Participant learning in diabetes education is enhanced by dynamic and enriching experiences. Three key teaching strategies to facilitate meaningful patient-centred learning experiences are responding to immediate needs, incorporating group work and offering a variety of instructional methods. Effective teaching strategies bridge the gap between knowledge and practice, and guide patients through the lifestyle change process (1).

Respond to immediate needs

Effective teaching occurs when diabetes educators meet patients’ immediate needs and accept their learning needs and goals (2). To this end, they should:

• Assess learning needs and preferred learning methods to create an individual plan.
• Capture teachable moments. Motivation is highest during these moments, which are likely to occur when the patient perceives the need to learn new skills or change existing habits.
• Address ‘burning’ questions. Providing telephone communication shortly after diagnosis is an effective means of addressing important questions and capturing teachable moments (3).

Incorporate group work

Adults want control over what and how they learn (4). Diabetes educators can facilitate adult learning through the structure of group classes with the following:

• Give the responsibility of learning to the learner (2).
• Create stimulating learning environments. Small-group teaching is generally well accepted by learners; group discussions can also foster the discussion of realistic solutions by those with similar experiences (4,5).
• Appropriate scheduling will improve attendance. Shorter classes focusing on 1 topic are more effective than those that incorporate many topics over several days (6). Short sessions with mini-topics offered at various times provide the option of attending

classes when the need for knowledge has been identified by the patient.

• Encourage lifelong continuing education by providing interesting and fun events. Those that offer hot topics or a form of entertainment will encourage attendance. Ongoing education reinforces knowledge and enhances lifestyle change efforts (7).
• Develop strategies that promote the participation of all and reduce the dominance of a few, e.g. invite participants to construct group rules at the beginning of the session and encourage reluctant participants to interject comments by requesting round robin responses.
• Limit presentations to 20 minutes, with a recap every 7 to 10 minutes followed by a discussion with strategies for behaviour change (8).

Offer a variety of instructional methods

Not all adults learn the same way, so it is important to provide a variety of teaching tools (4,5):

• Educational videos are helpful for low-literacy individuals (4,5).
• Case studies integrate knowledge and enhance problem-solving skills (9).
• Have fun! Well designed games are effective for promoting praxis, reinforcing complex facts and assessing knowledge and skills (4). Crossword puzzles can introduce new vocabulary in a comfortable, non-threatening way and can be created with software programs (10).
• Humour enhances the learning environment by increasing the comfort level of participants. It also enhances the development of problem-solving skills and encourages experimentation with new thoughts and ideas (11).
• Establish opportunities for self-directed learning that extend beyond formal sessions. A lending library of videos and books is an effective, efficient and economical strategy for alternative learning.

Conclusion

The current literature suggests that adult education should respond to patients’ immediate needs, incorporate group work and offer a variety of instructional methods, all of which clearly enhance learning experiences. Interaction with and involvement from participants in personally meaningful ways enhances the learning environment.

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