Certificate Course in EVIDENCE BASED DIABETES MANAGEMENTccebdm.org/dw/Cycle3old/evolution report...
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Certificate Course in EVIDENCE BASED DIABETES MANAGEMENT CYCLE-III (FEB 2013-JAN 2014) EVALUATION REPORT PUBLIC HEALTH FOUNDATION OF INDIA International Diabetes Federation Recognized Education Programme 2014-2016 Supported by an educational grant from This diabetes education program is recognized by the International Diabetes Federation
Transcript of Certificate Course in EVIDENCE BASED DIABETES MANAGEMENTccebdm.org/dw/Cycle3old/evolution report...
Certificate Course in
EVIDENCE BASEDDIABETES MANAGEMENT CYCLE-III (FEB 2013-JAN 2014)
EVALUATION REPORT
PUBLICHEALTHFOUNDATIONOF INDIA
International Diabetes Federation
Recognized EducationProgramme2014-2016
Supported by an educational grant from
This diabetes education program is recognized by the International Diabetes Federation
LIST OF CONTRIBUTORS
Director, Center of Excellence in Cardio-metabolic Risk Reduction in South Asia (CoE-CARRS)Executive Director, Centre for Chronic Disease Control (CCDC)
Public Health Foundation of India, New Delhi
PROF. D PRABHAKARAN
DR. SHIVANGI VATSMonitoring and Evaluation Coordinator
Certificate Course in Evidence Based Diabetes Management
DR. SHREYAS SHARMAAssistant Monitoring and Evaluation Coordinator
Certificate Course in Evidence Based Diabetes Management
DR. VARIYATA BAGREAssistant Monitoring and Evaluation Coordinator
Certificate Course in Evidence Based Diabetes Management
DR. RAKESH MEHRAAssistant Program Coordinator
Certificate Course in Evidence Based Diabetes Management
DR. SHIFALIKA GOENKALead Faculty - Curriculum Development
Certificate Course in Evidence Based Diabetes ManagementAssociate Professor, Indian Institute of Public Health, New Delhi
DR. SANDEEP BHALLAProgram In-charge
Certificate Course in Evidence Based Diabetes ManagementPublic Health Specialist, Adjunct Associate Professor
Public Health Foundation of India, New Delhi
Certificate Course in Evidence Based Diabetes Management
1
LIST OF CONTRIBUTORS
Director, Center of Excellence in Cardio-metabolic Risk Reduction in South Asia (CoE-CARRS)Executive Director, Centre for Chronic Disease Control (CCDC)
Public Health Foundation of India, New Delhi
PROF. D PRABHAKARAN
DR. SHIVANGI VATSMonitoring and Evaluation Coordinator
Certificate Course in Evidence Based Diabetes Management
DR. SHREYAS SHARMAAssistant Monitoring and Evaluation Coordinator
Certificate Course in Evidence Based Diabetes Management
DR. VARIYATA BAGREAssistant Monitoring and Evaluation Coordinator
Certificate Course in Evidence Based Diabetes Management
DR. RAKESH MEHRAAssistant Program Coordinator
Certificate Course in Evidence Based Diabetes Management
DR. SHIFALIKA GOENKALead Faculty - Curriculum Development
Certificate Course in Evidence Based Diabetes ManagementAssociate Professor, Indian Institute of Public Health, New Delhi
DR. SANDEEP BHALLAProgram In-charge
Certificate Course in Evidence Based Diabetes ManagementPublic Health Specialist, Adjunct Associate Professor
Public Health Foundation of India, New Delhi
Certificate Course in Evidence Based Diabetes Management
1
CONTENTS
PREFACE
EXECUTIVE SUMMARY
BACKGROUND & INTRODUCTION
Diabetes, the Global Epidemic ................................................................................................ Rational of the Program ........................................................................................................... Overview of Certificate Course in Evidence Based Diabetes Management ............................Evaluation Plan ........................ ................................................................................................Objectives of Evaluation ..........................................................................................................
METHODOLOGY
Study Design ............................................................................................................................ 12
Study Population ...................................................................................................................... 12Sample Size .............................................................................................................................. 12
Sampling ................................................................................................................................... 12
Data Collection ........................................................................................................................ 13
Data Analysis ............................................................................................................................ 13
Ethical Issues ............................................................................................................................ 13
RESULTS
Accomplishment of CCEBDM Objectives ................................................................................ 17
Profile of the Respondents........................................................................................................ 14In-clinic Practice Adopted by the Respondents ........................................................................ 14
Curriculum Based Knowledge Enhancement ........................................................................... 14Respondents’ Feedback on Curriculum .................................................................................... 16Respondents’ Feedback on the Effectiveness of Course Curriculum ....................................... 16
Impact of the Course on Respondents’ Clinical Practice .......................................................... 17
LIMITATIONS OF THE STUDY
REFERENCES
CONCLUSION
Certificate Course in Evidence Based Diabetes Management
3
Page Nos.
6
7
9
12
14
18
19
19
ACRONYMS & ABBREVIATIONS 5
99101111
CONTENTS
PREFACE
EXECUTIVE SUMMARY
BACKGROUND & INTRODUCTION
Diabetes, the Global Epidemic ................................................................................................ Rational of the Program ........................................................................................................... Overview of Certificate Course in Evidence Based Diabetes Management ............................Evaluation Plan ........................ ................................................................................................Objectives of Evaluation ..........................................................................................................
METHODOLOGY
Study Design ............................................................................................................................ 12
Study Population ...................................................................................................................... 12Sample Size .............................................................................................................................. 12
Sampling ................................................................................................................................... 12
Data Collection ........................................................................................................................ 13
Data Analysis ............................................................................................................................ 13
Ethical Issues ............................................................................................................................ 13
RESULTS
Accomplishment of CCEBDM Objectives ................................................................................ 17
Profile of the Respondents........................................................................................................ 14In-clinic Practice Adopted by the Respondents ........................................................................ 14
Curriculum Based Knowledge Enhancement ........................................................................... 14Respondents’ Feedback on Curriculum .................................................................................... 16Respondents’ Feedback on the Effectiveness of Course Curriculum ....................................... 16
Impact of the Course on Respondents’ Clinical Practice .......................................................... 17
LIMITATIONS OF THE STUDY
REFERENCES
CONCLUSION
Certificate Course in Evidence Based Diabetes Management
3
Page Nos.
