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Development, Implementation, and Evaluation of a Physician-Targeted Inpatient Glycemic Management Curriculum
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| Zeitschriftentitel: | Journal of Medical Education and Curricular Development |
|---|---|
| Personen und Körperschaften: | , , , , , , , |
| In: | Journal of Medical Education and Curricular Development, 6, 2019, S. 238212051986134 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
SAGE Publications
|
| Schlagwörter: |
| author_facet |
Mathioudakis, Nestoras Bashura, Holly Boyér, LaPricia Langan, Susan Padmanaban, Bama S Fayzullin, Shamil Sokolinsky, Sam Hill Golden, Sherita Mathioudakis, Nestoras Bashura, Holly Boyér, LaPricia Langan, Susan Padmanaban, Bama S Fayzullin, Shamil Sokolinsky, Sam Hill Golden, Sherita |
|---|---|
| author |
Mathioudakis, Nestoras Bashura, Holly Boyér, LaPricia Langan, Susan Padmanaban, Bama S Fayzullin, Shamil Sokolinsky, Sam Hill Golden, Sherita |
| spellingShingle |
Mathioudakis, Nestoras Bashura, Holly Boyér, LaPricia Langan, Susan Padmanaban, Bama S Fayzullin, Shamil Sokolinsky, Sam Hill Golden, Sherita Journal of Medical Education and Curricular Development Development, Implementation, and Evaluation of a Physician-Targeted Inpatient Glycemic Management Curriculum General Medicine |
| author_sort |
mathioudakis, nestoras |
| spelling |
Mathioudakis, Nestoras Bashura, Holly Boyér, LaPricia Langan, Susan Padmanaban, Bama S Fayzullin, Shamil Sokolinsky, Sam Hill Golden, Sherita 2382-1205 2382-1205 SAGE Publications General Medicine http://dx.doi.org/10.1177/2382120519861342 <jats:sec><jats:title>Objective:</jats:title><jats:p>Diabetes is prevalent among hospitalized patients and there are multiple challenges to attaining glycemic control in the hospital setting. We sought to develop an inpatient glycemic management curriculum with stakeholder input and to evaluate the effectiveness of this educational program on glycemic control in hospitalized patients.</jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p>Using the Six-Step Approach of Kern to Curriculum Development for Medical Education, we developed and implemented an educational curriculum for inpatient glycemic management targeted to internal medicine residents and hospitalists. We surveyed physicians (n = 73) and conducted focus group sessions (n = 18 physicians) to solicit input regarding educational deficits and desired format of the educational intervention. Based on feedback from the surveys and focus groups, we developed educational goals and objectives and a case-based curriculum, which was delivered over a 1-year period via in-person teaching sessions by 2 experienced diabetes physicians at 3 hospitals. Rates of hypoglycemia and hyperglycemia were evaluated among at-risk patient days using an interrupted time-series design.</jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p>We developed a mnemonic-based (SIGNAL) curriculum consisting of 10 modules, which covers key concepts of inpatient glycemic management and provides an approach to daily glycemic management: S = steroids, I = insulin, G = glucose, N = nutritional status, A = added dextrose, and L = labs. Following implementation of the curriculum, there was no difference in the rates of hyperglycemia in insulin-treated patients following the intervention; however, there was an increase in the rates of hypoglycemia defined as blood glucose (BG) ⩽ 70 mg/dL (5.6% vs 3.0%, P < .001) and clinically significant hypoglycemia defined as BG < 54 mg/dL (1.9% vs 0.8%, P = .01). There was poor penetration of the curriculum, with 60%, 20%, and 90% of the learning modules being delivered at the three participating hospitals, respectively.</jats:p></jats:sec><jats:sec><jats:title>Conclusions:</jats:title><jats:p>In this pilot study, a physician-targeted educational curriculum was not associated with improved glycemic control. Adapting the intervention to increase penetration and integrating the curriculum into existing clinical decision support tools may improve the effectiveness of the educational program on glycemic outcomes.</jats:p></jats:sec> Development, Implementation, and Evaluation of a Physician-Targeted Inpatient Glycemic Management Curriculum Journal of Medical Education and Curricular Development |
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Journal of Medical Education and Curricular Development |
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| title |
Development, Implementation, and Evaluation of a Physician-Targeted Inpatient Glycemic Management Curriculum |
| title_unstemmed |
Development, Implementation, and Evaluation of a Physician-Targeted Inpatient Glycemic Management Curriculum |
| title_full |
Development, Implementation, and Evaluation of a Physician-Targeted Inpatient Glycemic Management Curriculum |
| title_fullStr |
Development, Implementation, and Evaluation of a Physician-Targeted Inpatient Glycemic Management Curriculum |
| title_full_unstemmed |
Development, Implementation, and Evaluation of a Physician-Targeted Inpatient Glycemic Management Curriculum |
| title_short |
Development, Implementation, and Evaluation of a Physician-Targeted Inpatient Glycemic Management Curriculum |
| title_sort |
