Related Experiment Video
Updated: May 2, 2026

Author Spotlight: Integrating Tai Chi with Mindfulness Training to Achieve an Effective Mind-Body Exercise
Published on: July 14, 2023
Improving Foot Examinations in Patients With Diabetes: A Performance Improvement Continuing Medical Education
Susan M Szpunar1, Steven E Minnick1, Imhoitsemeh Dako1
1St. John Hospital and Medical Center, Department of Medical Education, Grosse Pointe Woods, Michigan (Dr Szpunar, Dr Minnick, Dr Dako, Mr Saravolatz).
Purpose:
The purpose of this project was to determine if a Performance-Improvement Continuing Medical Education (PI-CME) project, using the American Medical Association's methodology, would help improve the timeliness and comprehensiveness of foot examinations in patients with diabetes.
Methods:
A PI-CME project was conducted with the Internal Medicine faculty staff physicians (n = 8) and residents (n = 45). Following the 3 steps of PI-CME, participants received baseline reports about their performance defined by the American Diabetes Association's guidelines for foot examinations (stage A). Each group received an educational intervention (stage B) and a reminder tool for use in the practice. Participants received individualized reports about their performance post intervention (stage C) for comparison with preintervention data and reflection on any changes in compliance.
Results:
In the faculty and resident clinics, the percentage of patients who received an annual foot examination when due increased significantly. Both clinics also showed improvements in the percentage of patients who received all 3 components of the exam, with the greatest improvement in the resident clinic.
Conclusions:
The PI-CME approach can be successfully used both with faculty staff physicians (who receive CME credits) and residents (who do not receive credits) to improve performance on diabetes quality measures.
Related Concept Videos
Diabetic Foot Ulcer
Peripheral Artery Disease IV: Nursing Management
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
Methods of Documentation III: PIE
Peripheral Artery Disease III: Interprofessional Care
Peripheral Artery Disease V: Postoperative Nursing Management