6
7
9
12
14
18
19
19
ACRONYMS & ABBREVIATIONS 5
99101111
Appendix 1: Tables And Figures
Table 1: State Wise Distribution of Sample.......................................................................... 20
Table 2: In-clinic Facilities Provided by the Respondents ................................................... 22
Table 3: Number of Patients Treated in Last Month ........................................................... 22
Table 4: Curriculum Based Knowledge Improvements and
Value Addition of Course to Clinical Practice ...................................................... 22
Table 5: Knowledge Enhancement n Management of Diabetes Related Complications .. 23
Table 6: Respondents Feedback on the Course Curriculum ............................................. 24
Table 7: Respondents Feedback on the Teaching Methods and Teaching Environment... 24
Table 8: Respondents’ Preference on the Modules for Knowledge Enrichment .............. 25
Table 9: Most Useful Topics in Curriculum ......................................................................... 25
Table 10: Improvisation in the Clinical Practices by Respondents
After Completion of this Course ......................................................................... 26
Table 11: Professional Network .......................................................................................... 26
Figure 1: Gender Distribution ............................................................................................. 27
Figure 2: Participants’ Qualification ..................................................................................... 27
Figure 3: Sector Affiliation ........................................................................................... ........ 27
................................................................................................... 20
Appendix 2: Consent Form ................................................................................................. . . ..... 28
Appendix 3: Participant Interview Questionnaire ........................................................................ 30
Appendix 4: List of Evaluators...................................................................................................... 38
Appendix 5: List of CCEBDM Modules ........................................................................................ 39
Appendix 6: Centre Location Map, CCEBDM Cycle III .............................................................. 40
APPENDIX 20 ACRONYMS & ABBREVIATIONSCCEBDM Certificate Course in Evidence Based Diabetes Management
DALY Disability Adjusted Life Years
DM Doctorate of Medicine
DMDEA Dr Mohan’s Diabetes Education Academy
DNB Diplomate of National Board
HT Hindustan Times
IDF International Diabetes Federation
IIPH Indian Institute of Public Health
MD Doctor of Medicine
MSD Merck , Sharp and Dohme Pharmaceuticals India Private Limited
NCDs Non-communicable Diseases
PhD Doctor of Philosophy
PHFI Public Health Foundation of India
T2DM Type 2 Diabetes Mellitus
US United States
WHO World Health Organization
4
CCEBDM Cycle-III (Feb 2013-Jan 2014)EVALUATION REPORT Certificate Course in Evidence Based Diabetes Management
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Appendix 1: Tables And Figures
Table 1: State Wise Distribution of Sample.......................................................................... 20
Table 2: In-clinic Facilities Provided by the Respondents ................................................... 22
Table 3: Number of Patients Treated in Last Month ........................................................... 22
Table 4: Curriculum Based Knowledge Improvements and
Value Addition of Course to Clinical Practice ...................................................... 22
Table 5: Knowledge Enhancement n Management of Diabetes Related Complications .. 23
Table 6: Respondents Feedback on the Course Curriculum ............................................. 24
Table 7: Respondents Feedback on the Teaching Methods and Teaching Environment... 24
Table 8: Respondents’ Preference on the Modules for Knowledge Enrichment .............. 25
Table 9: Most Useful Topics in Curriculum ......................................................................... 25
Table 10: Improvisation in the Clinical Practices by Respondents
After Completion of this Course ......................................................................... 26
Table 11: Professional Network .......................................................................................... 26
Figure 1: Gender Distribution ............................................................................................. 27
Figure 2: Participants’ Qualification ..................................................................................... 27
Figure 3: Sector Affiliation ........................................................................................... ........ 27
................................................................................................... 20
Appendix 2: Consent Form ................................................................................................. . . ..... 28
Appendix 3: Participant Interview Questionnaire ........................................................................ 30
Appendix 4: List of Evaluators...................................................................................................... 38
Appendix 5: List of CCEBDM Modules ........................................................................................ 39
Appendix 6: Centre Location Map, CCEBDM Cycle III .............................................................. 40
APPENDIX 20 ACRONYMS & ABBREVIATIONSCCEBDM Certificate Course in Evidence Based Diabetes Management
DALY Disability Adjusted Life Years
DM Doctorate of Medicine
DMDEA Dr Mohan’s Diabetes Education Academy
DNB Diplomate of National Board
HT Hindustan Times
IDF International Diabetes Federation
IIPH Indian Institute of Public Health
MD Doctor of Medicine
MSD Merck , Sharp and Dohme Pharmaceuticals India Private Limited
NCDs Non-communicable Diseases
PhD Doctor of Philosophy
PHFI Public Health Foundation of India
T2DM Type 2 Diabetes Mellitus
US United States
WHO World Health Organization
4
CCEBDM Cycle-III (Feb 2013-Jan 2014)EVALUATION REPORT Certificate Course in Evidence Based Diabetes Management
5
PREFACEAccording to the World Health Organization (WHO) Media centre, (Diabetes Factsheet, 2013),
347 million people worldwide have diabetes and by 2035, this will rise to 592 million. WHO
projects that diabetes will be the 7th leading cause of death in 2030. But healthy diet, regular
physical activity, maintaining a normal body weight and avoiding tobacco use can prevent or delay
the onset of type 2 diabetes. India, with more than 65 million diabetics represents the world’s
second largest diabetes population after China (IDF, Diabetes Atlas, 6th edition, 2013). It is
estimated that by 2035, every fifth person with diabetes will be an Indian. Due to this, the
economic burden in India will be highest in the world. India’s diabetes statistics may ring alarming
bells for the government and healthcare authorities (HT Correspondent, Hindustan Times).
Recognition of this fact has fueled the growth and development of formalized diabetes education
throughout the world. Hence, the Certificate Course in Evidence Based Diabetes Management
(CCEBDM) has been devised to train the primary care physicians in India.
The Certificate Course in Evidence Based Diabetes Management is a 12 modular course with
once a month contact session for primary care physicians. The CCEBDM is a joint certification by
Public Health Foundation of India (PHFI) and Dr. Mohan’s Diabetes Education Academy
(DMDEA), Chennai, delivered by PHFI, New Delhi and supported with an unrestricted
educational grant provided by MSD Pharmaceutical Pvt. Ltd. India.
CCEBDM started its journey as Cycle I in August 2010 with 100 centres in 57 cities across 18
states with enrolment of 1208 participants, which concluded in July 2011. Following the success
of first cycle, CCEBDM launched its second cycle on December 2011 with 119 centres across 65
cities in 19 states and 1 UT. Total number of participants enrolled in Cycle II were 1568. Recently,
we completed CCEBDM Cycle III in January 2014 in which 2306 participants were enroled in 134
centers across 73 cities in 19 states and 1 Union Territory and conducted a nation-wide evaluation
of the program to assess the effectiveness of this PAN India program in delivering the evidence
based knowledge from February 2014 to March 2014.
We are thankful to our team of 31 observers who undertook the extensive evaluation process
and collected the feedback of 185 participants all across the country. This report is an effort to
compile the results of evaluation process and we will try to incorporate the suggestions given by
the participants in upcoming cycles. Also, we would like to thank our educational grant partner
MSD Pharmaceutical Pvt Ltd, India for their continuous support in completing this cycle
successfully.
The Public Health Foundation of India, New Delhi and Dr Mohan’s Diabetes Education Academy, Chennai
EXECUTIVE SUMMARYThis summary provides an overview of the key findings from data collected and feedback
received during the course of one and half month long evaluation process of Certificate Course
in Evidence Based Diabetes Management, Cycle III. This program is aimed to improve the
knowledge and skills of primary care physicians for better diabetes management and to build
the network among primary care physicians and already existing endocrinologist and
diabetologist for knowledge sharing and better referral mechanism.
The purpose of the comprehensive evaluation was to identify challenges, barriers and potential
solutions to improve the quality of evidence based diabetes care education offered by the
CCEBDM.
