Sneak Peek from Academic Medicine: Educating Resident Physicians Using Virtual Case-Based Simulation Improves Diabetes Management

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In two weeks, Academic Medicine will post new published ahead-of-print articles. Until then, here’s a preview of a research report by JoAnn Sperl-Hillen and her colleagues.

Educating Resident Physicians Using Virtual Case-Based Simulation Improves Diabetes Management: A Randomized Controlled Trial

JoAnn Sperl-Hillen, MD, Patrick J. O’Connor, MD, MA, MPH, Heidi L. Ekstrom, MA, William A. Rush, PhD, Stephen E. Asche, MA, Omar D. Fernandes, MPH, Deepika Apana, Gerald H. Amundson, Paul E. Johnson, PhD, and Debra M. Curran, MA, RN


To test a virtual case-based Simulated Diabetes Education (SimDE) intervention developed to teach primary care residents how to manage diabetes.

Nineteen primary care residency programs, with 341 volunteer residents in all post-graduate years (PGY), were randomly assigned to a SimDE intervention group or control group (CG). The web-based interactive educational intervention used computerized virtual patients who responded to provider actions through programmed simulation models. Eighteen distinct learning cases (L-cases) were assigned to SimDE residents over 6 months from 2010–2011. Impact was assessed using performance on 4 virtual assessment cases (A-cases), an objective knowledge test, and pre-post changes in self-assessed diabetes knowledge and confidence. Group comparisons were analyzed using generalized linear mixed models, controlling for clustering of residents within residency programs and differences in baseline knowledge.

The percentage of residents appropriately achieving A-case composite clinical goals for glucose, blood pressure, and lipids was: A-Case 1, SimDE = 21.2%, CG = 1.8%, P = .002; A-Case 2, SimDE = 15.7%, CG  =  4.7%, P = .02; A-Case 3, SimDE = 48.0%, CG = 10.4%, P < .001; A-Case 4, SimDE = 42.1%, CG = 18.7%, P = .004. The mean knowledge score and pre-post changes in self-assessed knowledge and confidence were significantly better for SimDE group than CG participants.

A virtual case-based simulated diabetes education intervention improved diabetes management skills, knowledge, and confidence for primary care residents.

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