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The Impact of an Experience-Based Versus Traditional Continuous Glucose Monitoring Curriculum on Internal Medicine
Eric B Ohlendorf1, Kenneth M Fifer2,3, Emily J Gallagher2,4
1Department of Medicine, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA. eric.ohlendorf@mountsinai.org.
Background:
Continuous glucose monitoring (CGM) is an important tool in diabetes care, yet providers often have limited familiarity with its use. Personal CGM use may enhance provider knowledge and confidence.
Objective:
We evaluated whether an experience-based CGM curriculum (EC) improves confidence and knowledge among internal medicine (IM) residents compared with a traditional curriculum (TC).
Design:
IRB-exempt, prospective, randomized educational intervention.
Participants:
Thirty-six IM residents.
Interventions:
Residents were assigned to either EC (didactic, clinic, 10 days of personal CGM wear) or TC (didactic and clinic only).
Main Measures:
Primary outcome: change in CGM confidence scores as measured by pre- and post-curriculum surveys.
Secondary Outcome:
percentage of post-curriculum knowledge questions answered correctly on the knowledge assessment. Paired pre- vs post-survey responses were compared using McNemar testing; EC vs TC were compared using Fisher's exact test. A qualitative outcome analyzed free-text responses regarding participant experience using CGM.
Results:
Thirty-six residents completed the pre-curriculum survey and 27 the post-curriculum survey (n = 13 EC, n = 14 TC), with 23 paired responses. Overall confidence improved across multiple CGM domains. Confidence in helping a patient apply a CGM sensor increased significantly overall (p = 0.0001), with greater improvement in EC (p = 0.0003). Smartphone integration showed a similar pattern (EC vs TC p = 0.012) as did confidence addressing patient questions (EC vs TC p = 0.012). Confidence explaining CGM function (p = 0.004) and interpreting reports (p = 0.004) increased overall but without between-group differences. Knowledge scores were similar (EC 67 ± 12% vs TC 62 ± 16%). Qualitative themes included insight into the patient experience, improved procedural confidence, greater lifestyle counseling ability, and endorsement of experiential learning.
Conclusions:
Providing an opportunity to personally use CGMs among IM residents produced greater gains in applied and patient-facing skills than a traditional curriculum. These findings support incorporating hands-on CGM experience into residency training to better prepare trainees for modern diabetes care.
