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Liu MY, Liao LL, Huang YT, Lee YC, Lai IJ. Effectiveness of a scenario-based simulation course on improving the clinical communication skills of dietetic students. BMC MEDICAL EDUCATION 2025; 25:106. [PMID: 39844115 PMCID: PMC11756091 DOI: 10.1186/s12909-025-06684-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 01/09/2025] [Indexed: 01/24/2025]
Abstract
BACKGROUND Effective clinical communication skills are essential for dietitians as it impacts patient outcomes and satisfaction across diverse clinical and public healthcare settings. Despite its importance as a core competency, many dietetics programs, including those in Taiwan, need to provide sufficient training in this area. This study aimed to develop and assess a scenario-based simulation course to improve communication skills in dietetic students. METHODS A non-randomized control group pretest-posttest design was used. The intervention consisted of a 12-week scenario-based simulation communication course divided into three units employing diverse teaching methods. One hundred nineteen third-year dietetic students from two universities were enrolled through convenience sampling, with 59 students in the experimental group and 60 in the control group. The experimental group participated in the course intervention, whereas the control group received no clinical communication skills training. Effectiveness was assessed by comparing participants' self-assessment of communication skills and Objective Structured Clinical Examination (OSCE) scores before and after the intervention and collecting feedback on learning satisfaction. Data were analyzed using paired t-tests and ANCOVA. RESULTS The results showed that the post-test scores of the experimental group were significantly higher than those of the control group in terms of self-assessed clinical communication confidence, self-efficacy, and competence after controlling for pre-test scores. In the experimental group, the post-test OSCE scores were significantly higher than the pre-test scores, except for one item related to the nutrition assessment of diabetes. The intervention course's average learning satisfaction score was above 4.4 (out of 5 points). CONCLUSIONS This course effectively enhanced dietetic students' clinical communication confidence, self-efficacy, and communication skills. These results can provide a reference for integrating clinical communication courses into undergraduate dietetics curricula.
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Affiliation(s)
- Mei-Yuan Liu
- Department of Nutrition, Chi Mei Medical Center, Tainan City, Taiwan
- Department of Nutrition and Health Sciences, Chang Jung Christian University, Tainan City, Taiwan
| | - Li-Ling Liao
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung City, Taiwan.
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.
| | - Yu-Ting Huang
- Department of Health Management and Enhancement, Open University of Kaohsiung, Kaohsiung City, Taiwan
| | - Yi-Chen Lee
- Department of Nutrition, College of Medicine, I-Shou University, Kaohsiung City, Taiwan
- Department of Nutrition Therapy, E-DA Cancer Hospital, Kaohsiung City, Taiwan
| | - I-Ju Lai
- Department of Nutrition, College of Medicine, I-Shou University, Kaohsiung City, Taiwan.
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Cockcroft EJ, Clarke R, Dias RP, Lloyd J, Mann RH, Narendran P, Reburn C, Smith B, Smith JR, Andrews RC. Effectiveness of Educational and Psychoeducational Self-Management Interventions in Children and Adolescents With Type 1 Diabetes: A Systematic Review and Meta-Analysis. Pediatr Diabetes 2024; 2024:2921845. [PMID: 40302946 PMCID: PMC12016993 DOI: 10.1155/2024/2921845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 07/25/2024] [Accepted: 09/05/2024] [Indexed: 05/02/2025] Open
Abstract
Aim: Type 1 diabetes (T1D) is one of the most common chronic conditions in children and adolescents. Approximately 1.5 million young people are currently living with T1D throughout the world. Despite recent improvement in overall indices of metabolic control in children and adolescents with T1D, control remains suboptimal and additional approaches are needed. The aim of the study was to conduct a systematic review and meta-analysis of educational and psychoeducational self-management interventions, to help optimize future interventions including physical activity support. Methods: A systematic review and meta-analysis were conducted according to our registered protocol (PROSPERO CRD42022295932) and are reported in line with the PRISMA 2020 guidance. We searched five databases (MEDLINE, EMBASE, PsycINFO [via Ovid], CINAHL [via EBSCO], Cochrane Library) from 1994 up to May 2024. We included randomized controlled trials assessing the effectiveness of self-management interventions. Outcomes of interest included HbA1c and quality of life (QoL) as well as self-care behaviors, diabetes knowledge, and self-efficacy. Meta-analyses were conducted using a random effects model. Results: In total, 46 papers were included, reporting on 30 interventions. Meta-analyses showed small short-term improvements in HbA1c (MD = -2.58 mmol/L, 95% CI -4.44 to -0.71, p=0.007) and QoL (mean difference [MD] = 1.37, 95% CI 0.19-2.54, p=0.02). Prespecified subgroup analyses suggested no significant difference in effectiveness of psychoeducational and education-only interventions. Quality of included studies was low with 27 having a high risk of bias. Conclusion: There is a lack of robust evidence that current self-management interventions result in clinically meaningful improvements in HbA1c and QoL. Future research should focus on redefining approaches to supporting and encouraging self-management.
