A student-implemented elective to improve medical student confidence in providing diabetes self-management support

Assessing student pharmacists' confidence and knowledge of basic diabetes self-management skills

INTRODUCTION

The significance of diabetes self-management and recent advances in diabetes medications call for healthcare professionals' preparedness in educating patients. This study assessed correlations between student pharmacists' confidence and knowledge of diabetes self-management skills.

METHODS

An online questionnaire was administered to third-year student pharmacists at one United States college of pharmacy. Students indicated their level of agreement (strongly disagree, disagree, agree, strongly agree) with nine confidence items and identified the correct multiple-choice response for nine knowledge items. Correlations between confidence and knowledge scores were assessed using simple linear regression, logistic regression, and Spearman rank (Rho) test.

RESULTS

Forty-five students completed the questionnaire. The majority agreed/strongly agreed that they were confident in their knowledge for eight of the nine confidence items. The majority correctly answered six of the nine knowledge items. No associations were identified between confidence and knowledge scores in the linear regression (beta scaled = 0.25) or Spearman's correlation test (r = 0.294). In the logistic regression model, confidence and knowledge scores were associated positively for three domains: glucose meter use (odds ratio [OR] = 4.88), glucagon-like peptide-1 receptor agonist use (OR = 4.23) and hyperglycemia treatment (OR = 3.33); confidence and knowledge scores were associated negatively with one domain: insulin syringe administration (OR = 0.41).

CONCLUSIONS

This study found no overall association between confidence and knowledge scores in third-year student pharmacists' basic diabetes self-management skills, although there were significant associations with four specific domains. Student pharmacists may require additional training to improve their diabetes self-management skills.

The Current Status of Preclinical Endocrine Education in U.S. Medical Schools

OBJECTIVE

To characterize the current landscape of pre-clinical medical endocrine education in United States (U.S.) allopathic medical schools.

METHODS

U.S. endocrine curriculum directors were asked to voluntarily complete a 16-question emailed survey surveying the status of endocrine pre-clinical education at their medical school.

RESULTS

There were 69 of 155 (45%) endocrine block director respondents who completed the online survey between July to Sept 2021. A larger incoming class, a longer duration of an endocrine curriculum, and the offering of a separate endocrine curriculum (i.e. apart from the teaching of other organ systems) were each independently associated with an increased number of faculty teaching the course. Schools that used a gland/organ-based curriculum only and those that used a combination of gland/organ with topic based were differed significantly in their use of large lectures, small groups, and several curriculum components including point of care glucose testing, continuous glucose monitoring, and insulin pumps.

CONCLUSION

This survey study reports the current landscape of preclinical endocrine education in the U.S. and describes opportunities to improve interest in pursuing endocrinology as a career.

Diabetes SPECIAL (Students Providing Education on Chronic Illness and Lifestyle): a novel preclinical medical student elective

BACKGROUND

Traditional medical student curricula limit substantial clinical experiences until the third and fourth years of medical school. This delay in valuable experiences hinders the ability of some medical students to choose a specialty to pursue, delays the formation of meaningful longitudinal mentorship relationships, and limits the development of important clinical acumen. Furthermore, the use of medical students in preclinical years may help to improve patient care and outcomes.

APPROACH

The novel preclinical Diabetes SPECIAL (Students Providing Education on Chronic Illness and Lifestyle) elective was designed to introduce first year medical students to the field of endocrinology, promote the development of a professional identity, improve medical student communication skills, and raise awareness of the complexities of managing patients living with diabetes mellitus. Furthermore, and novel to this experience, was to measure the impact of this elective on patient outcomes.

EVALUATION

Students attended patient appointments, communicated with their assigned patients regularly, relayed important health information to the attending endocrinologist, and attended monthly didactic sessions. The elective outcomes were evaluated via completed surveys by patients, students, and attending physicians as well as medical record review for pre- and post-elective hemoglobin A1C levels.

REFLECTION

Students, faculty, and patients who participated in this elective generally reported having a positive experience. Seven out of 10 patients had a reduction in their hemoglobin A1C levels. The outcomes from the pilot of this novel preclinical elective support the importance of early clinical exposure in medical student training and highlight potential positive impacts on both medical student education and patient outcomes.

A co-curricular diabetes-specific elective with interprofessional students and faculty

BACKGROUND AND PURPOSE

Develop and assess the effectiveness of an interprofessional co-curricular elective in improving pharmacy students' confidence in providing diabetes self-management education and support (DSMES) to patients.

EDUCATIONAL ACTIVITY AND SETTING

As part of an interprofessional collaboration, a student organized diabetes-specific enrichment elective, was offered originally to medical students and then extended to include pharmacy students. The interprofessional elective included an overview of diabetes and its prevention, medications, insulin therapy/administration, blood glucose monitoring, insulin pumps, nutrition and fitness. This elective served as a co-curricular activity, in that it was not offered for course credits, rather provided an opportunity to learn in an interprofessional environment with small group, unstructured interactions. The impact of the elective on pharmacy student confidence was evaluated using a retrospective pre-post survey.

FINDINGS

A total of 16 pharmacy students participated (response rate of 63%). A Wilcoxon signed-rank test revealed an increase in students' confidence in most of the areas assessed. Eighty percent of respondents found the elective valuable.

SUMMARY

An interprofessional co-curricular diabetes-specific elective significantly improved pharmacy students' confidence in providing DMSES to patients in the majority of assessed areas. Pharmacy and medical students were given the opportunity to learn alongside one another and learn from an interprofessional team of instructors in a setting that modeled such communication and collaboration. Developing such enrichment electives may be beneficial to equip students with the skills needed to provide education/support to patients with chronic diseases and interact with other health professionals effectively.

Impact of supplemental training programs on improving medical students' confidence in providing diabetes self-management education and support

BACKGROUND/PURPOSE

The purpose of this study was to evaluate the effectiveness of supplemental diabetes-related training modalities and volunteer activities in increasing first-year medical students' knowledge/comfort in providing diabetes self-management education and support (DSMES) to patients.

METHODS

A group of medical students developed supplemental diabetes-related training/volunteer programs. The training modalities included an optional 7-session interprofessionally taught Diabetes Enrichment Elective and a 3-hour endocrinologist-led training session intended to prepare students for involvement in an inpatient DSMES volunteer program. The volunteer program provided the students with the opportunity to provide DSMES to patients with diabetes admitted to an academic medical center. Those participating in any of the stated programs were compared to those with no such training regarding confidence in providing DSMES using an optional online survey. The results were analyzed by using Mann-Whitney U test and descriptive analyses.

RESULTS

A total of 18 first-year medical students responded to the optional survey with a response rate of ~30% (10 of 33) among participants in any training/volunteer program. First-year medical students who attended any of the offered optional programs had statistically significant higher comfort level in 4 of the 6 areas assessed regarding providing DSMES compared with those with no such training (p<0.05), with medium to large effect size (r=0.48-0.59).

CONCLUSION

This study suggests that the supplemental preclerkship diabetes-specific training modalities/volunteer programs can provide benefit in providing medical students with practical knowledge while improving their confidence in providing DSMES to patients with diabetes.