Teaching Project

Kim Forbes
NGR 6791 Teaching Strategies
Description/Context:
Diabetes must be managed 24 hours a day, 7 days a week. The type 1 diabetic child has special care needs that must be
consistently met. For students with type 1 diabetes, that means careful monitoring of blood glucose levels throughout the school
day and administering multiple doses of insulin therapy that is now prescribed for most young people with diabetes. While at
school and away from a primary care giver (parent/guardian), it is important that there be an adequate continuum of care to
ensure health and safety. As a result, the school health team, which includes the school nurse, teachers, office personnel and
other school staff members, play an important role in helping students manage their diabetes. This class was designed to present
information about the management and care of the type 1 diabetic in the school setting. School staff, need up to date information
on the basic etiology, pathophysiology, identification of signs and symptoms, interventions and treatment options related to the
school-aged diabetic child.
Intended Audience:
An invitation for the class was sent to the nursing staff at a local elementary school. The school clinic staff consists of
experienced registered nurses of varying backgrounds and training that are responsible for giving daily basic care to school aged
children with type 1 diabetes. The head nurse requested that teachers with diabetic children in their classroom attend as well to
help create a knowledge base and understanding of the condition and management. There were 10 attendees total (6 nurses and 4
teachers).
Objectives:
Upon completion of this class, the school nurse will be able to:
1.) Recall basic etiology/pathophysiology as it relates to diabetes type 1.
2.) Recognize and differentiate between the signs and symptoms of hypoglycemia and hyperglycemia.
3.) Demonstrate standard techniques for proper insulin administration via an insulin pen injector and an insulin pump.
4.) Demonstrate proper technique for obtaining a blood glucose reading via blood glucose monitor.
5.) Explain the proper treatment regime for hypoglycemia and identify when each treatment type (i.e. snack, glucose
gel/tabs, Glucagon) is appropriate.
6.) Verbalize an understanding of the rights of the student with type 1 diabetes in connection to the 504 plan.
***The teachers were expected to meet all of the above objectives EXCEPT #3 & 4. However, they were given the opportunity
and encouraged to demonstrate these skill if they wanted to do so (especially #4).
Preparation Insurance:
An email was sent to each invitee with course objectives and handouts for review via attachment. As well, each person attending
will be responsible to write a short summary of a chosen article that they will bring to class and share. The article must be on the
topic of type 1 diabetes (management, interesting tips, facts or research) in the school setting and be no more than 100 words.
Obstacles:
1.) Diverse levels of knowledge Having a class with both medical and non-medical professionals presented a challenge.
Trying to find a common language for both was difficult. I did not want to talk over or down to anyone or cause
frustration. To overcome this obstacle I acknowledged before class that the obstacle existed and explained that I would
stay after the class to answer questions, expand on or simplify any information needed. I also explained everything on

the PowerPoint slides in laymans terms, looking for both verbal and non-verbal clues from the teaching staff. We kept
open communication during class and questions were asked as needed.
2.) Lack of participation There were those in the class that were unwilling to participate in the self-blood glucose monitor
testing activity. This was a highly encouraged, but non-required activity since it involved a physically invasive action.
This was explained to be an activity that would not only teach procedural technique, but would also encourage empathy
regarding the daily activities of the diabetic child. All of the nursing staff completed the activity but a few teachers did
not.
3.) Unfamiliar technology - The classroom used had a Smart Board available. I had never used one, so the lack of
familiarity caused a slight delay in the start of the class. I was able to get help from one of the teachers and the
presentation moved on smoothly from there.
4.) Time constraints The case study discussion went well, however it ran over a bit and took time from the
demonstration/return demonstration activity. Luckily, this was mostly for the nursing staff and there were only 6 of
them to get through it. It caused the class to run over by about 5-10 min., which most did not seem to mind.

Content Outline:
Teaching Strategy

Content Covered

Power point/Lecture

Prevalence and statistical data

(25 min.)

