Are residents receiving the training needed within their residency programs to optimally manage patients with diabetes?

Morales, Javier; Kuritzky, Louis; Lavernia, Frank; Santiago, M. C.

doi:10.1080/00325481.2020.1857603

Cited by 6 publications

(4 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As CGM prescribing extends beyond diabetes specialists and into primary care settings, standardized training on CGM interpretation may support primary care providers for whom CGM-related education has been limited. 41 Existing education on standardized CGM data interpretation developed by national organizations including the American Diabetes Association and the American Association of Clinical Endocrinology could be leveraged. CGM data interpretation is time-intensive, and the majority of respondents reported inadequate time for data review, which is likely to be another barrier to widespread prescribing by primary care providers.…”

Section: Discussionmentioning

confidence: 99%

Diabetes Specialists Value Continuous Glucose Monitoring Despite Challenges in Prescribing and Data Review Process

Kompala

Wong

Neinstein

2022

J Diabetes Sci Technol

View full text Add to dashboard Cite

Background: Diabetes clinicians are key facilitators of continuous glucose monitoring (CGM) provision, but data on provider behavior related to CGM use and CGM generated data are limited. Methods: We conducted a national survey of providers caring for people with diabetes on CGM-related opinions, facilitators and barriers to prescription, and data review practices. Results: Of 182 survey respondents, 73.2% worked at academic centers, 70.6% were endocrinologists, and 70.7% practiced in urban settings. Nearly 70% of providers reported CGM use in the majority of their patients with type 1 diabetes. Half of the providers reported CGM use in 10% to 50% of their patients with type 2 diabetes. All respondents believed CGM improved quality of life and could optimize diabetes control. We found no differences in reported rates of CGM use based on providers’ years of experience, patient volume, practice setting, or clinic type. Most providers reviewed CGM data each visit (97.7%) and actively involved patients in the data interpretation (98.8%). Only 14.1% of clinicians reported reviewing CGM data without any prompting from patients or their family members outside of visits. Most providers (80.7%) reported their CGM data review was valued by patients although only half reported having adequate time (45.1%) or an efficient process (56.1%) to do so. Conclusions: Despite uniform support for CGM by providers, ongoing challenges related to cost, insurance coverage, and difficulties with prescription were major barriers to CGM use. Increased use of CGM in appropriate populations will necessitate improvements in data access and integration, clearly defined workflows, and decreased administrative burden to obtain CGM.

show abstract

Section: Discussionmentioning

confidence: 99%

Diabetes Specialists Value Continuous Glucose Monitoring Despite Challenges in Prescribing and Data Review Process

Kompala

Wong

Neinstein

2022

J Diabetes Sci Technol

View full text Add to dashboard Cite

show abstract

“…Prior studies investigating graduate and post-graduate medical education revealed that a minority of residents and physicians felt prepared to use CGMs or CGM data in clinical decision making. 22,23 There is a need for medical education initiatives throughout all training levels focused on health technologies for diabetes care. Our findings provide preliminary evidence that the program addresses these basic training needs while preparing volunteers to bring new technology to the care of underserved populations.…”

Section: Discussionmentioning

confidence: 99%

Experiential Learning With Continuous Glucose Monitors: A Novel Curriculum for Volunteers in a Student-Run Free Clinic

