title: Educating resident physicians using virtual case-based simulation improves diabetes management: a randomized controlled trial.
abstract: OBJECTIVE
  To test a virtual case-based Simulated Diabetes Education intervention (SimDE) developed to teach primary care residents how to manage diabetes.
  
  
  METHODS
  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.
authors.affiliation: 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.
authors.forename: JoAnn
authors.initials: J
authors.lastname: Sperl-Hillen
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: O'Connor
authors.forename: Heidi L
authors.initials: HL
authors.lastname: Ekstrom
authors.forename: William A
authors.initials: WA
authors.lastname: Rush
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Asche
authors.forename: Omar D
authors.initials: OD
authors.lastname: Fernandes
authors.forename: Deepika
authors.initials: D
authors.lastname: Appana
authors.forename: Gerald H
authors.initials: GH
authors.lastname: Amundson
authors.forename: Paul E
authors.initials: PE
authors.lastname: Johnson
authors.forename: Debra M
authors.initials: DM
authors.lastname: Curran
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation; D003194:Computer-Assisted Instruction / Q000379:methods*; D003479:Curriculum; D003920:Diabetes Mellitus / Q000628:therapy*; D005194:Family Practice / Q000193:education*; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D016544:Patient Simulation; D014584:User-Computer Interface