Cross sectional study design was used in this evaluation and stratified random sampling
techniques was used to identify the sampling units from two strata i.e. graduates and post
graduates. 185 CCEBDM participants were randomly selected out of the total enrolled in
Cycle III and only eligible participants were included in the evaluation process. Mixed method
approach was used to collect the data in the form of closed as well as open ended
questionnaire. Collected data is entered and analysed using Microsoft Access and excel.
KEY FINDINGS:
The course has helped in knowledge enhancement of 97 percent of the respondents in
terms of prevention, investigation, diagnosis and treatment of diabetes
Around 88 percent of the respondents agreed that this course has added value in
planning a routine treatment of diabetic patients
All respondents agreed that they are now able to manage hypoglycaemia
independently and providing life style modification advices to diabetic patients
Almost 70 percent respondents can now identify and refer the complicated cases
to speciality centers and remaining stated that now they can manage such cases
independently
Majority of respondents (97 percent) were confident in managing patients on insulin
after completion of this course
6
CCEBDM Cycle-III (Feb 2013-Jan 2014)EVALUATION REPORT Certificate Course in Evidence Based Diabetes Management
7
PREFACEAccording to the World Health Organization (WHO) Media centre, (Diabetes Factsheet, 2013),
347 million people worldwide have diabetes and by 2035, this will rise to 592 million. WHO
projects that diabetes will be the 7th leading cause of death in 2030. But healthy diet, regular
physical activity, maintaining a normal body weight and avoiding tobacco use can prevent or delay
the onset of type 2 diabetes. India, with more than 65 million diabetics represents the world’s
second largest diabetes population after China (IDF, Diabetes Atlas, 6th edition, 2013). It is
estimated that by 2035, every fifth person with diabetes will be an Indian. Due to this, the
economic burden in India will be highest in the world. India’s diabetes statistics may ring alarming
bells for the government and healthcare authorities (HT Correspondent, Hindustan Times).
Recognition of this fact has fueled the growth and development of formalized diabetes education
throughout the world. Hence, the Certificate Course in Evidence Based Diabetes Management
(CCEBDM) has been devised to train the primary care physicians in India.
The Certificate Course in Evidence Based Diabetes Management is a 12 modular course with
once a month contact session for primary care physicians. The CCEBDM is a joint certification by
Public Health Foundation of India (PHFI) and Dr. Mohan’s Diabetes Education Academy
(DMDEA), Chennai, delivered by PHFI, New Delhi and supported with an unrestricted
educational grant provided by MSD Pharmaceutical Pvt. Ltd. India.
CCEBDM started its journey as Cycle I in August 2010 with 100 centres in 57 cities across 18
states with enrolment of 1208 participants, which concluded in July 2011. Following the success
of first cycle, CCEBDM launched its second cycle on December 2011 with 119 centres across 65
cities in 19 states and 1 UT. Total number of participants enrolled in Cycle II were 1568. Recently,
we completed CCEBDM Cycle III in January 2014 in which 2306 participants were enroled in 134
centers across 73 cities in 19 states and 1 Union Territory and conducted a nation-wide evaluation
of the program to assess the effectiveness of this PAN India program in delivering the evidence
based knowledge from February 2014 to March 2014.
We are thankful to our team of 31 observers who undertook the extensive evaluation process
and collected the feedback of 185 participants all across the country. This report is an effort to
compile the results of evaluation process and we will try to incorporate the suggestions given by
the participants in upcoming cycles. Also, we would like to thank our educational grant partner
MSD Pharmaceutical Pvt Ltd, India for their continuous support in completing this cycle
successfully.
The Public Health Foundation of India, New Delhi and Dr Mohan’s Diabetes Education Academy, Chennai
EXECUTIVE SUMMARYThis summary provides an overview of the key findings from data collected and feedback
received during the course of one and half month long evaluation process of Certificate Course
in Evidence Based Diabetes Management, Cycle III. This program is aimed to improve the
knowledge and skills of primary care physicians for better diabetes management and to build
the network among primary care physicians and already existing endocrinologist and
diabetologist for knowledge sharing and better referral mechanism.
The purpose of the comprehensive evaluation was to identify challenges, barriers and potential
solutions to improve the quality of evidence based diabetes care education offered by the
CCEBDM.
Cross sectional study design was used in this evaluation and stratified random sampling
techniques was used to identify the sampling units from two strata i.e. graduates and post
graduates. 185 CCEBDM participants were randomly selected out of the total enrolled in
Cycle III and only eligible participants were included in the evaluation process. Mixed method
approach was used to collect the data in the form of closed as well as open ended
questionnaire. Collected data is entered and analysed using Microsoft Access and excel.
KEY FINDINGS:
The course has helped in knowledge enhancement of 97 percent of the respondents in
terms of prevention, investigation, diagnosis and treatment of diabetes
Around 88 percent of the respondents agreed that this course has added value in
planning a routine treatment of diabetic patients
All respondents agreed that they are now able to manage hypoglycaemia
independently and providing life style modification advices to diabetic patients
Almost 70 percent respondents can now identify and refer the complicated cases
to speciality centers and remaining stated that now they can manage such cases
independently
Majority of respondents (97 percent) were confident in managing patients on insulin
after completion of this course
6
CCEBDM Cycle-III (Feb 2013-Jan 2014)EVALUATION REPORT Certificate Course in Evidence Based Diabetes Management
7
BACKGROUND & INTRODUCTIONDiabetes, the Global Epidemic: Diabetes Mellitus (DM) is now one of the most common non-
communicable diseases (NCDs) globally. It is the fourth leading cause of death in most high-
income countries and there is substantial evidences that it is an epidemic in many developing and
newly industrialized nations. Complications from diabetes, such as coronary artery and peripheral
vascular disease, stroke, diabetic neuropathy, amputations, renal failure and blindness are resulting
in increased DALY and huge health cost for every society. Diabetes is undoubtedly one of the most
challenging health problems of 21st century [1].
As documented by International Diabetes Federation (IDF), the estimated diabetes prevalence for
2013 rose to 382 million, representing 8.3% of the world’s adult population, with a prediction that
by 2035 the number of people with diabetes will have risen to 592 million [1]. Also, India has
second largest number of people suffering from diabetes in the world. It is estimated that by 2035,
India will have 109.0 million people with diabetes, second to China which will have 142.7 million
diabetics. In India, 1.1 million deaths were attributable to diabetes in 2013, which was highest in
the region.
Rational of the Program: Unlike other developing countries in the world, primary care
physicians play a major role in prevention, detection and management of diabetes mellitus in India.
