Tele-education to improve residents' knowledge and quality of care in hospital hyperglycemia: a multicenter randomized clinical trial.
To evaluate the impact of a structured tele-education program on hospital hyperglycemia and diabetes, focusing on residents' medical knowledge and inpatient care.
This open-label, multicenter, randomized clinical trial enrolled internal medicine residents from four university hospitals in southern Brazil. Teams were block-randomized to an intervention group that received an online lecture plus 30 days of tele-education via WhatsApp, or to a control group with no intervention. The primary outcome was medical knowledge, assessed with a validated 10-item questionnaire. Secondary outcomes included quality of insulin prescriptions, hypoglycemia and hyperglycemia rates, and hospital length of stay (LOS). Analyses were performed using SPSS v29 (5% significance).
Fifty residents completed the study. The intervention group achieved higher post-intervention knowledge scores than the control group (median 8 vs. 6 correct answers; p = 0.005) and showed significant improvement from preto post-test (6 to 8; p < 0.001), with consistent gains across centers. Clinical data from 149 hospitalized patients were analyzed (mean age 67.8 years; 55% female); 56% had diabetes, and 44% had hospital-related hyperglycemia. There was a nonsignificant trend toward more appropriate NPH (p = 0.107) and regular insulin (p = 0.203) prescriptions in the intervention group. Median LOS was longer in the intervention group (19 vs. 13 days; p = 0.009).
The tele-education program improved residents' knowledge of inpatient hyperglycemia. Larger studies are needed to confirm clinical effects and long-term outcomes of tele-education in hospital glycemic management.
This open-label, multicenter, randomized clinical trial enrolled internal medicine residents from four university hospitals in southern Brazil. Teams were block-randomized to an intervention group that received an online lecture plus 30 days of tele-education via WhatsApp, or to a control group with no intervention. The primary outcome was medical knowledge, assessed with a validated 10-item questionnaire. Secondary outcomes included quality of insulin prescriptions, hypoglycemia and hyperglycemia rates, and hospital length of stay (LOS). Analyses were performed using SPSS v29 (5% significance).
Fifty residents completed the study. The intervention group achieved higher post-intervention knowledge scores than the control group (median 8 vs. 6 correct answers; p = 0.005) and showed significant improvement from preto post-test (6 to 8; p < 0.001), with consistent gains across centers. Clinical data from 149 hospitalized patients were analyzed (mean age 67.8 years; 55% female); 56% had diabetes, and 44% had hospital-related hyperglycemia. There was a nonsignificant trend toward more appropriate NPH (p = 0.107) and regular insulin (p = 0.203) prescriptions in the intervention group. Median LOS was longer in the intervention group (19 vs. 13 days; p = 0.009).
The tele-education program improved residents' knowledge of inpatient hyperglycemia. Larger studies are needed to confirm clinical effects and long-term outcomes of tele-education in hospital glycemic management.
Authors
Lopes Lopes, Silva Silva, Caetano Caetano, Riboli Riboli, Pinheiro Pinheiro, Bortoluzzi Bortoluzzi, Nunes Nunes, Souza Souza, Herdt Herdt, Scharnberg Scharnberg, Rech Rech, Weinert Weinert, Bohlke Bohlke
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