Educational Efficacy Assessment of a Serious Game to Teach Insulin Therapy to Primary Care Physicians

NCT01759953 | Completed DMC

• 1 other identifier: InsuOnline-01
• Study Type: interventional
• Target: 170
• Locations: 1 country
• Sites: 1

Brief Summary

Background: Physicians´ lack of knowledge contributes to underuse of insulin and poor glycemic control in adults with diabetes mellitus (DM). Traditional continuing medical education have limited efficacy, so new approaches are required. Objective: We report the design of a trial to assess the educational efficacy of InsuOnline©, a game for education of primary care physicians (PCPs) on initiation and adjustment of insulin for the treatment of DM, which was designed to be: a) educationally adequate; and b) self-motivating and attractive. Methods: A multidisciplinary team, with endocrinologists, experts in medical education, and programmers, was assembled for design and development of InsuOnline©, a serious game which includes game elements and a well-defined, evidence-based curriculum of topics on insulin therapy. The first step of our study will be usability and playability tests, with PCPs and medical students, playing the game on a desktop. After that and further adjusts, we will perform an unblinded randomized controlled trial, with PCPs who work in the city of Londrina, to assess the educational validity of the game. A group of 64 PCPs will play InsuOnline© on the web, and the control group, of 64 PCPs, will underwent traditional teaching activities (lecture and group discussion). Knowledge on how to initiate and adjust insulin will be assessed by a web-based multiple-choice questionnaire, and attitudes regarding diabetes/insulin will be assessed by Diabetes Attitude Scale 3, at 3 time points: before, immediately after, and 6 months after the intervention. Subjects´ general impressions on the interventions will also be assessed by free-text questions. Software logs will be reviewed.

Conditions

Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Knowledge, Attitudes, Practice

Keywords

Diabetes Mellitus; Insulin; Video Games; Medical Education; Educational Technology; Continuing Medical Education

Outcome Measures

Primary Outcomes (1)

• Knowledge on insulin therapy for diabetes

  Average number of correct answers to a standardized web-based questionnaire on use of insulin for treatment of diabetes

  In up to one year

Secondary Outcomes (1)

• Attitudes regarding diabetes/insulin

  In up to one year

Other Outcomes (3)

• General impressions about the intervention

  In up to one year

• Usage data

  In up to one year

• Reasons for not finishing the game

  In up to one year

Study Arms (2)

InsuOnline game

ACTIVE COMPARATOR

Playing the InsuOnline game, on the web, in the player´s own time and rhythm, until its end, as already described previously.

Other: Game

Traditional CME

ACTIVE COMPARATOR

Traditional learning session as used for Continuing Medical Education, on insulin therapy, including a short lecture and a group discussion of the same clinical cases presented in the InsuOnline game

Other: Traditional CME

Interventions

Game OTHER

InsuOnline game, on the web, in the player´s own time and rhythm

Also known as: InsuOnline game, Serious game, Web-based game

InsuOnline game

Traditional CME OTHER

In-classroom traditional learning session about insulin therapy for diabetes, using a presential short lecture and a group discussion of the same clinical cases presented in the InsuOnline game

Also known as: Classroom education, Onsite learning session, Lecture and clinical cases discussion

Traditional CME

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Primary care physicians working in Londrina or other cities from the state of Paraná, Brazil

You may not qualify if:

• Clinical Endocrinologists
• Diabetologists
• Refuse to participate in the study

Sponsors & Collaborators

• Universidade Estadual de Londrina: lead

Study Sites (1)

Hospital Universitário de Londrina

Londrina, Paraná, 86038440, Brazil

Location

Related Publications (10)

• American Diabetes Association. Standards of medical care in diabetes--2012. Diabetes Care. 2012 Jan;35 Suppl 1(Suppl 1):S11-63. doi: 10.2337/dc12-s011. No abstract available.

  PMID: 22187469 BACKGROUND

• Mendes AB, Fittipaldi JA, Neves RC, Chacra AR, Moreira ED Jr. Prevalence and correlates of inadequate glycaemic control: results from a nationwide survey in 6,671 adults with diabetes in Brazil. Acta Diabetol. 2010 Jun;47(2):137-45. doi: 10.1007/s00592-009-0138-z. Epub 2009 Aug 5.

