Case-based curriculum for pediatric residents in diabetes fundamentals

Authors: AL-GADI, IMAN - Children'S Nutrition Research Center (CNRC); SISLEY, STEPHANIE - Children'S Nutrition Research Center (CNRC)

Submitted to: MedEdPORTAL
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/18/2021
Publication Date: 5/27/2021
Citation: Al-Gadi, I., Sisley, S. 2021. Case-based curriculum for pediatric residents in diabetes fundamentals. MedEdPORTAL. 17:11157. https://doi.org/10.15766/mep_2374-8265.11157.
DOI: https://doi.org/10.15766/mep_2374-8265.11157

Interpretive Summary: Physicians undergoing pediatric residency training traditionally receive education on how to diagnose and treat diabetes through patient-care and lectures. However, lectures are often not engaging and patient-learning opportunities may be different from trainee to trainee given differences in patients. Thus, we created three modules focused on diabetes fundamentals which would be critical for any pediatrician to learn. These modules focused on diabetic ketoacidosis (a severe, life-threatening complication of diabetes), how to treat patients who were just diagnosed with diabetes, and how to recognize and treat complications of diabetes. These modules were delivered separately in short (15-30 minute sessions) using active learning processes. We randomized residents to receive either traditional lectures or lectures plus our diabetes modules. Our study shows that pediatric trainees who received the modules improved more on diabetes knowledge and confidence in performing diabetes care compared to those with the traditional curriculum. Also, learners were extremely satisfied with the curriculum. This work provides new resources to help in the training of pediatricians on diabetes which was shown to be feasible and well-received in a very busy clinical environment.

Technical Abstract: Pediatricians are at the front line to diagnose new-onset diabetes and treat acute diabetes complications in children. Pediatric residents need a strong foundation in recognizing and managing pediatric diabetes, imposing a demand for a structured, comprehensive pediatric-specific diabetes curriculum. This three-module case-based curriculum focused on diabetes fundamentals relevant to pediatricians in the outpatient and inpatient settings. Each module covered an independent topic within pediatric diabetes. Topics included diabetic ketoacidosis, new-onset diabetes management, and acute complications of diabetes. The modules were focused, short, and flexible to accommodate learners' demanding clinical duties and time limitations. We delivered the curriculum to pediatric residents rotating in the inpatient endocrinology department over 3 separate days. Pre- and post-tests assessed learners' knowledge and confidence in diabetes care. We tested the curriculum for 7 months in 10 individual cycles, with 11 learners participating. We noted an increase in learners' scores on diabetes knowledge assessment of 16% (95% CI, 5-28; p = .01) after completing the curriculum. The residents' confidence in performing diabetes clinical care skills also improved, with the majority going from reporting low or neutral confidence before instruction to reporting high confidence after instruction. Learners reported 100% extreme satisfaction with the curriculum. This case-based curriculum exposed residents to pediatric diabetes using authentic, clinically relevant, engaging scenarios. The curriculum enabled learners to actively rationalize their thought process and slow down learning. Short and focused, the curriculum was suitable for mitigating the cognitive load and the time constraints in busy clinical environments.