of
the lecture, which they could not do before ).
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The Big Group PresentationThe Beginning (
Introduction) - gain attention and interest
e.g.by a question , a story ,problem, case
presentation, etc.. (or)- provide a
skeleton of the contents to be
covered
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The Flow of the presentation I- To keep
capturing attention 1- repeat significant
points. 2- check perception of the main
points. 3- have reasonable sense of humor
. 4- face audience and distribute eye
contact. 5- keep logical sequence
chronological, cause and
effect, less complex to more complex , problem
and solution, etc.
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The flow of the presentation ( cont.) 6-
change your methods. 7- avoid jargon ,
stereotyped phrases, unclear expressions ,
sophisticated words above learners level
of comprehension long complicated
sentences. 8- avoid monotony ,
mannerism. 9- ensure that everybody sees and
hears well.
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The flow of the presentation ( cont.)10- Use
properly selected A.V. aids e.g.charts, slides
(minimal, readable material) ,models,
specimens etc.11- Be aware of the time
allowed .12- Prepare for the unexpected
mishaps (projector lamps , power failure
, chart slipping, etc.
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The Audience Respect and get feed back from
the Audience 1- show respect and interest(
punctuality , dress?) 2- be concerned with
negative responses , yawns , expressions
of perplexion , whispering questions,
looks of unbelief or disapproval, etc. Dont
ignore !!3- do not be angered or intimidated
by negative responses but react by
re-shaping the presentation.4- get final
feedback e.g. by distributing collecting
handouts (later)
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The End 1- Draw conclusions , or invite
independent conclusions.2- Make end flows
naturally from introduction (e.g.
answering the questions , solve the problem ).
3- Simple summary. (pin point important
aspects.)4- Tie up loose points, to make the
whole presentation as a unit ..5-
Suggest ways for application and benefits.6-
suggest ways for continued learning.
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Small Group Education- Select suitable
size of the group ? - Educate, not teach (active
participation).- Monitor Group behavior
dynamics at different
stages.- Control individual dynamics
positive behaviours(encourage)
negative behaviours..(checked )
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The One-to-One Education 1- Listen. 2-
Motivate. 3- Individualize (quality)
according to stage of disease.
educational leveletc. 4- Not too
much (quantity). 5- Reward, more than blame.
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Teaching of Skills
Types of Skills 1- Psychomotor skills
2- Communication skills
3- Cognitive skills , like taking decisions
to which action to take .
How to Teach Skills ( 3 steps) (
Describe- Demonstrate- Exercise) Step 1-
Describe show importance, indications,
steps of performance ,
preparations,
precautionsetc.
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Teaching of SkillsStep 2-
Demonstrations
a) every one should be able to see
the demonstration. b) may have to
be repeated c) describe what you are doing
during the performance ( to explain)
d) support by AV aids
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Teaching of Skills Step 3 Exercising (
Training) a) everybody exercises. b)
Feed back ,to correct mistakes and
advice for better performance. c) use
helping methods play role ,
simulation equipment , etc. d) give
sufficient time for the training. e) initiate
training in groups or projects
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Teaching Attitudes Attitude
Tendency to behave
in specific way.? Could
they be acquired by
educational methods?
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Ways to teach, develop and encourage
behaviours1- Provide relevant information e.g.
dangers of smoking (to stop smoking), or
bad effects of hyperglycemia ,(to encourage
compliance). 2- Give example of model (good)
behaviour , to inspire.3- Acquiring a (good )
behaviour from long observation of
the results of a negative (bad) behaviours .
4- From close contact e.g. working or living
with individuals with positive or negative
attitude (camps..) 5- Give chance to discuss
(good bad behaviours ) in small groups
every one must share in the discussion and
should be free to express.
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Evaluation
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Evaluation by judgment A- Expert judgment by
trained observers the expert observer
determines how well , without
having to define further the concept of
well.
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Evaluation by judgment ( cont.) B- By the
use of tests and scales - The concept
well has to be
defined beforehand . -
Standardization ensures objectivity .
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EvaluationGeneral Considerations
- There is no one ideal method for
evaluation . - The choice of one
method depends on 1- is it reliable?
2- is it valid? 3- Time
consumed? 4- availability of its tools
. 5- Gives good FB (feed-back) to the
learning process 6-
Not only testing knowledge but also skills
and attitude.
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How to ensure reliability of the
test By using objective methods
e.g. MCQ s, check lists,
rating scales and similar
methods ,( to help the
examiners to unify their judgment
under all conditions ).
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To ensure validity, be sure that evaluation is
testing for the exact requirements of the job
e.g. 1- Discard Qs on sophisticated Kn
which is beyond the learners needs for
performing the required tasks in the
job. 2- Concentrate on the skills and attitudes
needed ( as was defined by task analysis and
job description.)
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Long Essay Questions Have
minimal advantages e.g 1- Very easy to
prepare ( for the examiner). 2- Tests
ability of student to construct an article.
Conclusion - Better not to use it.
- If necessary try to improve .
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Multiple Short Essay QuestionsAdvantage
s 1- covers a large part of the
curriculum 2- less unreliable
3- answered in shorter time ( by students).and
also marked in shorter time
( by examiner).Disadvantages Still tests
simple knowledge and no skills or application of
the knowledge in solving problems ( taking
decisions).
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The MCQ Type 1 Short stem a number of
choices Example During a
hypoglycemic episode (a) there may be
excessive sweating v (b) palpitations
v
(c ) there is hypotension v
(d) very dry mouth
v (e).. v
N.B. Here all choices should be taken
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Multiple Choice Questions (MCQ) Type 2one stem
4-6 (usually 5) choices - Example After
describing some clinical features
..what is the most probable diagnosis ?
(To answer select only one )( a )
Answer e.g. (c)( b )( c
).( d ).( e )
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Advantages of MCQ Test - scored in a short
time and precisely. - if numerous , covers
widely the syllabus. - can be used for self
assessment. - high reliability.Disadvantages
- difficult and need long time and
experience to prepare good
MCQs. - usually test only knowledge
(rarely skills e.g. in decision making ).
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Oral Examination -
Advantages (few) vivid, can probe increasing
depth of knowledge
(escalate).- Disadvantages - induces
anxiety to students (stress not existing in
practical life). - consumes long
time. - unreliable - can not test
skills (v. rarely). - does not give good
FB to the education process.Conclusion better
avoided
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Evaluation by Check Lists - very useful
for testing skills - Example during a
particular performance, the learners
actions are observed by the examiner
to score for each
appropriately performed step.
1- v 2- v
3- v 4-
v 5- v 6-
v 7- v
8- v 9- v
etc. - Has high reliability -
Gives good feed-back to teachers . (e.g. , if all
the learners miss a particular step or
do it with bad performance reconsider
the training course.)
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Check List / Rating scale, for measuring
attitudes (behaviours) e.g. of a person during
his training or working (job)
0 strongly lacking5 strongly agree/ evident
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The Follow-up Record of Proper Performance
The Record contains a number of tasks
enlisted. Each individual should fulfill
the performance of all tasks. A
satisfactory achievement of each task (
separately ) is noted.
Unsatisfactory performance indicates repeat
training (This method is very helpful to the
learning process )
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Alexandrie Palais du Montazah
Thank You