Clinical trial NCT00676208: Improving Medical Training for the Care of Chronic Conditions
Official title: Improving Medical Training for the Care of Chronic Conditions
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Diabetes Mellitus
Keywords: Shared Medical Appointments
Diabetes
Education
Lead sponsor: VA Office of Research and Development
Sponsor class: FED
First posted: 2008-05-12
Enrollment: 33
Sex: ALL
Minimum age (years): 20
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: While medical training has increasingly included chronic care management, quality care necessitates education approaches that go farther. In April 2005, the Louis Stokes Cleveland Veterans Affairs Medical Center (VAMC) implemented a weekly Diabetes Shared Medical Appointment (SMA). SMAs offer an important opportunity to improve chronic care and a unique setting for training physicians. In order to equip physicians with needed resources to manage chronic care, the ways in which SMA experiences are processed and integrated into learning about interdisciplinary approaches and expanding trainees' understanding of chronic care issues need to be examined.

Detailed description: : Most physicians receive training in and about an acute care-oriented health care system that cannot adequately address the challenges of chronic care management. While medical training has increasingly included chronic care management, quality care necessitates education approaches that go farther. In April 2005, the Louis Stokes Cleveland VAMC implemented a weekly Diabetes Shared Medical Appointment (SMA). Results indicate that SMAs are sustained and, as such, SMAs offer an important opportunity to improve chronic care and a unique setting for training physicians. SMAs offer the potential to provide training in crucial skills that have to date remained less amendable to traditional educational practices. In order to equip physicians with resources to effectively and efficiently manage chronic care, the ways in which SMA experiences are processed and integrated into learning about interdisciplinary approaches and expanding trainees' understanding of chronic care issues need to be examined. Without addressing this gap, it is not possible to develop a comprehensive care model that links education and patient outcomes for chronic conditions, such as diabetes. Building on previous pilot work, we continued to address evaluating and validating instruments. The proposed pilot project included using a think-aloud protocol to evaluate and validate new items and scales assessing interdisciplinary team and chronic care/diabetes beliefs, and evaluating and adjusting direct observation coding tools for chronic condition care.

Eligibility criteria: Inclusion Criteria:

Medical Students:

Inclusion: All medical students participating in diabetes Shared Medical Appointment sessions or other training experiences during the course of the study.

Exclusion Criteria:

medical students who have participated in SMAs for patients with diabetes at the Cleveland VAMC in the past.

Primary outcomes:
measure: Change in Confidence in Ability to Perform Teamwork
timeFrame: Pre-intervention and Post-Intervention at 1 month
Secondary outcomes:
measure: Change in Professionals' Attitudes About Diabetes
timeFrame: Pre-intervention and Post-intervention at 1 month
Other outcomes:
Locations:
city: Cleveland
country: United States
facility: Louis Stokes VA Medical Center, Cleveland, OH
state: Ohio
Study officials:
affiliation: Louis Stokes VA Medical Center, Cleveland, OH
name: David C Aron, MD MS
role: PRINCIPAL_INVESTIGATOR
References:
citation: Watts SA, Gee J, O'Day ME, Schaub K, Lawrence R, Aron D, Kirsh S. Nurse practitioner-led multidisciplinary teams to improve chronic illness care: the unique strengths of nurse practitioners applied to shared medical appointments/group visits. J Am Acad Nurse Pract. 2009 Mar;21(3):167-72. doi: 10.1111/j.1745-7599.2008.00379.x.