Abstract
Purpose Simulation training is prevalent in aviation and engineering industries, but acceptance by medical providers is unknown. Our objective was to design and evaluate resident physician satisfaction with simulated diabetes training.
Methods This web-based learning program integrated these components:
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18 unique diabetes learning cases,
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an interactive care management interface,
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a physiologic model to simulate outcomes of actions across a series of patient encounters, and
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a library of feedback messages to critique and guide provider actions.
A total of 341 consented primary care residents in 19 U.S. residency programs were randomized to receive (n=177) or not receive (n=164) the learning intervention. A satisfaction survey evaluating program features was completed by 94 (53%) of intervention subjects. Responses to open-ended questions about features considered valuable and areas needing improvement were assessed using qualitative methods.
Results Likert-scale responses were favorably higher than neutral for general satisfaction (93%), recommending to colleagues (91%), training adequacy (90%), navigation ease (95%), blood sugar displays (86%), drug info and help links (76%), goal progress graphs (49%), and feedback received (81%). Difficulty finding time to do cases was an issue for (51%) of responders. Open-ended responses (n=87) indicated that the most valuable learning pertained to insulin management (n=35), general management (n=23), and goal- achievement (n=10). Suggested improvements included software enhancements (n=34) and nothing bad to report (n=27).
Discussion Learning through case simulations in a web-based dynamic environment is rated highly for satisfaction and ease of use by resident physicians. Most would recommend it to colleagues.
