Enhancing Physician Clinical Competency: A Cluster Randomized Trial of a Multimodal Online Educational Program in a...

The escalating global diabetes epidemic necessitates an effective diabetes management workforce. Professional education can play a crucial role in strengthening clinical competency among physicians, ensuring effective guideline implementation, particularly in countries like the Kingdom of Saudi Arabia (KSA), where the high prevalence of diabetes and complex health care challenges demand enhanced expertise. This study assessed the impact of an asynchronous, multimodal online program to enhance physicians' diabetes care competency implemented by the KSA Ministry of Health in an international cohort of physicians from 22 countries practicing in KSA.

A comprehensive needs assessment informed the design of the educational content, focusing on diabetes management, prevention, and complications. The program used a backward design approach, emphasizing critical thinking, clinical decision-making, and behavior change through case-based learning, reflective practice, and interactive activities. The effectiveness of the intervention was assessed through a cluster randomized trial comparing the online program against traditional continuing medical education (CME) methods. Clinical competency was measured using a timed, validated online case-based examination before and after the intervention. The comparator group continued routine clinical practice without access to the structured educational program during the study period. No restrictions were placed on participation in other CME activities, and such activities were not systematically tracked. This design reflected real-world usual care conditions. Computerized cluster randomization was performed at the health center level.

A total of 43 health centers (22 intervention; 21 comparator) were randomized as clusters. Of the 246 physicians randomly assigned (134 intervention; 112 comparator), 178 completed the study (98 intervention; 80 comparator). No health center dropped out of the study. Postintervention, the intervention group demonstrated a significant improvement in clinical competency scores compared with the comparator group (mean score 17.5 [95% CI 14.0-20.9]). Satisfaction ratings averaged 4.8 of 5, indicating high program approval. The study highlighted the potential of the program to effectively bridge knowledge gaps and enhance clinical competency in a diverse cohort.

The asynchronous online educational program significantly improved clinical competency among physicians in diabetes care, underscoring the effectiveness of innovative educational strategies in addressing global health care challenges. The design of the program, emphasizing interactive and reflective learning, offers a scalable model for professional education in diabetes management and potentially other areas of health care.