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Affiliation(s)
| | - Ross Clarke
- University of Exeter Medical School, EX1 2JP, Exeter, UK
| | - Renuka. P. Dias
- Department of Paediatric Endocrinology and Diabetes, Birmingham Women and Children's NHS Foundation Trust, B4 6NH, Birmingham, UK
- Institute of Metabolism and Systems Research, University of Birmingham, B15 2TT, Birmingham, UK
| | - Jenny Lloyd
- University of Exeter Medical School, EX1 2JP, Exeter, UK
| | - Robert H. Mann
- University of Exeter Medical School, EX1 2JP, Exeter, UK
| | - Parth Narendran
- Institute of Metabolism and Systems Research, University of Birmingham, B15 2TT, Birmingham, UK
- Department of Diabetes, University Hospitals Birmingham NHS Foundation Trust, B4 6NH, Birmingham, UK
| | | | - Ben Smith
- University of Exeter Medical School, EX1 2JP, Exeter, UK
| | - Jane R. Smith
- University of Exeter Medical School, EX1 2JP, Exeter, UK
| | - Robert. C. Andrews
- University of Exeter Medical School, EX1 2JP, Exeter, UK
- NIHR Exeter Biomedical Research Centre (BRC), EX1 2JP, Exeter, UK
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Alonso-Carril N, Rodriguez-Rodríguez S, Quirós C, Berrocal B, Amor AJ, Barahona MJ, Martínez D, Ferré C, Perea V. Could Online Education Replace Face-to-Face Education in Diabetes? A Systematic Review. Diabetes Ther 2024; 15:1513-1524. [PMID: 38743305 PMCID: PMC11211299 DOI: 10.1007/s13300-024-01595-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 04/18/2024] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVE Diabetes Self-Management Education and Support (DSMES) is a critical component of diabetes care. This study aims to examine the effect of online-based educational interventions on diabetes management compared to face-to-face interventions. METHODS A systematic review was conducted by searching three databases for studies in English or Spanish between December 2023 and March 2024. The inclusion criteria were studies that compared face-to-face DSMES with online interventions. RESULTS The follow-up duration of the trials ranged from 1 to 12 months. Multidisciplinary teams delivered online DSMES through various means, including Short Message Service (SMS), telephone calls, video calls, websites, and applications. Online DSMES was found to be comparable to face-to-face interventions in terms of glycated hemoglobin (HbA1c) levels in people with type 1 diabetes (T1D). In contrast, online interventions that focus on weight management in people with type 2 diabetes (T2D) have shown a significant reduction in HbA1c compared to face-to-face interventions. Online DSMES was found to be superior in terms of quality of life and cost-effectiveness in both T1D and T2D. None of the analyzed studies explored the differences between individual and group methodologies. CONCLUSIONS The current evidence indicates that online DSMES services provide at least comparable biomedical benefits to face-to-face interventions, suggesting that online interventions could be incorporated into clinical practice as a complement or reinforcement. However, further research is needed to explore the potential benefits and effectiveness of online group sessions in DSMES.
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Affiliation(s)
- Núria Alonso-Carril
- Endocrinology and Nutrition Department, Hospital Universitari Mútua de Terrassa, Dr Robert 5, 08221, Terrassa, Spain
- Department of Nursing, Rovira i Virgili University, Tarragona, Spain
| | - Silvia Rodriguez-Rodríguez
- Endocrinology and Nutrition Department, Hospital Universitari Mútua de Terrassa, Dr Robert 5, 08221, Terrassa, Spain
| | - Carmen Quirós
- Endocrinology and Nutrition Department, Hospital Universitari Mútua de Terrassa, Dr Robert 5, 08221, Terrassa, Spain
| | - Belén Berrocal
- Endocrinology and Nutrition Department, Hospital Universitari Mútua de Terrassa, Dr Robert 5, 08221, Terrassa, Spain
| | - Antonio J Amor
- Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Maria-José Barahona
- Endocrinology and Nutrition Department, Hospital Universitari Mútua de Terrassa, Dr Robert 5, 08221, Terrassa, Spain
| | - Davinia Martínez
- Nursing Department, Hospital Universitari Mútua de Terrassa, Terrassa, Spain
| | - Carme Ferré
- Department of Nursing, Rovira i Virgili University, Tarragona, Spain
| | - Verónica Perea
- Endocrinology and Nutrition Department, Hospital Universitari Mútua de Terrassa, Dr Robert 5, 08221, Terrassa, Spain.
