‘I’m the Boss’: testing the feasibility of an evidence-based patient education programme using problem-based learning

Abstract

Abstract

Patient education programmes have shown only small to modest effects on diabetes self-care and metabolic control. Despite that, almost all diabetes teams agree that patient education is an extremely important part of the treatment of diabetes. It is, therefore, important to identify components of successful patient education as a basis for creating and testing an evidence-based education programme. In a review of controlled studies evaluating patient education such components were identified and these were then used in building up the new programme. This programme, called ‘I’m the Boss’, is based on the notion that the patient is an active care participant, setting his own self-care goals, and is the one responsible for his own life. The content of the programme did not, therefore, focus on diabetes as such, but on life with diabetes. Six themes were explored during six three-hour weekly sessions. The educational method used was problem-based learning. This method is founded in cognitive theory and views the learner as active in seeking knowledge and able to solve the self-care problems identified. The aim of this study was to explore the feasibility of the programme which was tested in four small groups (five to eight participants) of diabetic patients together with two facilitators. After completing the programme, the patients participated in focus group interviews to evaluate the programme. They identified both positive and negative factors. After each session the two facilitators reflected upon the group dynamics. In particular, problems with allowing patients to be the experts should be highlighted. This programme has been modified according to the evaluation and it is now being tested in a randomised, controlled, multicentre study.