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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EIn the 20th century, health care was more episodic, had a fee-for-service structure, and relied primarily on the educational background of health care providers. Today, health care delivery is more integrated and geared toward transitioning patient to other treatments or discharge, and payment is contractually arranged (ie, capitated payment). The development of Certified Diabetes Educators is changing similar to the way medical advancements are altering the manner in which patients with diabetes are treated.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ENursing\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes Mellitus Diabetes \u0026amp; Metabolic Syndrome\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPrevention \u0026amp; Screening\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ENursing\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes Mellitus\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EEndocrinology\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Metabolic Syndrome\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPrevention \u0026amp; Screening\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EIn a keynote address, Angela McBride, PhD, RN, Indiana University School of Nursing, Indianapolis, Indiana, USA, argued that akin to the way medical advancements are altering the manner in which patients with diabetes are treated, the development of Certified Diabetes Educators (CDEs) is changing.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EIn the 20th century, health care was more episodic, had a fee-for-service structure, and relied primarily on the educational background of health care providers (HCPs). Today, health care delivery is more integrated and geared toward transitioning patient to other treatments or discharge, and payment is contractually arranged (ie, capitated payment). Health care is also increasingly reliant on evidence-based protocols, with care shifting as HCPs, with differing expertise (eg, CDEs), become involved.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EHistorically, health care tended to vary depending on patient needs; however, now, with the increased number of HCPs\u2014upward of 30\u2014a patient may contact daily, the emphasis is on eliminating unnecessary variation to help maximize the continued high-level care among the various HCPs. Health care was also individualized and process oriented, whereas now, it is increasingly evidence based and more standardized. Individualization is now tailored to patients who have more challenging health circumstances, with care dependent on the expertise of a particular HCP. Additionally, although health care used to depend on timing and location, these limitations are less important now because of information technologies such as telemedicine.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe paradigm shift in health care delivery has also involved a change in the academic preparation and in the required teaching skills of HCPs. The era of lecture-based rote learning of facts and attaining degrees has transitioned to an emphasis on \u201clearning how to learn\u201d and using these learning skills to continuously acquire knowledge over subsequent decades to develop expertise. Knowledge acquisition for health care performance and leadership continues long after the awarding of a degree.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EA multifaculty collaborative environment that harnesses the varied expertise to best deal with the given challenges, including diabetes education, has supplanted the academic environment of 50 years ago, which had little interfaculty interaction. Dr. McBride acknowledged that currently, a major factor of research is clinical need and funding, instead of the professional interest of the researcher, a predominant factor several generations ago.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003ELeadership in diabetes education involves seeking the input of a variety of different experts in a way that promotes collaborative efforts, rather than the traditional command-and-control administrative approach, with mentoring finished by the time academic tenure is achieved. The present realities of health care in general and diabetes care in particular call for a new breed of leader, who defines clear, accountable responsibilities for each team member and integrates reliable systems-based work flows into routine care provision.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EA leader\u0027s role in diabetes care consists of helping put digital tools that assist in decision making into practice, track adherence to therapy, and provide real-time updating of patient records. On the human side, a leader fosters an environment in which HCPs are committed to improving health care, even with the reality of financial restrictions. In Dr. McBride\u0027s view, CDEs have already embraced this new reality, which positions them at the center of health care as envisioned by the Institute of Medicine (IOM) [IOM. \u003Cem\u003EBest Care at Lower Cost: The Path to Continuously Learning Health Care in America.\u003C\/em\u003E Washington, DC: The National Academies Press, 2013]. She highlighted the quality reports issued by the IOM which discuss the importance of teaching lessons crucial to health care delivery that are efficient, effective, and continuously improving.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EAccording to Dr. McBride, leadership is not about a person\u0027s day-to-day activities, and it differs from administration. Instead, an effective leader harnesses a team aiming to spur transformational change. Modern leadership involves stages of responsibility and focus, which can all be aided by mentoring (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E).\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/14970\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/14970\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/14970\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-10\u0022 class=\u0022first-child\u0022\u003EStages and Needed Mentoring in a Leadership Career\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-12\u0022\u003EThe so-called gadfly stage is particularly important in inciting change. Freed of the restrictions of past academic and board positions, a leader can speak more forcefully about issues (eg, diabetes awareness and policy) than might have been possible in prior decades. And even in the twilight stage of a career, mentoring can be valuable, with the mentor helping the leader participate in national-level discussions, in which their views can help enact policy changes that can benefit many people.\u003C\/p\u003E\u003Cp id=\u0022p-13\u0022\u003EAlthough the changing landscape of leadership is causing concern in other disciplines, the future of CDEs is bright, according to Dr. McBride. This positions CDEs to take advantage of opportunities that lie ahead, such as orchestrating system-level change and participating, building, and leading the study of 21st-century teams (\u003Ca id=\u0022xref-table-wrap-2-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T2\u0022\u003ETable 2\u003C\/a\u003E).\u003C\/p\u003E\u003Cdiv id=\u0022T2\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/15037\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/15037\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/15037\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 2.\u003C\/span\u003E \n            \u003Cp id=\u0022p-14\u0022 class=\u0022first-child\u0022\u003ETop 10 Future Leadership Opportunities for CDEs\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-16\u0022\u003EOf the 20 TEDMED Great Challenges (\u003Ca href=\u0022http:\/\/www.tedmed.com\/greatchallenges\u0022\u003Ehttp:\/\/www.tedmed.com\/greatchallenges\u003C\/a\u003E), CDEs have the skills and direct involvement in 13: the role of patients, managing chronic illness, obesity, whole-patient care, making prevention popular, medical communication, fostering the adoption of best practices, addressing health care costs, the impact of poverty on health, wellness, sleep deprivation, promoting active lifestyles, and the impact of stress.\u003C\/p\u003E\u003Cp id=\u0022p-17\u0022\u003EDr. McBride concluded that HCPs\u0027 knowledge \u201cabout the diabetes continuum\u201d will assist in leadership in terms of the medical transitions that are coming with the era of accountable care organizations.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/26\/6.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzoutp\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzoutp\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}