Training of teachers in the management of children's diabetes at school : a rapid review

Abstract

Diabetes mellitus is a chronic disease that is increasing at an alarming rate in school-aged children. Due to the elaborate insulin regimen and day-to-day management and care of this disease, school-going children will require assistance with carrying out diabetes management tasks at school. Children require regular glucose testing, assistance with day-to-day management and monitoring of diabetes emergencies such as hyper- and hypoglycaemia. It is therefore imperative that schoolteachers are trained to know about diabetes care and management, and the handling of diabetes emergencies should these arise at school. The unsuccessful management of diabetes may lead to short-term and long-term complications. The inability to deal with diabetic emergencies is life-threatening and can even be fatal. Literature has thus far focussed on the perception of teachers, children, and parents on teachers' knowledge and ability to assist with the management of diabetes at school and the training of school nurses. However, there is very limited research on the training programmes available to equip teachers to manage diabetes successfully in school. This rapid review study aimed to collate and synthesise existing scientific literature on the training programmes available to educate teachers regarding diabetes and its management in the school setting. Scientific literature was identified using a pre-selected keyword search from the Ebsco Discovery Services (EDS) databases. A total number of 269 possible articles were identified, and after a rigorous, critical appraisal process, 11 articles were selected that matched the inclusion and exclusion criteria for this rapid review study. The extracted data were analysed using a thematic synthesis approach. Six main themes were derived from this process, namely training methods, the efficacy of programmes, diabetes knowledge, teachers' confidence, cost-effective methods, and content of the training programmes. It was found that online training and face to face training were efficacious and improved diabetes knowledge and teachers' confidence to manage diabetes in the school context. Moreover, it was noted that interactive education training programmes yielded the best results. It seemed most programmes concentrated on the theory regarding diabetes pathology and a practical demonstration of insulin regimens. It was recommended that further research be undertaken regarding diabetes programmes specifically for teachers and comparative studies between different training methods to ascertain the most effective approach. Further research must include larger sample sizes, more schools, and longer follow-up studies. There is also a need for additional research in more African countries to allow equal opportunity in schools for all children. The rapid review study was able to provide guidelines for the development of a training programme that could be implemented in South African schools. The review is one of the first of its kind that focusses on training programmes specifically for teachers and thus contributes to the body of evidence that serves to inform the development of a customised training programme that could prove effective in South Africa's distinctive school environment.