The Effect of a Checklist on the Quality of Education During Insulin Initiation by Trained Medical Students: a Randomized Controlled Trial
Trial Snapshot
- Phase
- Not Applicable
- Enrollment
- 100
- Locations
- 1
- Primary Endpoint
- The total number of educational points addressed for the safe and effective use of insulin (of the possible 21 specified)
Study Overview
Brief Summary
Diabetes prevalence continues to rise worldwide, leading to the increasing use of insulin. This especially applies to developing countries where the needle-and-syringe method of administration remains the most affordable and effective form of hyperglycemic treatment. Competent health care professionals are required to ensure safe insulin initiation. The investigators will evaluate a teaching intervention on insulin initiation for medical students, and whether after experiencing that intervention the use of a checklist, during simulate insulin initiation, improves the education they provide to patients.
Detailed Description
Introduction:
Diabetes is on the increase worldwide. The International Diabetes Federation estimates that there are currently 382 million persons diagnosed with diabetes. The prevalence is expected to increase to over 592 million in less than 25 years [1]. This increase is disproportional in the developing world, with 80% of those affected living in low- and middle-income countries. For example, in South and Central America, the prevalence of diabetes is estimated to increase by over 60% in the next two decades [2].
Insulin is one of the agents that can be used in the treatment of diabetes mellitus. Diabetes is characterized by a progressive decline in beta-cell function and insulin secretion. Over time, a significant number of persons with diabetes will require intensification of management, and possibly insulin treatment to achieve acceptable glycemic control [3]. Insulin remains the oldest and most effective treatment of hyperglycemia. It is also possibly the cheapest form of treatment relative to its potency, particularly when used in its animal or human forms.
Insulin is a particularly important treatment option in the developing world and in low-income groups in the developed world. In the developing world, drug affordability has limited the international evolution from an algorithmic to an individualized approach to glycemic management [4, 5]. In many countries, insulin remains the affordable second or third line choice for treatment, and will therefore be used with greater frequency.
Insulin initiation is, however, a complex task. To safely initiate insulin, many important aspects of patient education must be addressed. Patients must understand the technicalities of drawing insulin with a needle and syringe as well as administering insulin with a syringe, pen or pump. The side effects of weight gain and hypoglycemia must also be understood, including the recognition and treatment of the latter.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Single Group
- Masking
- None
Eligibility Criteria
- Ages
- 17 Years to 40 Years (Child, Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Undergraduate students in their final-year medicine clerkship at the University of the West Indies, who are within one year of starting supervised post-graduate employment (internship).
- •Students who consent to participate in the study (voluntary participation only).
Exclusion Criteria
- •Students who refuse consent to participate in the study.
Arms & Interventions
With checklist
Students will simulate insulin initiation with the aid of a checklist
Intervention: Checklist (Other)
Without checklist
Students will simulate insulin initiation without the aid of a checklist
Outcomes
Primary Outcomes
The total number of educational points addressed for the safe and effective use of insulin (of the possible 21 specified)
Time Frame: 2 years
Secondary Outcomes
- The number of educational points addressed under each of the four educational domains: insulin side effects, recognition and treatment of hypoglycemia, administration of insulin, and drawing up insulin using the syringe method.(2 years)