| Because of the complexity and individuality of people, the nature of knowing and teaching in patient education cannot be reduced to “the kinds of recipes as used in the physical sciences” (William, 2002, p. 54). Neither can we assume that the recipe we are using is working for all, or even, at all. As health care educators, we need to be open to explore and to meet the needs of the patient learners. This is not going to happen in one way, or a “right” way. Alternative (creative) ways of knowing lead to other, multi-dimensional methods of inquiry to understand the teaching and learning process in patient education.;The qualitative model which informed this study was an action research design, held with a group of seven women (eight, including myself), who had insulin-dependent diabetes for ten years or more. In addition to an initial planning stage using one-on-one interviews, the action research included three group intervention and reflection meetings, and one final reflection session as a conclusion (five meetings total). During the initial planning phase, participants discussed two primary questions in a narrative style of interviewing: (a) Tell me about your diagnosis, and (b) What types of activities do you enjoy outside of work? Based upon the results of these questions, the intervention (the action or implementation of the plan) included the body as a way of knowing through the use of meditation and understanding how one felt about having diabetes, forming those feelings into a simple image, and using that image to create metaphor and words to describe the experience of diabetes. Transforming those metaphors and images into photographs, participants expressed what they “knew” about diabetes on multiple levels.;Although participants initially could not express what having diabetes was like during the initial interviewing process and planning stage, after going through the action research process, participants could clearly communicate the experience of diabetes using the metaphor they created during the sessions. Paying attention to all aspects of knowing within the mind-body-spirit is important not only to those with diabetes, but the field of adult education as a whole. Following the work of many who write in adult education about the multiple ways adults construct knowledge, this research expands the understanding of how adults with diabetes come to learn, feel and know about their experience, and for others to learn how to use multiple modalities in teaching and learning. By using the body to process knowledge, and imagery as its product, we can help students understand more about themselves (and ourselves) than using a rational, linear approach alone.;The primary purpose of this action research study was to understand how adults make meaning of and experience diabetes, and to use multiple ways of knowing in the integration of diabetes care. The two research questions which formed the basis of this study were: “How do adults make meaning of their Type 1 diabetes?” and “What are the ways in which adults with diabetes could engage in creative expression to find greater meaning?” The action research was informed by a constructive postmodern and feminist poststructural perspective, where there is not one overriding, great Truth, but many truths as defined and experienced by the learners themselves (Foucault, 1980; St. Pierre, 2000; Tisdell, 1998). As they incorporate creative ways of knowing into their understanding of “their shifting selves,” learners experience opportunities for growth and development of their own identity and meaning. |
