Diabetes educator role boundaries in Australia: a documentary analysis

Area of Science:

• Health Workforce Studies
• Interprofessional Healthcare
• Diabetes Management

Background:

• The Australian Diabetes Educators Association (ADEA) was established in 1981 to support diabetes self-management education.
• The diabetes educator workforce in Australia is interdisciplinary, including nurses, podiatrists, and dietitians.
• Historically, nurses dominated the diabetes educator role, with perceived broader scopes of practice than other professions.

Purpose of the Study:

• To explore the interprofessional evolution of the Australian diabetes educator workforce from 1981 to 2017.
• To identify major drivers shaping the role boundaries of diabetes educators.
• To understand the nature of interprofessional role boundaries and differing scopes of practice.

Main Methods:

• A documentary analysis was conducted as a literature review.
• The STARLITE framework guided searches for relevant grey and peer-reviewed literature.
• A timeline of key events was developed and analyzed for emerging themes.

Main Results:

• Macro-level drivers significantly influenced the interprofessional evolution of the diabetes educator workforce.
• Key macro-level influences included non-medical prescribing, expanded Medicare Benefits Schedule rebates for allied health, and the competency movement.
• These drivers reflect and shape interprofessional role boundaries within the workforce.

Conclusions:

• The diabetes educator workforce has shifted from a nursing-dominant group with defined role boundaries to a more interdisciplinary body encouraging role flexibility.
• Recent evidence suggests a trend towards role boundary delineation at meso and micro levels.
• Understanding these evolving role boundaries is crucial for effective diabetes education delivery.