News and insights brought to you by the International Diabetes Federation

Diabetes education workshop in Costa Rica

Diabetes and related complications impose individual and family costs for public and private business, institutions, and health insurance. There is a diversity of diabetes education programs offered by public and private organizations in South and Central America. The content is usually complex and focuses only on people gaining new knowledge.  Education should and can make a difference in an individual’s ability to address lifestyle behaviours and self-manage.  In order to change the dynamic, our team looks at what a difference active learning and teamwork can make. Empowerment is the outcome.

In people living with chronic diseases such as diabetes, diagnosis involves some frustration and treatment rests heavily on their skill and motivation, and thus it is a learning situation. New challenges in care and prevention are presented to healthcare providers and a “know-how-to-work” attitude beyond clinical upgrade is required to be effective in facilitating active learning and new lifestyles in their work with people living with diabetes.

Teamwork plays an essential role

The meaning of teaching has fundamentally changed. Howard Gardner, of Harvard University, demonstrates that the traditional concept of transmitting knowledge has being replaced by cognitive processes based on active learning with the use of multiple intelligences. Carl Wieman, of Stanford University, explains how internal appropriation, and problem-solving experimentation are styles that generate sustainable changes: personal effectiveness, motivation towards life goals, and development of continued learning skills. Teamwork plays an essential role in shifting from ineffective intake in traditional education towards active learning and follow-up which leads to empowerment.

The association Dia Vida in Costa Rica began training sessions described below.

How was the exercise created?

We agreed among the group that health metrics are important predictors for diabetes management and prevention. It is important to consider behaviors like maintaining healthy weight, eating healthy and being physically active. Metrics include blood pressure, cholesterol and blood glucose. We reflect: “As always, the things we need to achieve are well known.”

What are the teamwork objectives?

The goal for the group is to build a tall and safe tower with wooden blocks. At the same time, keeping in mind all the basic principles valid for the management and prevention of diabetes. These principles are presented and integrated into a tower, allowing participants to communicate and talk to each other.

The principles are presented on blocks on the floor which may change according to the sessions’s thematic approach. A participant presents the rules for construction.

How to use the interaction metaphor to facilitate learning?

The group understands their ability to collaborate and build the tower using the crane. They begin to build.  Even with all the initial energy, two blocks fall out, the “eat healthy” envelope and the other on “regular weight”. What a parallel situation that is similar to everyday life! Everyone remembers the effort needed to achieve new behaviors. The crane ropes are down, and the group ask themselves, “What can we advise this group and how can we move forward?”

The group responds by reflecting and collect comments on how to continue. The group advises itself and continues to build successfully until the tower is high and safe, with all principles integrated. Health success is celebrated!

The educational alternative to initiating active learning has been demonstrated. Our participants all celebrate their success based on communicative skills such as “listening,” “expressing empathy” and “praising effort.”

Diabetes education has the great advantage that the success of its work is directly related to numerical indicators and easily measurable before, during and immediately after a diabetes education program. This activity demonstrated that collaborative learning and teamwork occur in any situation when two or more people try to learn something together.


Martin Carnap is responsible for facilitation and coaching for Metaaccion, a company in Costa Rica that specializes in the implementation of active methodologies for job training, process facilitation, organizational development and development of human potential in groups, organizations and communities.


Ana Ortega is President of DIA VIDA - Asociación Pro Diabetes, a member of the International Diabetes Federation in Costa Rica

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