  PMID: 19655083 BACKGROUND

• Hayes RP, Fitzgerald JT, Jacober SJ. Primary care physician beliefs about insulin initiation in patients with type 2 diabetes. Int J Clin Pract. 2008 Jun;62(6):860-8. doi: 10.1111/j.1742-1241.2008.01742.x. Epub 2008 Apr 3.

  PMID: 18393965 BACKGROUND

• Peyrot M, Rubin RR, Lauritzen T, Skovlund SE, Snoek FJ, Matthews DR, Landgraf R, Kleinebreil L; International DAWN Advisory Panel. Resistance to insulin therapy among patients and providers: results of the cross-national Diabetes Attitudes, Wishes, and Needs (DAWN) study. Diabetes Care. 2005 Nov;28(11):2673-9. doi: 10.2337/diacare.28.11.2673.

  PMID: 16249538 BACKGROUND

• Lehmann ED. Interactive educational simulators in diabetes care. Med Inform (Lond). 1997 Jan-Mar;22(1):47-76. doi: 10.3109/14639239709089834.

  PMID: 9183780 BACKGROUND

• Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, Peters AL, Tsapas A, Wender R, Matthews DR; American Diabetes Association (ADA); European Association for the Study of Diabetes (EASD). Management of hyperglycemia in type 2 diabetes: a patient-centered approach: position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2012 Jun;35(6):1364-79. doi: 10.2337/dc12-0413. Epub 2012 Apr 19. No abstract available.

  PMID: 22517736 BACKGROUND

• Lerario AC, Chacra AR, Pimazoni-Netto A, Malerbi D, Gross JL, Oliveira JE, Gomes MB, Santos RD, Fonseca RM, Betti R, Raduan R. Algorithm for the treatment of type 2 diabetes: a position statement of Brazilian Diabetes Society. Diabetol Metab Syndr. 2010 Jun 8;2(1):35. doi: 10.1186/1758-5996-2-35.

  PMID: 20529311 BACKGROUND

• Akl EA, Sackett K, Pretorius R, Erdley S, Bhoopathi PS, Mustafa R, Schunemann HJ. Educational games for health professionals. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD006411. doi: 10.1002/14651858.CD006411.pub2.

  PMID: 18254103 BACKGROUND

• Diehl LA, Souza RM, Gordan PA, Esteves RZ, Coelho IC. InsuOnline, an Electronic Game for Medical Education on Insulin Therapy: A Randomized Controlled Trial With Primary Care Physicians. J Med Internet Res. 2017 Mar 9;19(3):e72. doi: 10.2196/jmir.6944.

  PMID: 28279950 DERIVED

• Diehl LA, Souza RM, Alves JB, Gordan PA, Esteves RZ, Jorge ML, Coelho IC. InsuOnline, a Serious Game to Teach Insulin Therapy to Primary Care Physicians: Design of the Game and a Randomized Controlled Trial for Educational Validation. JMIR Res Protoc. 2013 Jan 21;2(1):e5. doi: 10.2196/resprot.2431.

  PMID: 23612462 DERIVED

MeSH Terms

Conditions

Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Behavior; Diabetes Mellitus; Insulin Resistance

Condition Hierarchy (Ancestors)

Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases; Autoimmune Diseases; Immune System Diseases; Hyperinsulinism

Study Officials

• Leandro A Diehl, M.D., MsC

  Universidade Estadual de Londrina

  PRINCIPAL INVESTIGATOR

• Pedro A Gordan, M.D., PhD

  Universidade Estadual de Londrina

  STUDY DIRECTOR

• Izabel CM Coelho, M.D., PhD

  Faculdades Pequeno Príncipe

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: December 21, 2012
• First Posted: January 3, 2013
• Study Start: July 1, 2014
• Primary Completion: December 1, 2015
• Study Completion: December 1, 2015
• Last Updated: December 7, 2015

Record last verified: 2015-12

Locations

BR (1)