Development and evaluation of a digital platform for teaching about the management of type 2 Diabetes Mellitus to undergraduate Medical students

Authors

DOI:

https://doi.org/10.33448/rsd-v10i14.21823

Keywords:

Type 2 Diabetes Mellitus; Treatment; Health education; Health technology; Teaching.

Abstract

Type 2 Diabetes Mellitus (Type 2 DM) is a chronic and highly prevalent disease that is considered a global epidemic. However, when properly treated, it can be well controlled and have its complications minimized. The use of digital technologies emerges as a potential instrument to help teaching about this very prevalent disease, even more in the scenario of student-centered education, more intensified in the period of the new coronavirus pandemic. This cross-sectional, descriptive study with a quantitative approach aims to develop and evaluate the usability of a digital platform as a tool for teaching medical students about drug treatment and microvascular complications in patients with type 2 diabetes. For the development of the digital platform, assumptions adapted from Echer (2005) were adopted and its usability was evaluated through the System Usability Scale (SUS) among undergraduate medical students. 45 responses were obtained. Students from different semesters participated, 93.3% having already taken the endocrinology programme. The application received a good usability evaluation, obtaining an average SUS score equal to 82.9, with a standard deviation of 13.8. In conclusion, the digital platform for teaching about the treatment and complications of type 2 Diabetes Mellitus had a good evaluation among medical students, and it can be used as an instrument for teaching this area of endocrinology in undergraduate medicine.

References

Agarwal, P., Mukerji, G., Desveaux, L., Ivers, N. M., Bhattacharyya, O., Hensel, J. M., Shaw, J., Bouck, Z., Jamieson, T., Onabajo, N., Cooper, M., Marani, H., Jeffs, L., & Sacha Bhatia, R. (2019). Mobile app for improved self-management of type 2 diabetes: Multicenter pragmatic randomized controlled trial. Journal of Medical Internet Research, 21(1). https://doi.org/10.2196/10321

Association, A. D. (2020a). 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care, 43(January), S14–S31. https://doi.org/10.2337/dc20-S002

Association, A. D. (2020b). 4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Medical Care in Diabetes-2020. Diabetes Care, 43(January), S37–S47. https://doi.org/10.2337/dc20-S004

Association, A. D. (2020c). 6. Glycemic Targets: Standards of Medical Care in Diabetes-2020. Diabetes Care, 43(January), S66–S76. https://doi.org/10.2337/dc20-S006

Association, A. D. (2020d). 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes-2020. Diabetes Care, 43(January), S98–S110. https://doi.org/10.2337/dc20-S009

Bahia, L. R., Araujo, D. V., Schaan, B. D., Dib, S. A., Negrato, C. A., Leo, M. P. S., Ramos, A. J. S., Forti, A. C., Gomes, M. B., Foss, M. C., Monteiro, R. A., Sartorelli, D., & Franco, L. J. (2011). The costs of type 2 diabetes mellitus outpatient care in the Brazilian Public Health System. Value in Health, 14(5 SUPPL.), S137–S140. https://doi.org/10.1016/j.jval.2011.05.009

Bangor, A., Staff, T., Kortum, P., Miller, J., & Staff, T. (2009). Determining what individual SUS scores mean: adding an adjective rating scale. Journal of Usability Studies, 4(3), 114–123.

Batch, B. C., Spratt, S. E., Blalock, D. V., Benditz, C., Weiss, A., Dolor, R. J., & Cho, A. H. (2021). General Behavioral Engagement and Changes in Clinical and Cognitive Outcomes of Patients with Type 2 Diabetes Using the Time2Focus Mobile App for Diabetes Education: Pilot Evaluation. Journal of Medical Internet Research, 23(1), 1–10. https://doi.org/10.2196/17537

Bonett, D. G., & Wright, T. A. (2015). Cronbach’s alpha reliability: Interval estimation, hypothesis testing, and sample size planning. Journal of Organizational Behavior, 36(1), 3–15. https://doi.org/10.1002/job.1960

Borges, D. de B., & Lacerda, J. T. de. (2018). Ações voltadas ao controle do Diabetes Mellitus na Atenção Básica: proposta de modelo avaliativo. Saúde Em Debate, 42(116), 162–178. https://doi.org/10.1590/0103-1104201811613

Brasil. (2001). Resolução CNE/CES No4, de 7 de novembro. Institui Diretrizes Curriculares Nacionais do Curso de Graduação em Medicina. Ministério Da Educação e Cultura. Conselho Nacional de Educação.

Brasil. (2002). Plano de reorganização da atenção à hipertensão arterial e ao diabetes mellitus: manual de hipertensão arterial e diabetes mellitus. In Ministério da Saúde.

