As part of the continuing education programs conducted at the Washington University Diabetes Research and Training Center, 65 health professionals participated in a 4-day simulation exercise which required them to adhere to a diabetic regimen. Instructions covered injections, urine testing, recording results, and calculating and following a meal plan. Evaluation of the simulation focused on the degree of participant adherence to each component, the problems they encountered, and how the experience influenced their patient/clinician interaction. Mean scores for adherence over the 4-day period for each component of the regimen were injections (82%), diet (67%), urine testing (58%), and recording results (56%). Of the total number of adherence problems encountered by the participants, 52% were diet-related, 17% involved urine testing, 17% time constraints, 10% loss of spontaneity, and 4% involved injections. Analysis of the impact of the experience in the work setting indicated improved participant sensitivity to diabetic patient adherence problems and increased ability to effectively counsel patients and family members.

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