Primary care physicians provide updated evidence based diabetic care to these patients. Incidence
and progression of many diabetes related complications can be reduced by effective diabetes
management [3]. But studies from different parts of the world showed that the knowledge of these
primary care physicians about diagnosis and treatment is not up to date, also their skills in managing
diabetes related acute and chronic complications are poor. According to a study conducted in Sri
Lanka, more than 50% of general practitioners actually don’t know the correct cut off value of
blood glucose to diagnose diabetes [4]. Primary care physicians in Canada face problems in
meeting the expectation of patients with diabetes as diabetes progresses because the lack in
knowledge related to diabetes treatment [5]. According to a study conducted by Desai A et al on
challenges in prevention and management of diabetes mellitus and metabolic syndrome, primary
care physicians are responsible for delayed management due to their sub-optimal knowledge of
guidelines [6]. Also, many of these studies showed the non-existence of a standardized system of
diabetes management and treatment. Many primary care physicians require updated evidence
based information to keep their educational as well as clinical skills updated [7]. Another study
upon U.S. – practicing physicians showed that continuous education improves the evidence based
clinical choices in response to management [8]. Diabetes education programs in India also showed
significant improvement in primary care physicians’ knowledge, skills and confidence level of
treating diabetic patients more effectively and independently [9]. Different studies also highlighted
the urgent need of strategies for better management and spread of awareness by the health care
providers [6]. Evidence-based medicine has been defined as the amalgamation of latest available
clinical research, physicians’ experience, and patient values i.e. their needs and expectations [1].
Healthcare professionals need up-to-date information on diabetes management and skills to treat
and educate patients with diabetes mellitus [2].
More than 90 percent of the respondents agreed that they are now able to manage
most of the diabetes related complications
All respondents agreed on the point that the course curriculum was up to date and 89
percent stated that there were adequate practical case studies in the curriculum
According to 94 percent of the respondents, the teaching methodology adopted by the
faculty was effective and 97 percent stated that the contact sessions were very
interactive and informative
The respondents (81 percent) informed the interviewers that faculty was very
enthusiastic and used extra slides for better understanding of the important topics.
Almost all the respondents were satisfied with the curriculum structure and preferred
all the modules for knowledge enhancement.
After completion of the course, some physicians set up their own diabetic clinics. Many of them
started providing patient education resources at their clinics and started incorporating updated
clinical guidelines in their day to day practice.
The course has helped in enhancing the knowledge and skills of primary care physicians and
equipped them to manage diabetics in their daily clinical practice. Participants strongly agreed
that the course has appraised them with the newer and updated techniques in treating diabetic
which will be very helpful in better patient outcome.
8
CCEBDM Cycle-III (Feb 2013-Jan 2014)EVALUATION REPORT Certificate Course in Evidence Based Diabetes Management
9
BACKGROUND & INTRODUCTIONDiabetes, the Global Epidemic: Diabetes Mellitus (DM) is now one of the most common non-
communicable diseases (NCDs) globally. It is the fourth leading cause of death in most high-
income countries and there is substantial evidences that it is an epidemic in many developing and
newly industrialized nations. Complications from diabetes, such as coronary artery and peripheral
vascular disease, stroke, diabetic neuropathy, amputations, renal failure and blindness are resulting
in increased DALY and huge health cost for every society. Diabetes is undoubtedly one of the most
challenging health problems of 21st century [1].
As documented by International Diabetes Federation (IDF), the estimated diabetes prevalence for
2013 rose to 382 million, representing 8.3% of the world’s adult population, with a prediction that
by 2035 the number of people with diabetes will have risen to 592 million [1]. Also, India has
second largest number of people suffering from diabetes in the world. It is estimated that by 2035,
India will have 109.0 million people with diabetes, second to China which will have 142.7 million
diabetics. In India, 1.1 million deaths were attributable to diabetes in 2013, which was highest in
the region.
Rational of the Program: Unlike other developing countries in the world, primary care
physicians play a major role in prevention, detection and management of diabetes mellitus in India.
Primary care physicians provide updated evidence based diabetic care to these patients. Incidence
and progression of many diabetes related complications can be reduced by effective diabetes
management [3]. But studies from different parts of the world showed that the knowledge of these
primary care physicians about diagnosis and treatment is not up to date, also their skills in managing
diabetes related acute and chronic complications are poor. According to a study conducted in Sri
Lanka, more than 50% of general practitioners actually don’t know the correct cut off value of
blood glucose to diagnose diabetes [4]. Primary care physicians in Canada face problems in
meeting the expectation of patients with diabetes as diabetes progresses because the lack in
knowledge related to diabetes treatment [5]. According to a study conducted by Desai A et al on
challenges in prevention and management of diabetes mellitus and metabolic syndrome, primary
care physicians are responsible for delayed management due to their sub-optimal knowledge of
guidelines [6]. Also, many of these studies showed the non-existence of a standardized system of
diabetes management and treatment. Many primary care physicians require updated evidence
based information to keep their educational as well as clinical skills updated [7]. Another study
upon U.S. – practicing physicians showed that continuous education improves the evidence based
clinical choices in response to management [8]. Diabetes education programs in India also showed
significant improvement in primary care physicians’ knowledge, skills and confidence level of
treating diabetic patients more effectively and independently [9]. Different studies also highlighted
the urgent need of strategies for better management and spread of awareness by the health care
providers [6]. Evidence-based medicine has been defined as the amalgamation of latest available
clinical research, physicians’ experience, and patient values i.e. their needs and expectations [1].
Healthcare professionals need up-to-date information on diabetes management and skills to treat
and educate patients with diabetes mellitus [2].
More than 90 percent of the respondents agreed that they are now able to manage
most of the diabetes related complications
All respondents agreed on the point that the course curriculum was up to date and 89
percent stated that there were adequate practical case studies in the curriculum
According to 94 percent of the respondents, the teaching methodology adopted by the
faculty was effective and 97 percent stated that the contact sessions were very
interactive and informative
The respondents (81 percent) informed the interviewers that faculty was very
enthusiastic and used extra slides for better understanding of the important topics.
Almost all the respondents were satisfied with the curriculum structure and preferred
all the modules for knowledge enhancement.
After completion of the course, some physicians set up their own diabetic clinics. Many of them
started providing patient education resources at their clinics and started incorporating updated
clinical guidelines in their day to day practice.
The course has helped in enhancing the knowledge and skills of primary care physicians and
equipped them to manage diabetics in their daily clinical practice. Participants strongly agreed
that the course has appraised them with the newer and updated techniques in treating diabetic
which will be very helpful in better patient outcome.
8
CCEBDM Cycle-III (Feb 2013-Jan 2014)EVALUATION REPORT Certificate Course in Evidence Based Diabetes Management
9
Several studies have been undertaken in the country to show the poor quality of care rendered to
diabetic patients in the country. Also, many of these studies showed the non-existence of a
standardized system of diabetes management and treatment. In a large multi-center collaborative
observational study consisting of 100 consecutive reviews patients treated for more than one year
at each of the 26 participating centres showed that type 2 diabetes begins at an early age amongst
Indians [3]. With increasing duration of diabetes and uncontrolled glycaemic load resulted in late
onset of complications. Diabetes care in India need concerted efforts to increase awareness
amongst health professionals. These studies also showed that increasing awareness about the
current status of diabetes care provides a useful benchmark to plan future improvements [3].
Research studies also highlighted the lack of awareness and patient education resources for
Diabetes in India. In a study conducted in southern India involving 3681 adults, results showed that
knowledge regarding causes of diabetes, its prevention and the methods to improve health was
significantly low among the general population. The study also highlighted the urgent need of
strategies for better management and spread of awareness by the health care providers [4].