Etiology and pathophysiology of type 1

Class Objective(s) Met

# 1, 2, 5, & 6

diabetes

Common causes of hyperglycemia and

hypoglycemia (normal blood glucose
levels discussed at this time via lecture)

Signs and symptoms of hyperglycemia and

hypoglycemia

Treatment/interventions for hyperglycemia

Treatment/interventions for hypoglycemia

Patient rights while in the school setting

and review of 504 plan (lecture)

Online Video (5 min.)

Teachers role in an emergency (lecture)

Fox news segment regarding prevalence

#1

and newest etiology theory

Case Studies (15 min.)

Treatment/intervention

Think-Pair-Share activity

Emotional support

Patient rights

Signs and symptoms (hype/hypoglycemia)

Demonstration/Return
demonstration (15 min.)

Proper technique for the following skills:

Giving insulin injection via the insulin

injector pen

Verbalizing SQ injection sites

Receiving a blood glucose reading via a

blood glucose monitor

Use the bolus wizard feature to give

insulin via Medtronic insulin pump.

#1, 2, 5 & 6

#3&4

Handouts (for take home and

How to use a Glucagon emergency kit

reference)

Handling hypoglycemia

Back to school reminders (checklist) for

#5&6

the type 1 diabetic

Full page of support websites for children

and families living with diabetes

Teaching/Learning strategies with Rationale (specific content is listed in content outline section above):
PowerPoint/ Lecture This was a structured method of information delivery meant to accommodate the assimilator,
auditory (aural) and visual learners (ppt. includes pictures). Along with the lecture, an outline of the PowerPoint was
passed out for follow-along and note taking. This was a particularly helpful teaching method for this audience. With
both medical and non-medical participants, it helped to demonstrate patterns, highlight main ideas and present unique
ways of viewing information (Bastable, 2014). I also felt it would be a good way to control the information given since
there was such a diverse set of learners present. I could place more complex ideas for the nursing staff in the
PowerPoint and wrap up the information in a more simplistic way for the teaching staff.
Online Video This activity would appeal mostly to the visual and analytical learner (Bastable, 2014). This was a news
segment interview addressing the prevalence and rapid rise in numbers of newly diagnosed type 1 diabetics nationwide.
As well as the newest theories to account for this increase in incidence. This method was used to expose the students to
the latest ideas and information regarding type 1 diabetes (Billings & Halstead, 2012). The link for the video is:
http://video.foxnews.com/v/1684293109001/
Think-Pair-Share (Case Study) This strategy involves the students breaking into 2 groups (nurses and teachers).
There were 2 different case study scenarios for each group (4 total) that were specific to their learning needs and area of
education. First the students read each scenario and had to think about the issue, then they pair (I did groups of 3-4) up,
and finally they share their thoughts (Herrman, 2008). This activity would be best for the read/write learners, divergers
and accommodators because they must figure out the answers to the scenario in a group, discuss and write the answer to
share (Bastable, 2014). This activity was necessary to promote group learning and new ideas, as well as to address
empathy and tolerance for different points of view. One of the teachers has a 6 year-old son with type 1 diabetes and I
felt adding that element (the view as a teacher and a parent) to the discussion enhanced the activity as well. This added
a sense of deeper emotional understanding to those who otherwise could not picture what having the disease is like.
Demonstration/Return Demonstration This activity was centered on 3 main skills: 1.) Performing a blood glucose
test via the blood glucose meter 2.) Proper technique for giving insulin via insulin pen and 3.) Administering an insulin
bolus via insulin pump using the bolus wizard feature. This activity would be best suited for the visual, kinesthetic
and converger type learners as they enjoy doing hands-on activities (Bastable, 2014). Visibly showing a process often
aids in retention and skills become more understandable as a result of the demonstration. Once the student demonstrates
the learned skill, it allows for constructive feedback from the educator further enhancing retention (Billings & Halstead,
2012).
Critical Thinking Approach:
The specific strategies included to ensure critical thinking:
1.) Video with discussion after regarding prevalence and newest etiology theories was used to stimulate critical thinking
(Billings & Halstead, 2012).
2.) Case studies included open-ended questions that moved throughout an unfolding scenario in which answers must change as

