Diabetes educators positioned to lead in new era


Angela McBride, PhD, RN, FAAN: ‘That is why the IOM says you are the example of everything they talk about in the ACA and in population-based care. There is enormous external demand for what you know.’

Just as advances in medicine are changing the treatment of patients with diabetes, advances in academia are changing the development of diabetes educators and their paths to leadership in medicine, said longtime educator Angela McBride, PhD, RN, FAAN.

Dr. McBride discussed paradigm shifts in academia and medicine, and their influences, during her Friday keynote address, “Diabetes Education: The Demand for 21st Century Leadership.” She is university dean emerita at the Indiana University School of Nursing, who “came of age in the 20th century, when we were dealing with education in a different way.”

In that earlier era of education, mentoring was only necessary during school, orientation or tenure-probationary years, and the effective administrator largely operated from a command-and-control framework, Dr. McBride said.

In the 20th century, health care was episodic, had a fee-for-service payment system and was shaped by the educational background of providers, Dr. McBride said. Today, health care has integrated delivery systems, managed transitions, capitated payment, and care increasingly shaped by evidence-based protocols. Other changes in 21st century health care include reducing unnecessary variation, an emphasis on outcomes and recognition of the value of expert teams.

“This is important to you because diabetes educators have the defining expertise for where the world is going, particularly in light of changes noted in Institute of Medicine (IOM) quality reports and the Affordable Care Act,” she said.

Likewise, academia has changed in the 21st century. The emphasis has shifted from learning facts and getting degrees to learning to learn and continuously learning.

“Do you know 10 years later how to keep up with the new information?” Dr. McBride asked. “We develop expertise over time. An emphasis for me is that when I leave this conference I will have enhanced my own learning.

“I got my master’s in the 1960s. If I operate in a job that needs a master’s, they don’t want the knowledge I have from 1964, they want to know what is important in 2014.”

Other changes in academia are that disciplinary silos have been replaced by an emphasis on interprofessional practice, and research is now shaped by clinical need and funding, not personal interest.

“If the funding is there for research, it tells you this is an area important to society,” Dr. McBride said. “When we now look at funding, increasingly the emphasis is on different kinds of scholarship and different kinds of funding.”

Dr. McBride then shifted gears to focus on the changing definition of leadership, which has ties to changes in academia, where the emphasis is on transitioning to meet changing demands.

“For me, leadership is not the same as administration,” she said. “It is not what you do day in and day out in your current position. Leadership includes teamwork, helping others and improving things for transformational change.”

This is good news for diabetes educators because IOM quality reports discuss diabetes as an area that demonstrates the importance of the new types of leadership needed, Dr. McBride said. This includes teaching lessons central to the delivery of care that is efficient, effective and continuously improving.

“That is what you are doing. That is why the IOM says you are the example of everything they talk about in the ACA and in population-based care,” she said. “There is enormous external demand for what you know.”

This positions diabetes educators to take advantage of opportunities that lie ahead, such as orchestrating system-level change and participating, building and leading the study of 21st century teams.

“Your knowledge about the diabetes continuum is in fact molded for leadership in terms of the medical transitions that are coming with the era of accountable care organizations,” Dr. McBride concluded.

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