Overview of Certificate Course in Evidence Based Diabetes Management: Keeping in
mind the urgency and need of the time, Public Health Foundation of India launched Certificate
Course in Evidence Based Diabetes Management (CCEBDM) in collaboration with Dr Mohan’s
Diabetes Education Academy (DMDEA). CCEBDM is based on the principles of Evidence Based
Guideline. The fundamental objective of CCEBDM is to improve treatment outcome for patients
by serving as evidence based guidance for clinical decision making in risk assessment, diagnosis,
prognosis and management of diabetes. It is an effort to translate and transfer emerging evidences
from clinical research to clinical practice.
CCEBDM is a country wide initiative launched with 100 centres in 57 cities across 18 states in
Cycle-I and after the roaring success of Cycle-I, expanded to 119 centres in 65 cities across 19
states and 1 Union Territory in Cycle-II. In January 2014, CCEBDM completed its third cycle
successfully in 134 centres across 73 cities in 19 states and 1 . The
core groups involved in the course were the National Experts, Regional Faculty and Observers. A
panel of 15 National Experts was involved in the review of curriculum and helped in deciding the
course modalities. In cycle-III a group of 164 Regional Faculty provided education to participants at
134 centres. There were 104 single trainer centres and 30 merged centres with two Regional
Faculty. The ratio of trainer to participant is 1: 10-15. The course had an enrolment of 2306
participants. A network of 84 eminent Observers from all over the country were involved in
regular monitoring of the Program.
Union Territory (Appendix 6)
Evaluation Plan: The evaluation for Certificate Course in Evidence Based Diabetes Management
was conducted in two months (February 2014 and March 2014) following the completion of
module 12 and the exit-examination conducted in January 2014. The evaluation was the
amalgamation of overall experiences of participants during the program. The objectives of the
CCEBDM, Cycle III evaluation were as follows:
OBJECTIVES OF EVALUATION:
To identify the challenges, barriers and potential solutions to improve quality of
evidence based diabetes care education offered by the course.
Primary objective:
Secondary objective:
To describe the clinic structure and diabetes management strategies of diabetes clinics
of the enrolled participants.
To assess the potential for the establishment of networks between primary care
physicians and existing specialized diabetes care centres for improving the patient
outcomes in diabetes care.
To collate the inputs and feedbacks of enrolled & eligible participants over the
improvement of the course for the next batches and identify the future potentials for
such type of advanced courses
10
CCEBDM Cycle-III (Feb 2013-Jan 2014)EVALUATION REPORT Certificate Course in Evidence Based Diabetes Management
11
The evaluation thoroughly examined the input, process, output and outcome of the program. It
measured the improvement in the knowledge and skills of all the eligible participants of CCEBDM
Cycle III in terms of diabetes management. It was also crucial to understand the barriers and
challenges of quality diabetes care. The evaluation of CCEBDM, Cycle III proved to be very critical
for improvising the curriculum for the next cycle.
Several studies have been undertaken in the country to show the poor quality of care rendered to
diabetic patients in the country. Also, many of these studies showed the non-existence of a
standardized system of diabetes management and treatment. In a large multi-center collaborative
observational study consisting of 100 consecutive reviews patients treated for more than one year
at each of the 26 participating centres showed that type 2 diabetes begins at an early age amongst
Indians [3]. With increasing duration of diabetes and uncontrolled glycaemic load resulted in late
onset of complications. Diabetes care in India need concerted efforts to increase awareness
amongst health professionals. These studies also showed that increasing awareness about the
current status of diabetes care provides a useful benchmark to plan future improvements [3].
Research studies also highlighted the lack of awareness and patient education resources for
Diabetes in India. In a study conducted in southern India involving 3681 adults, results showed that
knowledge regarding causes of diabetes, its prevention and the methods to improve health was
significantly low among the general population. The study also highlighted the urgent need of
strategies for better management and spread of awareness by the health care providers [4].
Overview of Certificate Course in Evidence Based Diabetes Management: Keeping in
mind the urgency and need of the time, Public Health Foundation of India launched Certificate
Course in Evidence Based Diabetes Management (CCEBDM) in collaboration with Dr Mohan’s
Diabetes Education Academy (DMDEA). CCEBDM is based on the principles of Evidence Based
Guideline. The fundamental objective of CCEBDM is to improve treatment outcome for patients
by serving as evidence based guidance for clinical decision making in risk assessment, diagnosis,
prognosis and management of diabetes. It is an effort to translate and transfer emerging evidences
from clinical research to clinical practice.
CCEBDM is a country wide initiative launched with 100 centres in 57 cities across 18 states in
Cycle-I and after the roaring success of Cycle-I, expanded to 119 centres in 65 cities across 19
states and 1 Union Territory in Cycle-II. In January 2014, CCEBDM completed its third cycle
successfully in 134 centres across 73 cities in 19 states and 1 . The
core groups involved in the course were the National Experts, Regional Faculty and Observers. A
panel of 15 National Experts was involved in the review of curriculum and helped in deciding the
course modalities. In cycle-III a group of 164 Regional Faculty provided education to participants at
134 centres. There were 104 single trainer centres and 30 merged centres with two Regional
Faculty. The ratio of trainer to participant is 1: 10-15. The course had an enrolment of 2306
participants. A network of 84 eminent Observers from all over the country were involved in
regular monitoring of the Program.
Union Territory (Appendix 6)
Evaluation Plan: The evaluation for Certificate Course in Evidence Based Diabetes Management
was conducted in two months (February 2014 and March 2014) following the completion of
module 12 and the exit-examination conducted in January 2014. The evaluation was the
amalgamation of overall experiences of participants during the program. The objectives of the
CCEBDM, Cycle III evaluation were as follows:
OBJECTIVES OF EVALUATION:
To identify the challenges, barriers and potential solutions to improve quality of
evidence based diabetes care education offered by the course.
Primary objective:
Secondary objective:
To describe the clinic structure and diabetes management strategies of diabetes clinics
of the enrolled participants.
To assess the potential for the establishment of networks between primary care
physicians and existing specialized diabetes care centres for improving the patient
outcomes in diabetes care.
To collate the inputs and feedbacks of enrolled & eligible participants over the
improvement of the course for the next batches and identify the future potentials for
such type of advanced courses
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The evaluation thoroughly examined the input, process, output and outcome of the program. It
measured the improvement in the knowledge and skills of all the eligible participants of CCEBDM
Cycle III in terms of diabetes management. It was also crucial to understand the barriers and
challenges of quality diabetes care. The evaluation of CCEBDM, Cycle III proved to be very critical
for improvising the curriculum for the next cycle.
Data Collection: Evaluation was conducted using a self-administered participant interview
questionnaire (Appendix 3). This tool was developed by the CCEBDM team members after the
discussion and consultation with the evaluators who were responsible for conducting the
evaluation. Tool consists of questions on clinical practices, feedback on curriculum and
effectiveness of the program in meeting program’s objectives. Interview schedule has open as well
as closes ended questions. Likert scale (strongly agree, agree, neither agree nor disagree, disagree,
strongly disagree) was used to assess their confidence level and feedback. Tool was used by the
evaluators for making on-site observations as well as interviewing the participants about the
impact of the course whether it has helped them in improving their diabetes management
practices and to assess the self-perceived improvements in knowledge and clinical skills adopted by
the 185 participants after the completion of CCEBDM. The tool was divided into four major
sections to capture the responses of the participants:
• Participant Information
• Clinical Practice Structure Information
• Feedback on CCEBDM Curriculum
• Feedback on Faculty, Teaching Methods and Environment
Data Analysis: The data was entered and maintained in Microsoft Access and Excel 2010
respectively. Appropriate themes and domains were identified and described accordingly.
