Elaine J. Boswell

Evaluation of a training program for improving adherence promotion skills

A workshop for improving the adherence counseling skills of health professionals was developed and evaluated. Target audiences have included medical students, nursing students, dietetic interns, and practising nurses and dietitians. Four categories of skills are taught: relationship building, interviewing, problem diagnosis, and behavioral intervention. Teaching methods include faculty demonstration, participant rehearsal, and group and individual feedback. The Adherence Promotion Training (APT) workshop has been offered as a 3- to 5-day intensive course and as a semester-long elective. A reliable coding system was developed to assess these skills from videotaped provider-patient interactions. A standardized patient task was given to 60 subjects before and after participation in the adherence counseling skills workshop. Videotapes were coded by trained raters, who were masked to whether the tape came from before or after the workshop. Significant short-term improvements were observed in all four core skills. This uncontrolled evaluation suggests that the Adherence Promotion Training program is a promising way to enhance the ability of health professionals to care for nonadherent patients.

Tool Chest: Sydney Meets the Ketone Challenge—A Videodisc for Teaching Diabetes Sick-Day Management Through Problem Solving

Correspondence to James W. Pichert, PhD, 315 Medical ~rt~ F3uilciing, Vanderbiit University School of Medicine, Nashville. TN 372322230. This article describes a teaching tool with an underlying instructional objective of helping persons with diabetes learn how to care for themselves during intercurrent illness. The tool, a videodisc, Sydney Meets the Ketone Challenge, is a story about a young woman who wakes up in the hospital because she mismanages her diabetes

Evaluation of a home study continuing education program on patient teaching skills

&NA; We developed a home study version of an established and successful workshop program called Effective Patient Teaching (EPT), making use of suggested guidelines for developing home study courses. The self‐study modules we produced consisted of workbook materials, videotaped illustrations, and practice exercises, all of which focused on patient teaching and counseling skills. During a period of 2 years and 3 months, 28 participants enrolled in the home study course. Only one participant completed the entire course. Another participant completed the portion purchased. The barrier most commonly cited as preventing completion of the home study course was other work‐related deadlines. We suspect that our requirement for a feedback procedure (either an audio‐ or n videotape of an instruction interview) may also have prevented submission of a completed course. The low, completion rate made quantitative evaluations impossible. Although the literature includes reported successes in the use of self‐learning courses, few formal evaluations have been conducted and reported. The efficacy of home study courses, particularly when enhanced skill is the desired outcome rather than knowledge gain, is yet to be e published, and merits close examination and rigorous evaluations.

The activity activity: a tool for teaching how to adjust for exercise variations.

cose goals, a challenge even for people with little variation in their day-to-day activity levels, requires special effort for most adolescents who typically have considerable daily variations in their activity level. Adolescents with diabetes often fail to appreciate, recognize, or anticipate how much their activity levels vary, thereby short-circuiting any prospect for taking compensatory action. In addition, many of those who do recognize activity variations often do not know appropriate food or insulin algorithms for compensating. We designed a teaching tool called the Activity Activity to teach adolescents strategies for recognizing and balancing variations in physical activity with food or insulin. The tool is designed for use in small groups of adolescents, such ai those who participate in support groups or diabetes camps. The skills that are taught help empower people with diabetes to overcome some of the obsta-

A Team Approach: Selecting Teaching Strategies to Promote Patient Adherence

ten years. She and her siblings had been moved to a group home two months prior to her referral to the diabetes center. WS had a lifelong history of obesity and an unclassified degree of mental retardation. Regarding independence and self-care in the group home, WS was responsible for preparing and administering her insulin injections and for performing daily urine tests. The houseparents prepared the food.