Influence of frequency, time interval from initial instruction, and method of instruction on performance competency for blood glucose monitoring.

Abstract

In a sample of 178 nurses who had been instructed in the performance of fingerstick monitoring of blood glucose (MBG), we investigated variables that may predict their proficiency at subsequent MBG performance. All nurses were given initial instruction in a classroom-type setting or via a self-instructional packet, and initial proficiency was documented by initial testing. All nurses were retested 1-8 mo later. To address whether actual frequency of performing MBG at work affected proficiency, the nurses were categorized based on the frequency of performing MBG groups: greater than 1 test/day (n = 53), greater than 1 test/wk (n = 51), greater than 1 test/mo (n = 52), and less than 1 test/mo (n = 22). No differences in test and retest scores were detected. To address whether the time interval from the original instruction and test to the retest affected proficiency, the nurses were divided into groups who had initial test less than 6 mo (n = 108) and greater than 6 mo (n = 70) before the retest. Mean change in test scores was less in the greater than 6-mo group than in the less than 6-mo group (P less than 0.01), and they had a lower retest fail rate (3 vs. 12%, P = 0.03). To explain this unexpected finding, test scores were analyzed by groups based on the type of original instruction. Nurses who attended class (n = 79) were compared with those who had self-instruction (n = 99). The classroom-trained group had less change in test-to-retest score (P = 0.0002) and a lower retest failure rate (3 vs. 12%, P less than 0.05).