development, implementation, and evaluation of a physician-targeted inpatient glycemic management curriculum |
| topic |
General Medicine |
| url |
http://dx.doi.org/10.1177/2382120519861342 |
| publishDate |
2019 |
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238212051986134 |
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<jats:sec><jats:title>Objective:</jats:title><jats:p>Diabetes is prevalent among hospitalized patients and there are multiple challenges to attaining glycemic control in the hospital setting. We sought to develop an inpatient glycemic management curriculum with stakeholder input and to evaluate the effectiveness of this educational program on glycemic control in hospitalized patients.</jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p>Using the Six-Step Approach of Kern to Curriculum Development for Medical Education, we developed and implemented an educational curriculum for inpatient glycemic management targeted to internal medicine residents and hospitalists. We surveyed physicians (n = 73) and conducted focus group sessions (n = 18 physicians) to solicit input regarding educational deficits and desired format of the educational intervention. Based on feedback from the surveys and focus groups, we developed educational goals and objectives and a case-based curriculum, which was delivered over a 1-year period via in-person teaching sessions by 2 experienced diabetes physicians at 3 hospitals. Rates of hypoglycemia and hyperglycemia were evaluated among at-risk patient days using an interrupted time-series design.</jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p>We developed a mnemonic-based (SIGNAL) curriculum consisting of 10 modules, which covers key concepts of inpatient glycemic management and provides an approach to daily glycemic management: S = steroids, I = insulin, G = glucose, N = nutritional status, A = added dextrose, and L = labs. Following implementation of the curriculum, there was no difference in the rates of hyperglycemia in insulin-treated patients following the intervention; however, there was an increase in the rates of hypoglycemia defined as blood glucose (BG) ⩽ 70 mg/dL (5.6% vs 3.0%, P < .001) and clinically significant hypoglycemia defined as BG < 54 mg/dL (1.9% vs 0.8%, P = .01). There was poor penetration of the curriculum, with 60%, 20%, and 90% of the learning modules being delivered at the three participating hospitals, respectively.</jats:p></jats:sec><jats:sec><jats:title>Conclusions:</jats:title><jats:p>In this pilot study, a physician-targeted educational curriculum was not associated with improved glycemic control. Adapting the intervention to increase penetration and integrating the curriculum into existing clinical decision support tools may improve the effectiveness of the educational program on glycemic outcomes.</jats:p></jats:sec> |
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| author | Mathioudakis, Nestoras, Bashura, Holly, Boyér, LaPricia, Langan, Susan, Padmanaban, Bama S, Fayzullin, Shamil, Sokolinsky, Sam, Hill Golden, Sherita |
| author_facet | Mathioudakis, Nestoras, Bashura, Holly, Boyér, LaPricia, Langan, Susan, Padmanaban, Bama S, Fayzullin, Shamil, Sokolinsky, Sam, Hill Golden, Sherita, Mathioudakis, Nestoras, Bashura, Holly, Boyér, LaPricia, Langan, Susan, Padmanaban, Bama S, Fayzullin, Shamil, Sokolinsky, Sam, Hill Golden, Sherita |
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| description | <jats:sec><jats:title>Objective:</jats:title><jats:p>Diabetes is prevalent among hospitalized patients and there are multiple challenges to attaining glycemic control in the hospital setting. We sought to develop an inpatient glycemic management curriculum with stakeholder input and to evaluate the effectiveness of this educational program on glycemic control in hospitalized patients.</jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p>Using the Six-Step Approach of Kern to Curriculum Development for Medical Education, we developed and implemented an educational curriculum for inpatient glycemic management targeted to internal medicine residents and hospitalists. We surveyed physicians (n = 73) and conducted focus group sessions (n = 18 physicians) to solicit input regarding educational deficits and desired format of the educational intervention. Based on feedback from the surveys and focus groups, we developed educational goals and objectives and a case-based curriculum, which was delivered over a 1-year period via in-person teaching sessions by 2 experienced diabetes physicians at 3 hospitals. Rates of hypoglycemia and hyperglycemia were evaluated among at-risk patient days using an interrupted time-series design.</jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p>We developed a mnemonic-based (SIGNAL) curriculum consisting of 10 modules, which covers key concepts of inpatient glycemic management and provides an approach to daily glycemic management: S = steroids, I = insulin, G = glucose, N = nutritional status, A = added dextrose, and L = labs. Following implementation of the curriculum, there was no difference in the rates of hyperglycemia in insulin-treated patients following the intervention; however, there was an increase in the rates of hypoglycemia defined as blood glucose (BG) ⩽ 70 mg/dL (5.6% vs 3.0%, P < .001) and clinically significant hypoglycemia defined as BG < 54 mg/dL (1.9% vs 0.8%, P = .01). There was poor penetration of the curriculum, with 60%, 20%, and 90% of the learning modules being delivered at the three participating hospitals, respectively.</jats:p></jats:sec><jats:sec><jats:title>Conclusions:</jats:title><jats:p>In this pilot study, a physician-targeted educational curriculum was not associated with improved glycemic control. Adapting the intervention to increase penetration and integrating the curriculum into existing clinical decision support tools may improve the effectiveness of the educational program on glycemic outcomes.</jats:p></jats:sec> |
