Does a doctor have to observe a full 5-day patient course as part of their DAFNE training?
“We do not see how a doctor can fully understand DAFNE, be involved with the course or follow-up patients without investment in the process. Yes it is time consuming – but time well spent!”- the Nottingham team
Does DAFNE have to be a week-long course?
It is the whole DAFNE ‘package’ which has been tested and been shown to work. [11] If changes are to be made, they too must be subject to rigorous evaluation, before they can be recommended. People expect to be offered a ‘tested product’.
We can't find dietitians; can we go ahead without them?
The accurate assessment of carbohydrate is vital to the success of the DAFNE approach. During the learning stage both participants and non-dietetic educators need support from a trained dietitian. However they do not need to be present throughout each course. Some centres enlist support from part-time dietitians to help them to start up.
Remember! DAFNE is professionally satisfying for dietitians and may help recruitment.
The DAFNE approach - we do that anyway!
Many DAFNE graduates say this before they complete a DAFNE programme. Some have learnt over many years by private trial and error how to adjust insulin to food in a very sophisticated way. DAFNE teaches the skills that take the guesswork out of insulin adjustment and builds up confidence quickly to make the very large changes in insulin needed on a meal by meal basis, in a truly free diet.
The DAFNE Educator Programme seems to take a huge amount of time – is it really necessary to attend it all?
Patient education needs to be prescribed with the same rigour and to the same standards as any drug or technological therapy. Learning to be a DAFNE educator is a skill, like learning the DAFNE approach itself, and needs time and practice. The training course contains all the components necessary for an adult to learn a new skill (observation, practice, reflection etc) and has been developed with expert educational advice. Feedback from nurses and dietitians who have completed the DAFNE Educator Programme (DEP) suggests that if anything the DEP is too short.
We can't do DAFNE on top of everything else - too busy!
There is no doubt that delivering DAFNE is labour intensive, but this can be viewed as short-term pain for long-term gain. DAFNE has a unique spectrum of outcomes, when compared with conventional management of Type 1 diabetes. DAFNE graduates usually require less support afterwards so clinics have much less of a role.
DAFNE educators agree that delivering the DANE programme is so rewarding, any effort is well worth it; one educator stated “The job satisfaction I get from teaching DAFNE makes the rest of my job worthwhile.”
Why aren’t the curriculum and resources available to everyone?
DAFNE is a package in which all parts are mutually dependent. This includes training and peer review.
QA - is this really necessary?
Any intervention for patients requires QA. How else will a professional or patient know they are getting a quality product? Just as a laboratory tests, or the labs themselves are subject to review, so the evaluation of education has its own well-tried methodology. This involves structured observation, feedback and public review and scrutiny. The DAFNE QA programme uses a ‘quality circle’ methodology, which has been tried and tested in Germany. It involves a 3-yearly structured questionnaire and week long observational visit to each centre. The results are reported to the Collaborative and will be publicly available.
How much does DAFNE cost?
The costs are detailed in the DAFNE Funding Pack