Sperl-Hillen JoAnn, O'Connor Patrick J, Ekstrom Heidi L, Rush William A, Asche Stephen E, Fernandes Omar D, Appana Deepika, Amundson Gerald H, Johnson Paul E, Curran Debra M
Dr. Sperl-Hillen is senior research investigator, HealthPartners Institute for Education and Research, Minneapolis, Minnesota. Dr. O'Connor is assistant medical director, HealthPartners Institute for Education and Research, Minneapolis, Minnesota. Ms. Ekstrom is senior research project manager, HealthPartners Institute for Education and Research, Minneapolis, Minnesota. Dr. Rush is research investigator, HealthPartners Institute for Education and Research, Minneapolis, Minnesota. Mr. Asche is manager of statistical services, HealthPartners Institute for Education and Research, Minneapolis, Minnesota. Mr. Fernandes is research project manager, HealthPartners Institute for Education and Research, Minneapolis, Minnesota. Ms. Appana is manager of Web development research, HealthPartners Institute for Education and Research, Minneapolis, Minnesota. Mr. Amundson is research info program analyst IV, HealthPartners Institute for Education and Research, Minneapolis, Minnesota. Dr. Johnson is professor, Curtis L. Carlson Chair in Decision Sciences, Carlson School of Management, University of Minnesota, Minneapolis, Minnesota. Ms. Curran is director of educational quality, HealthPartners Institute for Education and Research, Minneapolis, Minnesota.
Acad Med. 2014 Dec;89(12):1664-73. doi: 10.1097/ACM.0000000000000406.
To test a virtual case-based Simulated Diabetes Education intervention (SimDE) developed to teach primary care residents how to manage diabetes.
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.
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.
A virtual case-based simulated diabetes education intervention improved diabetes management skills, knowledge, and confidence for primary care residents.
测试一种基于虚拟病例的模拟糖尿病教育干预措施（SimDE），该措施旨在教授初级保健住院医师如何管理糖尿病。
19个初级保健住院医师培训项目，共有341名来自各个研究生阶段（PGY）的志愿者住院医师，被随机分配到SimDE干预组或对照组（CG）。基于网络的交互式教育干预使用了计算机化的虚拟患者，这些虚拟患者通过编程模拟模型对医疗服务提供者的操作做出反应。从2010年到2011年的六个月时间里，为SimDE组的住院医师分配了18个不同的学习病例（L病例）。通过对四个虚拟评估病例（A病例）的表现、一项客观知识测试以及自我评估的糖尿病知识和信心的前后变化来评估干预效果。使用广义线性混合模型进行组间比较，控制住院医师在住院医师培训项目中的聚集情况以及基线知识的差异。
在血糖、血压和血脂方面，住院医师在A病例中适当达成综合临床目标的百分比分别如下：A病例1：SimDE组 = 21.2%，CG组 = 1.8%，P = 0.002；A病例2：SimDE组 = 15.7%，CG组 = 4.7%，P = 0.02；A病例3：SimDE组 = 48.0%，CG组 = 10.4%，P < 0.001；A病例4：SimDE组 = 42.1%，CG组 = 18.7%，P = 0.004。SimDE组的平均知识得分以及自我评估知识和信心的前后变化显著优于CG组参与者。
基于虚拟病例的模拟糖尿病教育干预提高了初级保健住院医师的糖尿病管理技能、知识和信心。