Chu, A., Biancarelli, D., Drainoni, M. L., Liu, J. H., Schneider, J. I., Sullivan, R., & Sheng, A. Y. (2019). Usability of Learning Moment: Features of an E-learning Tool That Maximize Adoption by Students. The Western Journal of Emergency Medicine, 21(1), 78–84. https://doi.org/10.5811/westjem.2019.6.42657

Conway, C. M., & Kelechi, T. J. (2017). Digital health for medication adherence in adult diabetes or hypertension: An integrative review. JMIR Diabetes, 2(2), 1–13. https://doi.org/10.2196/diabetes.8030

da Silva Xavier, A., & Koifman, L. (2011). Educação superior no brasil e a formação dos profissionais de saúde com ênfase no envelhecimento. Interface: Communication, Health, Education, 15(39), 973–984. https://doi.org/10.1590/S1414-32832011005000019

Diabetes, S. B. de. (2019). Diretrizes da Sociedade Brasileira de Diabetes 2019-2020. In Sociedade Brasileira de Diabetes (Vol. 5, Issue 3).

Diehl, L. A., Souza, R. M., Alves, J. B., Gordan, P. A., Esteves, R. Z., Jorge, M. L. S. G., & Coelho, I. C. M. (2013). 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 Research Protocols, 2(1), 1–11. https://doi.org/10.2196/resprot.2431

Duckworth, W., Abraira, C., Moritz, T., Reda, D., Emanuele, N., Reaven, P. D., Zieve, F. J., Marks, J., Davis, S. N., Hayward, R., Warren, S. R., Goldman, S., McCarren, M., Vitek, M. E., Henderson, W. G., & Huang, G. D. (2009). Glucose control and vascular complications in veterans with type 2 diabetes. New England Journal of Medicine, 360(2), 129–139. https://doi.org/10.1056/NEJMoa0808431

Echer, I. C. (2005). Supporting Patient Autonomy Is Critical to Improving Health. Rev Latino-Am Enfermagem, 13(5), 754–757. https://www.psychologicalscience.org/news/releases/supporting-patient-autonomy-is-critical-to-improving-health.html

Eliane Dias, G., Cristina, A., Luiz, M., José Renan Cunha, M., & Maria Emília Caixeta de Castro, L. (2013). Matriz de competências essenciais para a formação e avaliação de desempenho de estudantes de medicina. Revista Brasileira de Educação Médica, 37(4), 526–539. http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-55022013000400008&lang=pt

Estrela, C. (2018). Metodologia Científica: Ciência, Ensino, Pesquisa. Editora Artes Médicas.

Faria, A. L., Perdigão, A. C. B., Marçal, E., Kubrusly, M., Peixoto, R. A. C., & Peixoto Junior, A. A. (2021). OSCE 3D: uma ferramenta virtual de avaliação de habilidades clínicas para tempos de pandemia de coronavírus. Revista Brasileira de Educação Médica, 45(2). https://doi.org/10.1590/1981-5271v45.2-20200460

França, T., Rabello, E. T., & Magnago, C. (2019). As mídias e as plataformas digitais no campo da Educação Permanente em Saúde: debates e propostas. Saúde Em Debate, 43(spe1), 106–115. https://doi.org/10.1590/0103-11042019s109

Garber, A. J., Abrahamson, M. J., Barzilay, J. I., Blonde, L., Bloomgarden, Z. T., Bush, M. A., Dagogo-Jack, S., DeFronzo, R. A., Einhorn, D., Fonseca, V. A., Garber, J. R., Garvey, W. T., Grunberger, G., Handelsman, Y., Hirsch, I. B., Jellinger, P. S., McGill, J. B., Mechanick, J. I., Rosenblit, P. D., & Umpierrez, G. E. (2017). Consensus Statement By the American Association of Clinical Endocrinologists and American College of Endocrinology on the Comprehensive Type 2 Diabetes Management Algorithm - 2017 Executive Summary. Endocrine Practice, 23(2), 207–238. https://doi.org/10.4158/EP161682.CS

Goh, P.-S., & Sandars, J. (2020). A vision of the use of technology in medical education after the COVID-19 pandemic. MedEdPublish, 9(1), 1–8. https://doi.org/10.15694/mep.2020.000049.1

Group, T. A. C. (2008). Intensive Blood Glucose Control and Vascular Outcomes in Patients with Type 2 Diabetes Mellitus. Endocrinology and Metabolism Clinics of North America, 47(1), 81–96. https://doi.org/10.1016/j.ecl.2017.10.002

Group, U. P. D. S. (UKPDS). (1998). Intensive Blood-Glucose Control with Sulfonylureas or Insulin Compared with Conventional Treatment and Risk of Complications in Patients with Type 2 Diabetes (UKPDS 34). The Lancet, 352(9), 149. https://doi.org/10.1097/00019616-199903000-00016