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| imprint | SAGE Publications, 2019 |
| imprint_str_mv | SAGE Publications, 2019 |
| institution | DE-105, DE-14, DE-Ch1, DE-L229, DE-D275, DE-Bn3, DE-Brt1, DE-Zwi2, DE-D161, DE-Gla1, DE-Zi4, DE-15, DE-Rs1, DE-Pl11 |
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| spelling | Mathioudakis, Nestoras Bashura, Holly Boyér, LaPricia Langan, Susan Padmanaban, Bama S Fayzullin, Shamil Sokolinsky, Sam Hill Golden, Sherita 2382-1205 2382-1205 SAGE Publications General Medicine http://dx.doi.org/10.1177/2382120519861342 <jats:sec><jats:title>Objective:</jats:title><jats:p>Diabetes is prevalent among hospitalized patients and there are multiple challenges to attaining glycemic control in the hospital setting. We sought to develop an inpatient glycemic management curriculum with stakeholder input and to evaluate the effectiveness of this educational program on glycemic control in hospitalized patients.</jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p>Using the Six-Step Approach of Kern to Curriculum Development for Medical Education, we developed and implemented an educational curriculum for inpatient glycemic management targeted to internal medicine residents and hospitalists. We surveyed physicians (n = 73) and conducted focus group sessions (n = 18 physicians) to solicit input regarding educational deficits and desired format of the educational intervention. Based on feedback from the surveys and focus groups, we developed educational goals and objectives and a case-based curriculum, which was delivered over a 1-year period via in-person teaching sessions by 2 experienced diabetes physicians at 3 hospitals. Rates of hypoglycemia and hyperglycemia were evaluated among at-risk patient days using an interrupted time-series design.</jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p>We developed a mnemonic-based (SIGNAL) curriculum consisting of 10 modules, which covers key concepts of inpatient glycemic management and provides an approach to daily glycemic management: S = steroids, I = insulin, G = glucose, N = nutritional status, A = added dextrose, and L = labs. Following implementation of the curriculum, there was no difference in the rates of hyperglycemia in insulin-treated patients following the intervention; however, there was an increase in the rates of hypoglycemia defined as blood glucose (BG) ⩽ 70 mg/dL (5.6% vs 3.0%, P < .001) and clinically significant hypoglycemia defined as BG < 54 mg/dL (1.9% vs 0.8%, P = .01). There was poor penetration of the curriculum, with 60%, 20%, and 90% of the learning modules being delivered at the three participating hospitals, respectively.</jats:p></jats:sec><jats:sec><jats:title>Conclusions:</jats:title><jats:p>In this pilot study, a physician-targeted educational curriculum was not associated with improved glycemic control. Adapting the intervention to increase penetration and integrating the curriculum into existing clinical decision support tools may improve the effectiveness of the educational program on glycemic outcomes.</jats:p></jats:sec> Development, Implementation, and Evaluation of a Physician-Targeted Inpatient Glycemic Management Curriculum Journal of Medical Education and Curricular Development |
| spellingShingle | Mathioudakis, Nestoras, Bashura, Holly, Boyér, LaPricia, Langan, Susan, Padmanaban, Bama S, Fayzullin, Shamil, Sokolinsky, Sam, Hill Golden, Sherita, Journal of Medical Education and Curricular Development, Development, Implementation, and Evaluation of a Physician-Targeted Inpatient Glycemic Management Curriculum, General Medicine |
| title | Development, Implementation, and Evaluation of a Physician-Targeted Inpatient Glycemic Management Curriculum |
| title_full | Development, Implementation, and Evaluation of a Physician-Targeted Inpatient Glycemic Management Curriculum |
| title_fullStr | Development, Implementation, and Evaluation of a Physician-Targeted Inpatient Glycemic Management Curriculum |
| title_full_unstemmed | Development, Implementation, and Evaluation of a Physician-Targeted Inpatient Glycemic Management Curriculum |
| title_short | Development, Implementation, and Evaluation of a Physician-Targeted Inpatient Glycemic Management Curriculum |
| title_sort | development, implementation, and evaluation of a physician-targeted inpatient glycemic management curriculum |
| title_unstemmed | Development, Implementation, and Evaluation of a Physician-Targeted Inpatient Glycemic Management Curriculum |
| topic | General Medicine |
| url | http://dx.doi.org/10.1177/2382120519861342 |