A learner-centered diabetes management curriculum: reducing resident errors on an inpatient diabetes pathway

Area of Science:

• Pediatric Endocrinology
• Medical Education
• Patient Safety

Background:

• Diabetes errors, especially insulin administration errors, pose significant risks in pediatric inpatient settings.
• Traditional lecture-based curricula have not sufficiently reduced resident-related diabetes errors.
• A need exists for more effective educational strategies to improve diabetes management by residents.

Purpose of the Study:

• To evaluate the effectiveness of a multifaceted, learner-centered diabetes curriculum in reducing inpatient errors.
• To assess the impact of the intervention on specific error categories including insulin, communication, intravenous fluids, nutrition, and discharge delay.
• To determine if a proactive learning model can decrease diabetes-related errors in a tertiary children's hospital.

Main Methods:

• An 8-week curriculum incorporating online tutorials, interactive discussions, Q&A sessions, and case-based error analysis was implemented.
• Resident errors identified through an incident reporting system were compared for a 9-month period before and a 10-month period after the intervention.
• Errors were categorized to analyze changes in specific types of diabetes management mistakes.

Main Results:

• The rate of patients with resident errors decreased significantly from 19.4% (28/144 admissions) before the intervention to 6.6% (11/166 admissions) after (P = 0.0007).
• The most common errors were related to insulin administration (43.8%) and communication (39.6%).
• A notable reduction in overall patient errors was observed post-intervention.

Conclusions:

• A learner-centered, interactive diabetes curriculum effectively reduced inpatient errors among pediatric residents.
• This educational model fosters proactive learning and demonstrates potential for improving patient safety in diabetes care.
• The findings suggest broader applicability of this educational approach to reduce errors in other medical disciplines.