more information is given (Billings & Halstead, 2012). The case study encouraged the students to work through problem
situations and generate solutions using learned knowledge and personal experience (Hoffman, 2008).
3.) Class discussion included higher reasoning questioning strategies that encouraged the important critical thinking skills in
relation to the learning activities (Hoffman, 2008).
Outcome Evaluation:
There were 2 methods used to determine outcome evaluation. 1.) Case study answers and follow up class discussion (please see
case study attachments) and 2.) Demonstration checklists, as follows:
Return Demonstration check off for administration via insulin pen
Places new needle onto pen with proper twisting
technique and lock into place.

Check for air bubbles, tapping them to the top to

expel them.
Dial 2 units on the pen to prime new needle and rid
the insulin of air. Looks for a steady stream of insulin
to ensure pen has been properly primed.

Blood Glucose Monitoring

Use lancet to obtain blood
sample
Place strip into glucose monitor
and wait for prompt
Place enough blood on glucose
strip to prompt machine
reading and verbalize normal
blood glucose
Using Bolus Wizard to give insulin via insulin pump
Place the following information into the
insulin pump using bolus wizard:

Properly names all SQ injection sites

Enter in BG of 144
Verbalizes proper injection technique including
holding the needle in the skin with plunger pushed
for 5-6 seconds before pulling our.

Enter 45 carbs
Push the ACT button until insulin has been
given.
Exhibit knowledge of how to look up bolus
history and active insulin.

Teaching Effectiveness Assessment Plan:

A post in-service survey (see below) was adapted and given to all participants to evaluate the effectiveness of this teaching plan.
The results were good and I received mostly strongly agree responses with only 2 agree responses (on 1 evaluation) regarding
course objectives being met in the learning activities and teaching activities meeting learning needs. Overall I received a very
positive reaction and was asked to re-teach this class in January for the remainder of the teachers and staff. This was an amazing
experience that I thoroughly enjoyed. If I had to do this class again, I would monitor the time taken in each activity better so we
would not run out of time or have to rush during last activity planned.

Post In-Service Survey

Date:______________

Please answer the following questions, circle your answer. These results will help us improve this course for future classes. Thanks You.
1.

The objectives of the course were met.

Strongly Agree
2.

Disagree

Strongly Disagree

Disagree

Strongly Disagree

The course was well organized.

Strongly Agree
3.

Agree

Agree

The mode of delivery facilitated learning.

Strongly Agree

Agree

Disagree

Strongly Disagree

4.

Course objectives were reflected on the learning activities (lecture/case studies/demonstration).

Strongly Agree
5.

Strongly Disagree

Agree

Disagree

Strongly Disagree

The instructors were effective in their teaching style.

Strongly Agree
7.

Disagree

The overall quality of the course was high.

Strongly Agree
6.

Agree

Agree

Disagree

Strongly Disagree

The teaching activities facilitated my learning.

Strongly Agree

Agree

Disagree

Strongly Disagree

Additional comments, suggestions, or concerns:

References

Bastable, S. B. (2014). Nurse as Educator: Principles of teaching and learning for nursing practice (3rd ed.). Sudbury, MA: Jones
and Barlett.
Billings, D. M. & Halstead, J. A. (2012). Teaching in Nursing: A Guide for Faculty (4 ed). Philadelphia, PA: W.B. Saunders
th

Company.

Faculty Center for Teaching and Learning: Electronic Workbook (n.d.) 101 interactive techniques. Retrieved on November 13,
2013 from http://www.fctl.ucf.edu/events/gtaprograms/workbook/files/101interactivetechniques.html InstructorActionLectureSmallClassSize
Herrman, J. W. (2008). Creative Teaching Strategies for the Nurse Educator. Philadelphia: F.A. Davis Co.
Hoffman, J. (2008). Teaching strategies to facilitate nursing students' critical thinking. Annual Review Of Nursing
Education, 6225-236.