Ethical Issues: A written informed consent (Appendix 2) was obtained from all the participants
after explaining the purpose of the study. All the steps of informed consent were followed as
prescribed and approved by the Ethics Review Committee of Public Health Foundation of India -
New Delhi. The data (both paper and electronic) was kept confidential. The results of the
evaluation will be shared with stakeholders, larger groups of researchers and academicians within
or outside the organization. The results of the study will be examined and strategically discussed by
the management and the stakeholders of the program for the improvement of the program for
future prospects and quality delivery of the program.
Study Design: A cross sectional survey on diabetes management strategies practised by 185
CCEBDM Participants at their diabetes clinics was conducted across the country. The evaluation
was conducted by 31 randomly selected evaluators (Appendix 4) from the team of CCEBDM
Observers comprising of faculties from IIPH-Delhi, IIPH-Hyderabad, CCEBDM Program
Secretariat, PHFI team members and doctors from medical colleges (public health specialists) and
other sectors.
Study Population: Study population of the evaluation was the participants of the program
enrolled under Cycle III (February 2013 – January 2014).
Sample Size: 185 CCEBDM Participants were randomly selected out of the total eligible
participants* in Cycle III from all across the country.
Sampling: A stratified random sampling technique was used for the selection of the sampling
units from 2109 eligible participants which comprised of 56.3 percent graduates and 43.7 percent
post graduates. The study population was stratified into two stratas (strata A & strata B).
Following in the description in the selected strata.
1. Strata A - Medical Graduates holding MBBS degree
2. Strata B - Medical Graduates holding MBBS degree along with MD/ DNB/ DM/ PhD
185 participants (93 graduates and 92 post graduates) were randomly selected from these two
strata. Same number of participants with similar representativeness were selected as buffer
sample. The butter was necessary to be identified keeping in view the feasibility, approachability,
availability and willingness of the respondent to take part in the evaluation study. So in total 370
participants were identified for this study.
METHODOLOGY
*completed all the interim assignments and scored more than 50 percent marks in exit exam Eligible Participants definition: The participants who has attended minimum 10 out of 12 contact sessions,
12
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Data Collection: Evaluation was conducted using a self-administered participant interview
questionnaire (Appendix 3). This tool was developed by the CCEBDM team members after the
discussion and consultation with the evaluators who were responsible for conducting the
evaluation. Tool consists of questions on clinical practices, feedback on curriculum and
effectiveness of the program in meeting program’s objectives. Interview schedule has open as well
as closes ended questions. Likert scale (strongly agree, agree, neither agree nor disagree, disagree,
strongly disagree) was used to assess their confidence level and feedback. Tool was used by the
evaluators for making on-site observations as well as interviewing the participants about the
impact of the course whether it has helped them in improving their diabetes management
practices and to assess the self-perceived improvements in knowledge and clinical skills adopted by
the 185 participants after the completion of CCEBDM. The tool was divided into four major
sections to capture the responses of the participants:
• Participant Information
• Clinical Practice Structure Information
• Feedback on CCEBDM Curriculum
• Feedback on Faculty, Teaching Methods and Environment
Data Analysis: The data was entered and maintained in Microsoft Access and Excel 2010
respectively. Appropriate themes and domains were identified and described accordingly.
Ethical Issues: A written informed consent (Appendix 2) was obtained from all the participants
after explaining the purpose of the study. All the steps of informed consent were followed as
prescribed and approved by the Ethics Review Committee of Public Health Foundation of India -
New Delhi. The data (both paper and electronic) was kept confidential. The results of the
evaluation will be shared with stakeholders, larger groups of researchers and academicians within
or outside the organization. The results of the study will be examined and strategically discussed by
the management and the stakeholders of the program for the improvement of the program for
future prospects and quality delivery of the program.
Study Design: A cross sectional survey on diabetes management strategies practised by 185
CCEBDM Participants at their diabetes clinics was conducted across the country. The evaluation
was conducted by 31 randomly selected evaluators (Appendix 4) from the team of CCEBDM
Observers comprising of faculties from IIPH-Delhi, IIPH-Hyderabad, CCEBDM Program
Secretariat, PHFI team members and doctors from medical colleges (public health specialists) and
other sectors.
Study Population: Study population of the evaluation was the participants of the program
enrolled under Cycle III (February 2013 – January 2014).
Sample Size: 185 CCEBDM Participants were randomly selected out of the total eligible
participants* in Cycle III from all across the country.
Sampling: A stratified random sampling technique was used for the selection of the sampling
units from 2109 eligible participants which comprised of 56.3 percent graduates and 43.7 percent
post graduates. The study population was stratified into two stratas (strata A & strata B).
Following in the description in the selected strata.
1. Strata A - Medical Graduates holding MBBS degree
2. Strata B - Medical Graduates holding MBBS degree along with MD/ DNB/ DM/ PhD
185 participants (93 graduates and 92 post graduates) were randomly selected from these two
strata. Same number of participants with similar representativeness were selected as buffer
sample. The butter was necessary to be identified keeping in view the feasibility, approachability,
availability and willingness of the respondent to take part in the evaluation study. So in total 370
participants were identified for this study.
METHODOLOGY
*completed all the interim assignments and scored more than 50 percent marks in exit exam Eligible Participants definition: The participants who has attended minimum 10 out of 12 contact sessions,
12
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In-Clinic Practice Adopted by the Respondents
Out of total sample, 44 percent have in-patient lab facilities while remaining 56 percent have association with external labs (table 2). 53 percent of all respondents were sending samples to external labs for the tests which were not conducted at their in-patient labs and labs associated with their clinics and majority of these tests were immunological tests, HBA1C, lipid profile, insulin peptide assay, creatinine albumin, thyroid tests etc.
Only 28 percent of the respondents have in house dietician for the diabetic patients and less than that (21 percent) have diabetes educator for the counselling of diabetic patients and their families.
Profile of the RespondentsFor the program evaluation, 185 participants from 59 cities across 19 states and 1 UT were interviewed from February 2014 to March 2014 (table 1).
RESULTS
The sample consisted of 71.9 percent male and 28.1 percent females (figure. 1). Respondents of the sample were equally represented across qualification line with 50.8 percent graduates and 49.2 percent post graduates (figure. 2). Average age of the sample was 40.5 years and average years of experience was 18.3 years (minimum 1 year, maximum 38 years). 53.5 percent of the sample were either private practitioners or associated with other private institutions, 41.6 percent were affiliated to government hospitals or medical colleges, 1.6 percent were engaged with non-profit organizations and rest 3.2 percent with autonomous bodies (figure. 3)
When enquired about the patient education resource, it was found that 55 percent of the respondents were providing patient education resources in the form of printed material (36.2 percent), videos(2.2 percent), printed as well as videos (10.3 percent) and in the form of group discussions/camps/lectures etc. (6.5 percent).