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Castillo-Ortega R, Vega-Vargas J, Durán-Aguero S. Assessment of clinical impact of SARS-CoV-2 in people with type 1 diabetes: A cohort study. Nutrition 2024; 118:112263. [PMID: 37988927 DOI: 10.1016/j.nut.2023.112263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVES During the coronavirus 2019 pandemic, there had been more than 758 million COVID-19 cases as of February 13, 2023, and it is the main cause of death in many countries. Due to the variation in disease presentation, scientists determined that people living with type 2 diabetes mellitus were at higher risk of mortality. However, people living with type 1 diabetes have not been thoroughly studied, especially in extreme regions of developing countries. The objective of this study was to analyze the effects of SARS-CoV-2 pandemic restrictions on different variables in a cohort with type 1 diabetes. METHODS This cohort-type study included pediatric and adult patients with type 1 diabetes at Regional Hospital Dr. Juan Noé Crevani in Arica, Chile. Biosocial and anthropometric factors, clinical history, self-care activities, and biochemical parameters were assessed and compared using analysis of variance and paired t tests between March 2020 and March 2021. RESULTS A total of 150 patients were assessed during the SARS-CoV-2 pandemic in Arica, Chile. One year after the pandemic struck, the main causes for metabolic deterioration were a reduction of carbohydrate counting by an average of 8.67% (P = 0.000), a reduction of adherence to treatment by an average of 25% (P = 0.000), and a shift to telemedicine as a main health care service (P = 0.023); these factors raised hemoglobin A1c (HbA1c) levels by 1.81%, 1.78% and 0.075%, respectively. The participants' average body mass index (BMI) increased by 1.26 kg/m2 and HbA1c levels increased by 0.16% during the first year of the pandemic. Also, hospitalizations increased about 2% (P = 0.984), and there was a significant increase in carbohydrate and snack intake (P = 0.330 and P = 0.811, respectively). Children's linear growth decreased by a standard deviation of 0.035 (P = 0.648), and their physical activity decreased by 12.67% (P = 0.383). CONCLUSIONS This study found that adherence to diabetes care was reduced during the pandemic owing to a variety of behavioral reasons and environmental changes (e.g., quarantines and food security). This affected this population's HbA1c levels, BMI, linear growth, and number of hospitalizations as main consequences. Telemedicine remains an important tool, but it must be reconsidered among all different age groups.
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Affiliation(s)
| | - Juan Vega-Vargas
- Departamento de Ingeniería Industrial y de Sistemas, Universidad de Tarapacá, Arica, Chile
| | - Samuel Durán-Aguero
- Escuela de Nutrición y Dietética, Facultad de Ciencias para el Cuidado de Salud, Universidad San Sebastian, Chile
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Cristello Sarteau A, Mayer-Davis E. Too Much Dietary Flexibility May Hinder, Not Help: Could More Specific Targets for Daily Food Intake Distribution Promote Glycemic Management among Youth with Type 1 Diabetes? Nutrients 2022; 14:nu14040824. [PMID: 35215477 PMCID: PMC8877269 DOI: 10.3390/nu14040824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/28/2022] [Accepted: 02/09/2022] [Indexed: 01/09/2023] Open
Abstract
Average glycemic levels among youth with type 1 diabetes (T1D) have worsened in some parts of the world over the past decade despite simultaneous increased uptake of diabetes technology, thereby highlighting the persistent need to identify effective behavioral strategies to manage glycemia during this life stage. Nutrition is fundamental to T1D management. We reviewed the evidence base of eating strategies tested to date to improve glycemic levels among youth with T1D in order to identify promising directions for future research. No eating strategy tested among youth with T1D since the advent of flexible insulin regimens—including widely promoted carbohydrate counting and low glycemic index strategies—is robustly supported by the existing evidence base, which is characterized by few prospective studies, small study sample sizes, and lack of replication of results due to marked differences in study design or eating strategy tested. Further, focus on macronutrients or food groups without consideration of food intake distribution throughout the day or day-to-day consistency may partially underlie the lack of glycemic benefits observed in studies to date. Increased attention paid to these factors by future observational and experimental studies may facilitate identification of behavioral targets that increase glycemic predictability and management among youth with T1D.
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Affiliation(s)
- Angelica Cristello Sarteau
- Department of Nutrition, University of North Carolina at Chapel Hill, 245 Rosenau Drive, Chapel Hill, NC 27599, USA;
- Correspondence:
| | - Elizabeth Mayer-Davis
- Department of Nutrition, University of North Carolina at Chapel Hill, 245 Rosenau Drive, Chapel Hill, NC 27599, USA;
- School of Medicine, University of North Carolina at Chapel Hill, 245 Rosenau Drive, Chapel Hill, NC 27599, USA
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