Effect of An Educational Inpatient Diabetes Management Program on Medical Resident Knowledge and Measures of Glycemic Control: A Randomized Controlled Trial |
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| Institution: | 1. Division of Endocrinology and Metabolism, University of Pittsburgh School of Medicine;2. Department of Pathology, University of Pittsburgh Medical Center;3. Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy;4. Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.;1. From the Division of Pediatric Endocrinology, Department of Pediatrics, University of Alabama School of Medicine, Birmingham, Alabama;2. Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama;3. Division of Pediatric Surgery, Department of Surgery, University of Alabama School of Medicine, Birmingham, Alabama;4. University of Alabama School of Medicine, Birmingham, Alabama;5. Ross University School of Medicine, Dominica, West Indies.;1. From the Department of Medicine, Division of Endocrinology, Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, Pennsylvania;2. Departments of Medicine, Humanities, and Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania;3. Grady Hospital Clinical Research Center, Emory University, Atlanta, Georgia.;1. From the Division of Hospital Medicine, Department of Medicine, University of California, San Diego, San Diego, California.;2. Center for Innovation and Improvement Science, University of California, San Diego, San Diego, California.;3. Division of Endocrinology, Department of Medicine, University of California, San Diego, San Diego, California.;4. Department of Nursing Education, Development & Research, University of California, San Diego, San Diego, California. |
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| Abstract: | ObjectiveTo investigate the effectiveness of an Inpatient Diabetes Management Program (IDMP) on physician knowledge and inpatient glycemic control.MethodsResidents assigned to General Internal Medicine inpatient services were randomized to receive the IDMP (IDMP group) or usual education only (nonIDMP group). Both groups received an overview of inpatient diabetes management in conjunction with reminders of existing order sets on the hospital Web site. The IDMP group received print copies of the program and access to an electronic version for a personal digital assistant (PDA). A Diabetes Knowledge Test (DKT) was administered at baseline and at the end of the 1-month rotation. The frequency of hyperglycemia among patients under surveillance by each group was compared by using capillary blood glucose values and a dispersion index of glycemic variability. IDMP users completed a questionnaire related to the program.ResultsTwenty-two residents participated (11 in the IDMP group and 11 in the non-IDMP group). Overall Diabetes Knowledge Test scores improved in both groups (IDMP: 69% ± 1.7% versus 83% ± 2.1%, P = .003; nonIDMP: 76% ± 1.2% versus 84% ± 1.4%, P = .02). The percentage of correct responses for management of corticosteroid-associated hyperglycemia (P = .004) and preoperative glycemic management (P = .006) improved in only the IDMP group. The frequency of hyperglycemia (blood glucose level > 180 mg/dL) and the dispersion index (5.3 ± 7.6 versus 3.7 ± 5.6; P = .2) were similar between the 2 groups.ConclusionAn IDMP was effective at improving physician knowledge for managing hyperglycemia in hospitalized patients treated with corticosteroids or in preparation for surgical procedures. Educational programs directed at improving overall health care provider knowledge for inpatient glycemic management may be beneficial; however, improvements in knowledge do not necessarily result in improved glycemic outcomes. (Endocr Pract. 2012;18:238-249) |
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