The median number of patients treated in last month by these respondents were 400 and 13.8 percent of these patients were diabetic (table 3)
Curriculum Based Knowledge Enhancement
All most all the respondents agreed that this course has improve their knowledge (92 percent strongly agree, 5 percent agree) and understanding about diabetes and the improved knowledge has added value to their routine treatment plans (88 percent strongly agree, 10 percent agree) (table 4).
When enquired further about the improvement in the clinical practices, 100 percent agreed that after completion of this course they started giving life style modification advices to diabetic patients. 69 percent were agreed on the point that they started referring complicated patients to specialists while 22 percent started treating these complicated cases on their own. After completion of this course, they (100 percent) became able in managing hypoglycaemic patients, 98 percent agreed on the point that now they are able to manage diabetic related complications and infection. And most importantly, 97 percent of them were now managing diabetic patients on insulin.
When questioned about the value addition in managing most common complications, respondents indicated that now they are able to manage peripheral neuropathy (97 percent), nephropathy (92 percent), cardiac complications (98 percent), diabetic foot (97 percent), retinopathy (92 percent) and skin lesions and infections (92 percent) very effectively and independently or in consultation with doctors having specialization in their perspective fields (table 5). While rest of the respondents reported that for treating these complications, they need special instruments and machines so they are not able to manage these complication independently. When a comparative analysis was done between graduates and postgraduates to assess any difference in the opinion of these two group regarding the value addition of this course to their knowledge and skills, it was found that there is no significant difference in their perception. Both groups agreed that this course was helpful in building their skills for better diabetes management. Also majority of respondents shared their experiences and cases which they have managed/treated independently after completion of this course.
Success stories shared by the respondents (during and after the course duration)
Respondent A -
Respondent B -
Respondent C -
Respondent D -
Respondent E -
Respondent F -
Respondent G -
A male patient 45 year old came with type 2 DM uncontrolled even with triple OHA. He was put on insulin & metformin, now his sugar is controlled well.
A patient of 68 year old with chest discomfort with dizziness, no history of DM in family. I treat him for ischemic heart disease in OPD but he is found diabetic with a sugar of 370mg/dl, so I admitted the patient in ICU, now he is started insulin & OHA
I successfully managed a case of DM Type 2, where the patient was uncontrolled previously on oral drugs & I switched him to Insulin. I was successful to modify diet of patient accordingly leading to better BMI and diabetic control of patient.
I remember one of my patients who came with extraction of tooth & following that there was constant oozing of blood form the affected area. I immediately went for his blood testing for FBS, PPBS & HbA1C. He was detected with uncontrolled diabetes and given OHA. Now he is fine.
Actually I have learnt to start insulin therapy to a patient who has uncontrolled diabetes posted for surgery without sending him/her to a physician for diabetes control before taking the patient for surgery
44 year old Male with past history of diabetes- 5years on Metformin & Glimepride- Uncontrolled. After the course added Sitagliptin which proved to be effective, DM could be controlled.
There were many cases I could confidently diagnose. A special case was 37 years male newly diagnosed which I could manage on insulin Basal+Bolus for the initial one month. Now it is on LSM+ Metformin 500mg RD
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In-Clinic Practice Adopted by the Respondents
Out of total sample, 44 percent have in-patient lab facilities while remaining 56 percent have association with external labs (table 2). 53 percent of all respondents were sending samples to external labs for the tests which were not conducted at their in-patient labs and labs associated with their clinics and majority of these tests were immunological tests, HBA1C, lipid profile, insulin peptide assay, creatinine albumin, thyroid tests etc.
Only 28 percent of the respondents have in house dietician for the diabetic patients and less than that (21 percent) have diabetes educator for the counselling of diabetic patients and their families.
Profile of the RespondentsFor the program evaluation, 185 participants from 59 cities across 19 states and 1 UT were interviewed from February 2014 to March 2014 (table 1).
RESULTS
The sample consisted of 71.9 percent male and 28.1 percent females (figure. 1). Respondents of the sample were equally represented across qualification line with 50.8 percent graduates and 49.2 percent post graduates (figure. 2). Average age of the sample was 40.5 years and average years of experience was 18.3 years (minimum 1 year, maximum 38 years). 53.5 percent of the sample were either private practitioners or associated with other private institutions, 41.6 percent were affiliated to government hospitals or medical colleges, 1.6 percent were engaged with non-profit organizations and rest 3.2 percent with autonomous bodies (figure. 3)
When enquired about the patient education resource, it was found that 55 percent of the respondents were providing patient education resources in the form of printed material (36.2 percent), videos(2.2 percent), printed as well as videos (10.3 percent) and in the form of group discussions/camps/lectures etc. (6.5 percent).
The median number of patients treated in last month by these respondents were 400 and 13.8 percent of these patients were diabetic (table 3)
Curriculum Based Knowledge Enhancement
All most all the respondents agreed that this course has improve their knowledge (92 percent strongly agree, 5 percent agree) and understanding about diabetes and the improved knowledge has added value to their routine treatment plans (88 percent strongly agree, 10 percent agree) (table 4).
When enquired further about the improvement in the clinical practices, 100 percent agreed that after completion of this course they started giving life style modification advices to diabetic patients. 69 percent were agreed on the point that they started referring complicated patients to specialists while 22 percent started treating these complicated cases on their own. After completion of this course, they (100 percent) became able in managing hypoglycaemic patients, 98 percent agreed on the point that now they are able to manage diabetic related complications and infection. And most importantly, 97 percent of them were now managing diabetic patients on insulin.
When questioned about the value addition in managing most common complications, respondents indicated that now they are able to manage peripheral neuropathy (97 percent), nephropathy (92 percent), cardiac complications (98 percent), diabetic foot (97 percent), retinopathy (92 percent) and skin lesions and infections (92 percent) very effectively and independently or in consultation with doctors having specialization in their perspective fields (table 5). While rest of the respondents reported that for treating these complications, they need special instruments and machines so they are not able to manage these complication independently. When a comparative analysis was done between graduates and postgraduates to assess any difference in the opinion of these two group regarding the value addition of this course to their knowledge and skills, it was found that there is no significant difference in their perception. Both groups agreed that this course was helpful in building their skills for better diabetes management. Also majority of respondents shared their experiences and cases which they have managed/treated independently after completion of this course.
Success stories shared by the respondents (during and after the course duration)
Respondent A -
Respondent B -
Respondent C -
Respondent D -
Respondent E -
Respondent F -
Respondent G -
A male patient 45 year old came with type 2 DM uncontrolled even with triple OHA. He was put on insulin & metformin, now his sugar is controlled well.
A patient of 68 year old with chest discomfort with dizziness, no history of DM in family. I treat him for ischemic heart disease in OPD but he is found diabetic with a sugar of 370mg/dl, so I admitted the patient in ICU, now he is started insulin & OHA
I successfully managed a case of DM Type 2, where the patient was uncontrolled previously on oral drugs & I switched him to Insulin. I was successful to modify diet of patient accordingly leading to better BMI and diabetic control of patient.
