The nurse is teaching a male adolescent recently diagnosed with type 1 diabetes mellitus (DM) about self-injecting insulin. Which approach is best for the nurse to use to evaluate the effectiveness of the teaching?

Choice A reason: Listing the procedural steps is helpful but does not demonstrate practical competence. Choice B reason: Reviewing glycosylated hemoglobin levels provides information about long-term glucose control but does not directly assess the technique. Choice C reason: Adolescents (ages 12–18) are in a developmental stage where peer validation is a powerful motivator. By demonstrating to a peer, the adolescent is forced to internalize the steps well enough to explain them. This confirms a higher level of mastery than simply repeating steps back to a dynamic authority figure like a nurse. In a testing environment, "demonstrating the technique" to a peer does not mean the nurse allows the adolescent to actually stick a needle into another person. It means the adolescent acts out the procedure (perhaps using a practice pad, an orange, or a needleless syringe) while explaining the steps to the peer. The nurse is the observer in this scenario. The adolescent is the "teacher," and the peer is the "audience." Choice D reason: Describing the level of comfort provides insight into his confidence but not necessarily his technical competence.