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Academic Medicine:
doi: 10.1097/ACM.0000000000000406
Research Reports

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

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

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Abstract

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

Method: Nineteen primary care residency programs, with 341 volunteer residents in all postgraduate 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 six months from 2010 to 2011. Impact was assessed using performance on four 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.

Results: The percentages of residents appropriately achieving A-case composite clinical goals for glucose, blood pressure, and lipids were as follows: 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; and 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.

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

© 2014 by the Association of American Medical Colleges

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