Altman-Merino,

Krishnapura,

Aggarwal

et al. 2024

J Stud Run Clin

View full text Add to dashboard Cite

Background: Growing evidence suggests that medical students and faculty preceptors have limited familiarity with continuous glucose monitors (CGMs), which may negatively affect how care teams counsel patients and monitor the use of CGMs. Although studies have shown that structured training for care teams may improve knowledge and comfort with various healthcare tools, to our knowledge, no study has attempted to do so for CGMs. Methods: We designed a user experience course for medical students and faculty mentors to address this gap at a student-run free clinic. This course allowed twenty participants to wear a CGM for two weeks and participate in three interactive didactic sessions and group reflections. We evaluated how knowledge and comfort with CGMs among participants changed after the course with a survey and focus group. Results: The cohort showed improvement in self-reported confidence in using the device, teaching patients how to use the device, and interpreting data (p<0.001). The majority of participants demonstrated improvement across all survey domains with higher post-intervention scores than pre-intervention scores. Qualitative analysis of group reflections elucidated three primary themes across participant experiences: the emotional impact of wearing the device, attitude changes with prolonged use, and behavior modification in response to glucose data. Conclusion: This novel educational initiative may improve knowledge about CGMs, ability to counsel patients to use the device, and understanding patients' experiences among medical students and faculty mentors. We plan to expand this educational opportunity to additional clinic volunteers, include patient perspectives, and share the curriculum with other student-run clinics.

show abstract

“…Diets should be rich in fruits and vegetables and low in saturated fat, red meats, and sodium. Patients should engage in 150 min or more of moderate exercise weekly 17,18 . Patients should be encouraged to refrain from smoking.…”

Section: Diet Exercise and Smokingmentioning

confidence: 99%

“…Two key overarching explanations for the outcomes of this paper include lack of resident education on ADA guidelines and time constraints within the outpatient clinic environment, both of which prevent accurate information conveyance to patients. Numerous studies have already elucidated the benefits on patient outcomes when clinicians are provided with intensive diabetes educational training 17,18 . One future direction therefore is to attempt to minimize time constraints and provide quick reminders of the preventative services.…”

Section: Future Directionsmentioning

confidence: 99%

Internal Medicine Resident Adherence to Evidence-Based Practices in Management of Diabetes Mellitus

Mehta

Cohen

Jaisinghani

et al. 2022

Journal of Medical Education and Curricular Development

View full text Add to dashboard Cite

Objective Diabetic preventative health maintenance involves (1) adherence to guidelines and (2) appropriate documentation. This study evaluates the frequency with which internal medicine (IM) residents met these two outcomes. We also evaluated if there were differences in outcomes between resident classes. Methods In this retrospective analysis, 234 diabetic outpatient visits were analyzed. Guidelines were derived from the American Diabetes Association (ADA). The outcomes for each guideline were averaged and stratified by resident class. Averages within and between classes were compared using the student's paired t-test and one-way ANOVA respectively. Results Classes were most adherent to A1c testing guidelines (PGY-1 96.1%, PGY-2 97.6%, and PGY-3 95.9%). PGY-1 and PGY-2 classes were least adherent to podiatry (27.5% and 17.6% respectively), whereas PGY-3 had equal least adherence rates to podiatry and lifestyle modification guidelines (36.7%). All classes had highest rates in documenting A1c findings (PGY-1 92.2%, PGY-2 97.6%, and PGY-3 85.7%) and lowest rates in documenting relevant podiatry information (PGY-1 5.9%, PGY-2 5.9%, and PGY-3 11.2%). Comparing sequential resident classes, there was a decline in lifestyle counselling and documentation from PGY-1 to PGY-2. From PGY-2 to PGY-3, there was improvement in adherence to statin, podiatry, microalbuminuria, and monofilament guidelines. There was also improvement in documenting statin and monofilament usage, however, A1c reporting declined. Conclusion The findings of the study suggest disproportionate levels of care in diabetes preventative management. Additionally, program directors should take caution in assuming linear improvement with sequential resident classes.

show abstract

Are residents receiving the training needed within their residency programs to optimally manage patients with diabetes?

Cited by 6 publications

References 29 publications

Diabetes Specialists Value Continuous Glucose Monitoring Despite Challenges in Prescribing and Data Review Process

Diabetes Specialists Value Continuous Glucose Monitoring Despite Challenges in Prescribing and Data Review Process

Experiential Learning With Continuous Glucose Monitors: A Novel Curriculum for Volunteers in a Student-Run Free Clinic

Internal Medicine Resident Adherence to Evidence-Based Practices in Management of Diabetes Mellitus

Contact Info

Product

Resources

About