Gusso, A. K., Castro, B. C. de, & Souza, T. N. de. (2021). Tecnologias de Informação e Comunicação no ensino de Enfermagem durante a pandemia da COVID-19: Revisão integrativa. Research, Society and Development, 10(6), e13610615576. https://doi.org/10.33448/rsd-v10i6.15576

Haas, L., Maryniuk, M., Beck, J., Cox, C. E., Duker, P., Edwards, L., Fisher, E. B., Hanson, L., Kent, D., Kolb, L., McLaughlin, S., Orzeck, E., Piette, J. D., Rhinehart, A. S., Rothman, R., Sklaroff, S., Tomky, D., & Youssef, G. (2014). Professional practice committee for the 2014 clinical practice recommendations. Diabetes Care, 37(SUPPL.1), 1630–1637. https://doi.org/10.2337/dc14-S144

Hägglund, M., & Scandurra, I. (2021). User evaluation of the swedish patient accessible electronic health record: System usability scale. JMIR Human Factors, 8(3). https://doi.org/10.2196/24927

Herrmann-Werner, A., Erschens, R., Zipfel, S., & Loda, T. (2021). Medical education in times of covid-19: Survey on teachers’ perspectives from a German medical faculty. GMS Journal for Medical Education, 38(5), 1–13. https://doi.org/10.3205/zma001489

Holman, R. R., Paul, S. K., Bethel, M. A., Matthews, D. R., & Neil, H. A. W. (2008). 10-Year Follow-up of Intensive Glucose Control in Type 2 Diabetes. New England Journal of Medicine, 359(15), 1577–1589. https://doi.org/10.1056/NEJMoa0806470

Hou, C., Carter, B., Hewitt, J., Francisa, T., & Mayor, S. (2016). Do mobile phone applications improve glycemic control (HbA1c) in the self-management of diabetes? A systematic review, meta-analysis, and GRADE of 14 randomized trials. Diabetes Care, 39(11), 2089–2095. https://doi.org/10.2337/dc16-0346

International Diabetes Federation. (2017). IDF Diabetes Atlas: Eighth edition 2017. In International Diabetes Federation. https://doi.org/http://dx.doi. org/10.1016/S0140-6736(16)31679-8

Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., Peters, A. L., Tsapas, A., Wender, R., & Matthews, D. R. (2012). Management of hyperglycemia in type 2 diabetes: A patient-centered approach. Diabetes Care, 35(6), 1364–1379. https://doi.org/10.2337/dc12-0413

Klonoff, D. C. (2013). The current status of mHealth for diabetes: Will it be the next big thing? Journal of Diabetes Science and Technology, 7(3), 749–758. https://doi.org/10.1177/193229681300700321

Koche, J. C. (2011). Fundamentos de metodologia científica. Petrópolis: Vozes. http://www.brunovivas.com/wp-content/uploads/sites/10/2018/07/K%C3%B6che-Jos%C3%A9-Carlos0D0AFundamentos-de-metodologia-cient%C3%ADfica-_-teoria-da0D0Aci%C3%AAncia-e-inicia%C3%A7%C3%A3o-%C3%A0-pesquisa.pdfhttps://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica.pdf?sequence=

Lee Ventola, C. (2014). Social media and health care professionals: Benefits, risks, and best practices. P and T, 39(7), 491–500.

Lima, C. J. M. de, Coelho, R. A., Medeiros, M. S., Kubrusly, M., Marçal, E., & Peixoto Júnior, A. A. (2019). Development and Validation of a Mobile Application for the Teaching of Electrocardiogram. Revista Brasileira de Educação Médica, 43(1 suppl 1), 157–165. https://doi.org/10.1590/1981-5271v43suplemento1-20190164.ing

Mello, C. de C. B., Alves, R. O., & Lemos, S. M. A. (2014). Metodologias de ensino e formação na área da saúde: revisão de literatura. Revista CEFAC, 16(6), 2015–2028. https://doi.org/10.1590/1982-0216201416012

Ozdalga, E., Ozdalga, A., & Ahuja, N. (2012). The smartphone in medicine: A review of current and potential use among physicians and students. Journal of Medical Internet Research, 14(5). https://doi.org/10.2196/jmir.1994

Patil, R. N., Almale, B. D., Patil, M., Gujrathi, A., Dhakne-Palwe, S., Patil, A. R., & Gosavi, S. (2016). Attitudes and perceptions of medical undergraduates towards mobile learning (M-learning). Journal of Clinical and Diagnostic Research, 10(10), JC06-JC10. https://doi.org/10.7860/JCDR/2016/20214.8682

Pereira A. S., et al. (2018). Metodologia da pesquisa científica. [free e-book]. Santa Maria/RS. Ed. UAB/NTE/UFSM.

