Issue: April 2021
Disclosures: Drago reports no relevant financial disclosures. Weiner reports she is a clinical adviser to Livongo Health.
March 08, 2021
3 min read
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Telehealth requires effective strategies for short teaching sessions

Issue: April 2021
Disclosures: Drago reports no relevant financial disclosures. Weiner reports she is a clinical adviser to Livongo Health.
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In this issue, Susan Weiner, MS, RDN, CDN, CDCES, FADCES, talks with Lorena Drago, RDN, MS, CDN, CDCES, about tips for successful short telehealth sessions for diabetes education.

Weiner: What are some of the challenges that come with conducting diabetes education sessions by telehealth?

Susan Weiner
Lorena Drago

Drago: Some people do not have a computer, so they use their phones. If you are going to use handouts and share the screen, provide instructions prior to the consultation advising the client to change the orientation to landscape. Prepare for the unexpected, and be flexible. You may have to resort to a telephone consultation without video.

Preparing handouts, having a plan for a telephone session and asking patients to "teach back" information can enhance diabetes education telehealth appointments.

Prepare an outline of the topics you want to cover. Have a few activities and case scenarios to share. For example, after your client provides you with the foods she ate at breakfast, ask, “How did you calculate the amount of carbohydrates in each meal? How many units of insulin did you use for that meal? If you would have eaten half of that meal, how would you calculate your dose?”

Weiner: What’s the secret to a successful 15-minute session?

Drago: The key is preparation. As a provider, you need to gather as much information as you can prior to the visit. When possible, even prepare the client prior to the visit, so the 15-minute consultation is truly devoted to teaching. Many platforms allow clients to fill out and submit responses to questionnaires before the meeting. You can also send reading material or a video ahead of time.

The other key factor is to focus on only one or two topics per session, because it helps the client retain the information.

Weiner: What is your method for introducing new concepts?

Drago: I use a three-pronged approach: Make sure you know what your client wants to know, determine what they already know, and then close the gap.

I ask my clients what they want to learn or what key topic they would like to take away from a visit. That helps me to focus the discussion. For example, a client might say they want to learn more about foods that will increase their blood sugar levels. That lets me know to cover carbohydrates in that session.

Then I’ll ask the client what they know about carbohydrates. Often they have an incomplete understanding of what carbohydrates are. A simple exercise that anyone can do is to write up a list with several foods and then ask the client to circle foods they believe have carbohydrate and indicate which ones influence blood sugar levels the most.

In just a few minutes, you know which particular concepts you need to clarify to close the gap between what they know and what they want to know.

Weiner: Describe your “teach-back” technique to assess a client’s understanding.

Drago: Teach back really is not about the client; it’s about how well the educator has explained the concepts. There are two things I like to ask. First, “I know this is not an easy topic, but can you tell me in your own words what we just talked about?” or “How would you explain to your spouse or your children what I just shared with you?”

Always the onus is on you, the educator, so you always want to say, “This is very complex information, and I just want to make sure that I was able to share it appropriately.”

Then second, ask, “Can you show me, or can you tell me?” This is very helpful when you’re demonstrating how to use a glucose meter or a continuous glucose monitor or even how to count carbs. Those are two good tips to have in your toolbox.

For more information:

Lorena Drago, RDN, MS, CDN, CDCES, is author of the bilingual book Beyond Rice and Beans: The Caribbean Latino Guide to Eating Healthy with Diabetes and The 15-Minute Consultation: Tips, Tools, and Activities to Make Your Nutrition Counseling More Effective. She is the owner of Hispanic Foodways LLC, a nutrition and diabetes consultant company. She can be reached at lorenamsrd@aol.com; Twitter: @lorenadrago.

Susan Weiner, MS, RDN, CDN, CDCES, FADCES, is co-author of The Complete Diabetes Organizer and Diabetes: 365 Tips for Living Well. She is the owner of Susan Weiner Nutrition PLLC and is the Endocrine Today Diabetes in Real Life column editor. She can be reached at susan@susanweinernutrition.com; Twitter: @susangweiner.