Foundation of Diabetic Education for Nurses - Term Paper Example

? Teaching: Diabetic Teaching Modern nursing programs face the need to make changes in the ways are taught to act as educators. Nurses as diabetes educators are viewed as an inseparable part of the healthcare team that works to improve care of diabetic patients. Hence, the need in nurse educators well-versed in diabetic care as well as approaches to diabetes education has to be urgently addressed. Just as teaching future nurses diabetes educators needs to be based on a relevant theoretical framework, various learning theories are discussed as a background of the learning process including constructivism, experiential learning, behaviorism, social learning, psychodynamic, humanistic, and cognitive learning theories, etc. The paper focuses on social constructivism as the foundation of diabetic education for nurses. Teaching: Diabetic Teaching Introduction Modern nursing programs face the need to make changes in the ways students are taught to act as educators. Candela, Dalley, and Benzel-Lindley (2006) admit that a lot of nurse educators these days use the same teaching methods to instruct as they had been taught; their major contribution is thus in merely rearranging the same study material they have been presenting for years. At the same time, the emphasis in teaching nurses, as Candela et al (2006) rightfully admit, needs to be shifted away from traditional knowledge acquisition skills via a variety of media to a non-linear approach to teaching and learning which is expected to improve critical thinking skills of future nurses. Giddens & Brady (2007) advocate the need to incorporate into the nursing curriculum such courses that are concept-based and in which concepts are taught across a person’s life span and various clinical settings. Nurses as diabetes educators are viewed as “a necessary cost-effective addition to the healthcare team” (Dudley, 1980, p.127) working to improve care delivered to a diabetic patient. Hence, the need in nurse educators well-versed in teaching and learning approaches to diabetes education has to be urgently addressed. It needs to be considered that nurses as diabetes educators are considerably more than agents of memorization. To be effective educators, they need to be capable of reflection, self-critique, lifelong education, and self-direction; they should have the ability to link concepts, do the synthesis of information, and demonstrate critical thinking skills (Brandon & All, 2010). Thus, it is imperative to synthesize extant approaches to teaching nurses as future educators and decide on the theoretical framework that is the most pertinent to nurse education. The importance of innovative approaches to teaching future diabetes educators is based on the fact that diabetes education is critical in helping people manage their disease and avoid grim consequences including lethal outcomes. Diabetes is a chronic life-long disease which is known to be primarily managed by an individual. Successful self-management of diabetes is based on the level of the individual’s knowledge, ability to effectively cope with the disease on a psychological level, and necessary psychomotor skills (Mendoza, Welbeck, & Parikh, 2010, p. 659). Statistically, the importance of diabetes education is evidenced by the following data: the results of the 2002 Diabetes Prevention Program research demonstrated that people who were at increased risk of developing Type 2 Diabetes who somehow changed their lifestyles significantly reduced their risk of developing Type 2 Diabetes (by 58%). Also, it was estimated that around 10 million U.S. citizens who are at a high risk for that type of diabetes are likely to significantly decrease their chances of developing it (and thus reduce hospitality, mortality, and adverse effects rates) by doing exercises and following a particular diet (Diabetes Prevention Program Research Group, 2002). In this context, the need to enhance nurses’ education is perceived as critical. This statement is well supported by the International Curriculum for Diabetes Health Education (2008) developed by the International Diabetes Federation. It characterizes “the lack of trained health professionals...as the most critical issue impeding the delivery of high quality diabetes education and care” (IDF, 2008). Based on what has been said above, this paper seeks to identify the most widely used approaches in education of nurses as future diabetes educators. Next, it aims to examine one theoretical approach that may be considered as the most effective in teaching diabetes educators. Specifically, the author focuses on the learning theory of constructivism. Finally, the purpose of this paper is to provide recommendations to help improve teaching of this skill. Approaches to Teaching Diabetes Educators: Literature Review Since the question of how exactly learning occurs has been the subject of long debate, a variety of learning theories emerged that explain the learning process from different perspectives. Within the context of diabetes educator teaching, learning is viewed as “a relatively permanent change in mental processing, emotional functioning, and/or behavior as a result of experience”. It is admitted to be a dynamic and lifelong process through which people acquire new skills or new knowledge while altering their feelings, thoughts, actions, and attitudes (Braungart & Braungart, p.44). Braungart & Braungart (2003) observe that the following key learning theories are applicable to teaching nurses as educators: behaviorist learning theory, cognitive learning theory, social learning theory, psychodynamic learning theory, and humanistic learning theory. Based on Redman (2001), they also note that the most frequently applied theories in healthcare practice education are social learning, cognitive, and behaviorist theories (Redman, 2001 in Braungart & Braungart, 2003, p.43). With regard to the behaviorist theory, the most pertinent way to facilitate the process of learning is linked to reinforcement offer, which is grounded on the extant association between the response and the stimulus. According to the