Powers, M. A., Davidson, J., & Bergenstal, R. M. (2013). Glucose pattern management teaches glycemia-related problem-solving skills in a diabetes self-management education program. Diabetes Spectrum, 26(2), 91–97. https://doi.org/10.2337/diaspect.26.2.91

Rhee, S. Y., Kim, C., Shin, D. W., & Steinhubl, S. R. (2020). Present and future of digital health in diabetes and metabolic disease. Diabetes and Metabolism Journal, 44(6), 819–827. https://doi.org/10.4093/DMJ.2020.0088

Salci, M. A., Meirelles, B. H. S., & Silva, D. M. G. V. da. (2018). Health education to prevent chronic diabetes mellitus complications in primary care. Escola Anna Nery, 22(1), 1–6. https://doi.org/10.1590/2177-9465-ean-2017-0262

Santos, L., & Torres, H. de C. (2012). Práticas Educativas em Diabetes Mellitus: Compreendendo as Competências dos Profissionais da Saúde. Texto e Contexto Enfermagem, 21(3), 574–580. https://doi.org/10.1590/S0104-07072012000300012

Sauro, J., & Lewis, J. R. (2011). When designing usability questionnaires, does it hurt to be positive? Conference on Human Factors in Computing Systems - Proceedings, May 2011, 2215–2223. https://doi.org/10.1145/1978942.1979266

Shan, R., Sarkar, S., & Martin, S. S. (2019). Digital health technology and mobile devices for the management of diabetes mellitus: state of the art. Diabetologia, 62(6), 877–887. https://doi.org/10.1007/s00125-019-4864-7

The Royal Australian College of General Practitioners. (2016). General practice management of type 2 diabetes: 2016-18. In Royal Australian College of General Practitioners. https://doi.org/http://dx.doi.org/10.1016/S1634-7358(15)69861-8

Veazie, S., Winchell, K., Gilbert, J., Paynter, R., Ivlev, I., Eden, K. B., Nussbaum, K., Weiskopf, N., Guise, J. M., & Helfand, M. (2018). Rapid Evidence Review of Mobile Applications for Self-management of Diabetes. Journal of General Internal Medicine, 33(7), 1167–1176. https://doi.org/10.1007/s11606-018-4410-1

Vêscovi, S. de J. B., Primo, C. C., Anna, H. C. S., Bringuete, M. E. de O., Rohr, R. V., Prado, T. N. do, & Bicudo, S. D. S. (2017). Aplicativo móvel para avaliação dos pés de pessoas com diabetes mellitus. Acta Paulista de Enfermagem, 30(6), 607–613. https://doi.org/10.1590/1982- 0194201700087

Vlachogianni, P., & Tselios, N. (2021). Perceived usability evaluation of educational technology using the System Usability Scale (SUS): A systematic review. Journal of Research on Technology in Education, 1–18. https://doi.org/10.1080/15391523.2020.1867938

Vos, T., Allen, C., Arora, M., Barber, R. M., Brown, A., Carter, A., Casey, D. C., Charlson, F. J., Chen, A. Z., Coggeshall, M., Cornaby, L., Dandona, L., Dicker, D. J., Dilegge, T., Erskine, H. E., Ferrari, A. J., Fitzmaurice, C., Fleming, T., Forouzanfar, M. H., & Zuhlke, L. J. (2016). Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet, 388(10053), 1545–1602. https://doi.org/10.1016/S0140-6736(16)31678-6

Wallace, S., Clark, M., & White, J. (2012). “It’s on my iPhone”: Attitudes to the use of mobile computing devices in medical education, a mixed-methods study. BMJ Open, 2(4), 1–7. https://doi.org/10.1136/bmjopen-2012-001099

Wiechmann, W., Kwan, D., Bokarius, A., & Toohey, S. L. (2016). There’s an App for That? Highlighting the difficulty in finding clinically relevant smartphone applications. Western Journal of Emergency Medicine, 17(2), 191–194. https://doi.org/10.5811/westjem.2015.12.28781

World Health Organization. (2009). Global Health Risks. World Health Organization. http://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.pdf

World Health Organization. (2016). Global Report on Diabetes. World Health Organization. https://doi.org/ISBN 978 92 4 156525 7

Published

02/11/2021

How to Cite

BENEVIDES, A. M. L. N.; RABELO, J. A. F. .; SOARES, P. R. de H. .; BARROS FILHO, E. M. de; FERREIRA, L. F. de A.; MEDEIROS, M. S. Development and evaluation of a digital platform for teaching about the management of type 2 Diabetes Mellitus to undergraduate Medical students. Research, Society and Development, [S. l.], v. 10, n. 14, p. e249101421823, 2021. DOI: 10.33448/rsd-v10i14.21823. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/21823. Acesso em: 19 apr. 2024.

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Section

Health Sciences