Assessment of Learning Guides Improvement in Diabetes Education Program: A QI Initiative for Type I Diabetes Mellitus in Children and Adolescents

Abstract

Aims: To develop objective assessment tools to evaluate proficiency of well-day (WD) and sick-day (SD) diabetes knowledge and management skills in families of pediatric type 1 diabetes patients and to utilize this information to modify our diabetes education (DE) program to improve learning of the desired knowledge and skills. Methods: Vignette-based assessment quizzes were developed to evaluate WD and SD diabetes knowledge and management skills. Vignettes assessed basic knowledge and skills including calculation of insulin doses, treatment of hypoglycemia, and management of hyperglycemia and ketones. These questionnaires were administered to 20 quasi-random patients and families at routine diabetes clinic visits during a baseline month and every month thereafter. Analysis of baseline data demonstrated significant knowledge deficits, and interventions were implemented to modify our DE curriculum and teaching techniques. Results: Sustained improvement of WD and SD diabetes knowledge and management skills were demonstrated with passing scores on WD and SD quizzes improving from a baseline of 28% and 15%, respectively, to a sustained pass rate ≥60% on each. Conclusions: This quality improvement initiative revealed that baseline diabetes knowledge and management skills were less than anticipated. Objective measurement of working knowledge retained by the families, allowed us to assess patient learning and to drive subsequent improvement in our education process. Changes in educational content and approach resulted in sustained improvement. Our work demonstrates a new paradigm in the teaching-learning interaction in the management of diabetes which is likely applicable to other chronic medical conditions.