social learning theory (Bandura, 1977), learning occurs within a social context and new behaviors are best learnt through models (namely, live model, verbal instruction, and symbolic modeling). Cognitive learning theory emphasizes the significance of what is happening inside a learner; individual cognition is perceived as the key to changing and learning (through perception, memory, thought, as well as different ways of information processing and structuring) (this theory includes such widely applied perspectives as social constructivism, gestalt, social cognition theory, etc). It views learning as a highly active process directed by a learning individual to a great extent where the learner perceives the information, interprets it based on already known information, and reorganizes it into new understanding or some new insights. Goals and expectations are important since they motivate individuals to learn (Vygotsky, 1978). Next, Dunning & Matias (2009) in the article “Experience and experiential role: Perceptions of the diabetes educator role” consider the Experiential Learning approach to be effective in teaching nurses as diabetic educators. This concept has developed within the general trend of cognitive learning (cognitive development) theory (specifically, based on works of Piaget, Dewey, and Knowles). It is based on understanding that knowledge is created through experience (Kolb, 1984 in Dunning & Matias, 2009, p. 148). By experience, a variety of life experiences is meant including volunteer work, traveling, work, recreational activities, homemaking, communication with experts, and homemaking, etc. Further, Brandon and All (2010) insist on using the theory of constructivism and the Constructive Theory Model to educate future diabetes educators. One of the key foundations of constructivism is that learning is viewed as an active process which entails learners constructing new concepts or ideas grounded on their current or past knowledge base (Hoover, 1996 in Brandon & All, 2010). Instead of using textbooks and instructor’s knowledge to solve problems, learners invent solutions as well as construct knowledge during the learning process. Hence, students learn by discovering them themselves. The role of educator is that of a coach and facilitator. Similalry, Nagia, Horson-Carlton, & Ryan (2004) argue in favor of Constructivism Theory in teaching nurses via online courses in distant education. On the basis of analysis of twenty nursing students’ online learning experiences, the authors conclude that the constructivism theory is effective in teaching nurses as students learn through reflection, application of critical thinking skills, exploring, interaction with other people, information sharing, as well as resources use. This approach has been found to be useful by its focus on learning goals and learning conditions along with its focus on planning and carrying out different instruction methods. Further, Avillion (2009) explores three major paradigms within the theoretical framework of nurses education: liberal education, behaviorist education, and humanist education. From the theoretical perspective, liberal education focuses on learner’s acquisition of knowledge in order to develop his or her intellect; behaviorist education actively engages individual in learning as well as demonstrating certain behaviors; the learner depends on instructor’s feedback; humanist education centers on partnering with the educator for the purposes of achieving self-actualization and views the learner in self-directed and enthusiastic light; andragogy fosters partnering with the educator to attain the full potential (Avillion, 2009, p.14). In summary, the theoretical foundations of teaching future nurses diabetes educators rest on the principles of constructivism, social learning, and cognitive theories; behaviorist, humanistic, and psychodynamic theories also apply. Besides, the principles of adult learning theory (in andragogy) and liberal education can be used. Specifically, within the adult learning paradigm the experiential learning framework may be used. Social Constructivism in Teaching Nurse Diabetes Educators Given the importance of collaboration and context in teaching/learning process, the social constructivist theory which focuses on the issue of social constructivism of knowledge seems pertinent to diabetes education. The major significance of the approach based on social construction is based on its directedness at social interaction. The centrality of the latter in learning has been thoroughly researched by Sharples (2000), and later by Sharples, Corlett, & Westmancott (2002). The principal rationale of these studies is grounded on acknowledgement that personal learning starts together with a learner and within an environment that may be described as being social, cultural, and technological. To illustrate, Sharples (2000) believes that “Learning is a constructive process of acting within an environment and reflecting upon it” (Sharples, 2000, p.4). In this regard, action presupposes displaying an ability of a patient to solve arising problems, take active part in various dialogues whose aim is to acquire new knowledge. Further, reflection presupposes that a learner can effectively abstract from some situated activity in order to incorporate previously acquired knowledge into present experience aimed at constructing specific new interpretations. Therefore, conversation in this context evolves as a central point during both action and reflection; it happens between the learner and his or her instructor in a clearly dialogic manner. So construction along with conversation and control make up three Cs which provide for successful construction of individuals’ knowledge (Sharples, Corlett, and Westmancott, 2002). It is assumed that diabetes education will bring benefit to learners by implementing the principles of social constructivism once they are seriously considered. Johnson & Johnson (1999), the authors of cooperative learning and social interdependence theory, have outlined them as follows: 1) It is necessary to start from individuals’ extant level of development and their cognitive