Educator talk ratio as a quality indicator in group-based patient education

Objective: The purpose of this study was to investigate participants' experiences of and satisfaction with the content and outcome of 13 different sessions of a 4-day diabetes education programme and to compare participants' experiences with the extent of educator talk in the sessions. A 10-second event coding was used to evaluate educators' application of participatory methods in patient education. 

Method: Four diabetes education courses, each consisting of 13 sessions with 10-12 participants, were monitored, using the 10-second event coding to assess educator talk ratios. Three focus group interviews were performed after the course, and 19 exploratory interviews were performed with participants within 3 months of the end of the course. Participants were asked about their experiences of personal outcomes derived from participation in the programme in general and from participation in each session. Qualitative data were analysed using systematic text condensation focused on participants' perceptions of the personal outcomes derived from each session. Participant reports were compared to measured educator talk ratios to assess relationships between experiences and educator talk ratios. 

Results: Positive participant-reported outcomes such as learning from each other and a feeling of safety and freedom were associated with low educator talk ratios in specific sessions. However, participants appreciated high talk ratios when educators presented knowledge attendees perceived as essential and meaningful to everyday life. 

Conclusion: The educator talk ratio is a useful metric to evaluate the quality of group-based diabetes education using participatory methods. However, it must be used in combination with an assessment of education content and format.