ability, taking into account the current knowledge base; 2) It is necessary to enable individuals to construct as well as acquire particular knowledge by the use of acknowledged learning practices based on individuals’ modification of prior knowledge; 3) It is necessary to establish relationships between those knowledge outlines that are already in place and those that will predictably be constructed as new knowledge; 4) It is necessary to engage students in activities of cooperative learning activities in the process of new knowledge construction. Social constructivism has been selected on the ground of the analysis of the use of theoretical approaches to teach diabetes educators. Within the constructivist framework, they will be able to learn to invent various solutions and construct new knowledge in the process of learning. The theoretical spiral of the constructivist model sets the students at center. Students interact within the spiral’s ring and make up a group which interacts with the educator. The latter acts as a mediator and brings learners closer to the given context. His task is to make a set of meaningful areas of students’ proximal development as well as cognitive bridges, which is achieved through social interactions. The scheme involves constant knowledge assessment. Once learners face a new activity, they utilize previously acquired knowledge to work out more complex concepts and ideas, as well as integrate some new information (Brandon & All, 2010). The use of case study as an active learning technique in educating nurses as future educators is highly appreciated since it enables students to understand various difficulties of management of diabetes and empower them to use acquired knowledge to explain these difficulties to their future patients (diagnosed with diabetes) (Sandstrom, 2006). Sandstrom (2006 in Brandon & All, 2010) suggests using three forms of case study. Learners are educated about patients' difficulty in caring about themselves having being diagnosed with a chronic illness. The method is utilized to develop critical thinking by centering on the patient’s needs and cooperating to solve problems. Such approach will enable learners to develop a better understanding of the illness, the ways it affects clients as well as needs, along with responses to research into the disease. Conclusion In summary, teaching future diabetes educators needs to be based on a relevant theoretical framework. A variety of learning theories may be used to underpin the learning process including constructivism, experiential learning, behaviorism, social learning, psychodynamic, humanistic, and cognitive learning theories, etc. It is recommended that social constructivism should be used to lay the foundation of diabetic education for nurses. Through its focus on students’ active participation in knowledge construction it allows them to develop skills of reflection, apply critical thinking skills, learn to explore, interact with other people, share information, as well as use resources. This approach has been found to be useful by its focus on learning goals and learning conditions along with its focus on planning and carrying out different instruction methods. One of the most beneficial learning technique is that of the case study. It facilitates education about patients' difficulty in self-management of diabetes after they were diagnosed with this disease. The technique is effective in development of skills of critical thinking as it centers on the patient’s needs and promotes cooperation in solving problems. The use of this technique helps learners develop a better understanding of diabetes, various ways it affects clients, in combination with needs along with responses to research into the disease. References Avillion, A. (2009). Learning styles in nursing education: Integrating teaching strategies into staff development. HCPro, Inc. Braungart, M. & Braungart, R. (2003). Applying learning theories to healthcare practice. In S. Bastabe (ed.) Nurse as educator: Principles of Teaching and Learning for Nursing Practice, Jones & Bartlett Learning, 43-73. Brandon, A. & All, A. (2010). Constructivism theory analysis and application to curricula. Nursing Education Perspectives, Vol. 31, No. 2, 89-92. Candela, L., Dalley, K., & Benzel-Lindley, J. (2006). A case for learning-centered curricula. Journal of Nursing Education, 45(2), 59-66.  Diabetes Prevention Research Group (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention of metformin. The New England Journal of Medicine, Vol 346, No. 6, 2 Feb 2002, Retrieved from http://www.nejm.org/doi/pdf/10.1056/NEJMoa012512. Dudley, J. (1980). The diabetes educator’s role in teaching the diabetic patient. Diabetes Care, Vol. 3, No.1, January-February, 127-133. Dunning, T. & Manias, E. (2013). Experience and experiential learning: Perceptions of the diabetes educator role. Journal of Diabetes Nursing, Vol. 13, No. 4, 148-156. Giddens, J. & Brady, D. (2007). Rescuing nursing education from content saturation: The case for a concept-based curriculum. Journal of Nursing Education, 46(2), 65-70.  Johnson, R. & Johnson, D. (1999). Making cooperative learning work. Theory into Practice, 38, Issue 2: 67–73. Mendoza, M., Welbeck, M., & Parikh, G. (2013). Behavioral and educational approaches to diabetes self-management. In L.Poretsky (ed.) Principles of diabetes mellitus, 659-685. IDF (2008). International curriculum for diabetes health professional education. Retrieved from http://www.idf.org/webdata/docs/Curriculum_Final%20041108_EN.pdf. Nagia, A., Hodson-Carlton, K., Ryan, M. (2004). Students’ perceptions of online learning: Implications for teaching. Nurse Educator, Vol. 29, Issue 3, 111-115. Sandstrom, S. (2006). Use of case studies to teach diabetes and other chronic illnesses to nursing students. Education Innovation, 45(6), 229-232.  Sharples, M. (2000). The design of personal mobile technologies for lifelong learning. Computers & Education, 34, 177-193. Sharples, M., Corlett, D., & Westmancott, O. (2002). The design and implementation of a mobile learning resource. Personal and Ubiquitous Computing, 6, 220-234. References Read More