I remember one of my patients who came with extraction of tooth & following that there was constant oozing of blood form the affected area. I immediately went for his blood testing for FBS, PPBS & HbA1C. He was detected with uncontrolled diabetes and given OHA. Now he is fine.
Actually I have learnt to start insulin therapy to a patient who has uncontrolled diabetes posted for surgery without sending him/her to a physician for diabetes control before taking the patient for surgery
44 year old Male with past history of diabetes- 5years on Metformin & Glimepride- Uncontrolled. After the course added Sitagliptin which proved to be effective, DM could be controlled.
There were many cases I could confidently diagnose. A special case was 37 years male newly diagnosed which I could manage on insulin Basal+Bolus for the initial one month. Now it is on LSM+ Metformin 500mg RD
14
CCEBDM Cycle-III (Feb 2013-Jan 2014)EVALUATION REPORT Certificate Course in Evidence Based Diabetes Management
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In response to questions related to teaching methods, 94 percent respondents said that teaching
methods adopted by the faculty were effective, 96 percent agreed on the relevance of the material
and 97 percent stated that the sessions were interactive and informative, faculty involved each and
participants in the discussion (table 7). It was informed by 81 percent respondents that faculty used
additional slides for more information and knowledge sharing during the conduction of session,
this shows the dedication, enthusiasm and interest of the faculty.
In response to session conduction rating, 97 percent agreed that session conduction environment
was good and 94 percent said that support was provided to the participants in understanding the
diabetes related topics with real time case discussions by the faculty.
Almost all the respondents were satisfied with the usefulness of all the modules (Appendix 5)
(table 8). Most preferred module according to 100 percent respondents was “Approach to
pharmacotherapy of T2DM”. And “Presentation and initial evaluation of patients with T2DM”,
“Non pharmacological management of T2DM”, “Acute complications of T2DM” and “Chronic
complications of T2DM” were the second most preferred modules for knowledge enrichment
according to 99 percent of respondents. 98 percent and 97 percent respondents agreed that
modules on "Other Complications of T2DM" and "Introductory Overview of Diabetes Mellitus"
respectively were also preferred for knowledge and skill enhancement. “Other Types of DM” was
also useful module as per the knowledge of 92 percent respondents.
Respondents’ Feedback on the Effectiveness of Course Curriculum
When asked them to rank the topics in terms of usefulness, it was found that topic on “Approach to
pharmacotherapy of T2DM” was ranked number one by 68 percent of the respondents followed
by “Chronic complications of T2DM” (by 40 percent), “Acute complications of T2DM” (by 38
percent) and “Presentation and initial evaluation of patients with T2DM” by 30 percent of the
respondents (table 9).
Respondents’ Feedback on Curriculum
97 percent of the sample agreed that this course has added value to their knowledge and skills
about diabetes management (table 6). And majority of respondents stated that this course is up to
date (100 percent), covers all the relevant topics (88 percent), and has adequate case studies (89
percent) and ideal for learning (96 percent). 92 percent of the sample agreed that this course is
successful in achieving its second objective of establishing network among primary care physicians
and existing endocrinologists.
Impact of the Course on Respondents’ Clinical Practice
When asked about the changes, incorporated in their day to day practice after completion of this course, responses received were listed in the table 10. 14 respondents started focusing on the patient education, now they started using leaflets, audio-visual aid in their clinics, counselling and motivating the patients for healthy life style practices which they were not practicing earlier. After completion of this course 4 respondents set up their own diabetes clinic. Some respondents upgraded their laboratory for diabetes related investigations and started using better injection practices and newer drugs for better management of diabetes. Few of the respondents, started using HbA1C as compulsory investigation for the doubtful cases coming to their clinic for treatment and practicing regular foot examination of the diabetic patients for early detection and management of diabetic foot practicing.
Accomplishment of CCEBDM Objectives
Based on the above stated results it is clear that CCEBDM has accomplished its primary objective to develop core skills and competencies in primary care physicians for the practice of evidence based diabetes more efficiently. Through the responses received from the respondents during the evaluation it was found that 92 percent of the sample agreed that this course was successful in building a professional network among the primary care physicians and existing diabetologist/ endocrinologists which is the second aim of CCEBDM (table 11). And all of the respondents were willing to recommend this course to their peer group. Respondents shared their network building experiences with the interviewer and some of them are written below:
Network Building Experiences of the Respondents
Respondent X -
Respondent Y -
Respondent Z -
Respondent M -
With well-known faculty member & fellow practitioners & by group discussion, I have started diabetic screening + awareness/ sensitising camp in many areas of their state
It helped in association with top practicing endocrinologists of this part of the country. It provided me an opportunity to interact with other participants, upgrade my knowledge on diabetes & its management
All physicians have decided to start a common counselling centres for all diabetics including physicians, dietician, physiotherapist which will be free of cost.
There is a Thrissur Diabetic club of which I am a member where consultants come together & discuss.
16
CCEBDM Cycle-III (Feb 2013-Jan 2014)EVALUATION REPORT Certificate Course in Evidence Based Diabetes Management
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In response to questions related to teaching methods, 94 percent respondents said that teaching
methods adopted by the faculty were effective, 96 percent agreed on the relevance of the material
and 97 percent stated that the sessions were interactive and informative, faculty involved each and
participants in the discussion (table 7). It was informed by 81 percent respondents that faculty used
additional slides for more information and knowledge sharing during the conduction of session,
this shows the dedication, enthusiasm and interest of the faculty.
In response to session conduction rating, 97 percent agreed that session conduction environment
was good and 94 percent said that support was provided to the participants in understanding the
diabetes related topics with real time case discussions by the faculty.
Almost all the respondents were satisfied with the usefulness of all the modules (Appendix 5)
(table 8). Most preferred module according to 100 percent respondents was “Approach to
pharmacotherapy of T2DM”. And “Presentation and initial evaluation of patients with T2DM”,
“Non pharmacological management of T2DM”, “Acute complications of T2DM” and “Chronic
complications of T2DM” were the second most preferred modules for knowledge enrichment
according to 99 percent of respondents. 98 percent and 97 percent respondents agreed that
modules on "Other Complications of T2DM" and "Introductory Overview of Diabetes Mellitus"
respectively were also preferred for knowledge and skill enhancement. “Other Types of DM” was
also useful module as per the knowledge of 92 percent respondents.
Respondents’ Feedback on the Effectiveness of Course Curriculum
When asked them to rank the topics in terms of usefulness, it was found that topic on “Approach to
pharmacotherapy of T2DM” was ranked number one by 68 percent of the respondents followed
by “Chronic complications of T2DM” (by 40 percent), “Acute complications of T2DM” (by 38
percent) and “Presentation and initial evaluation of patients with T2DM” by 30 percent of the
respondents (table 9).
Respondents’ Feedback on Curriculum
97 percent of the sample agreed that this course has added value to their knowledge and skills
about diabetes management (table 6). And majority of respondents stated that this course is up to
date (100 percent), covers all the relevant topics (88 percent), and has adequate case studies (89
percent) and ideal for learning (96 percent). 92 percent of the sample agreed that this course is
successful in achieving its second objective of establishing network among primary care physicians
and existing endocrinologists.
Impact of the Course on Respondents’ Clinical Practice
When asked about the changes, incorporated in their day to day practice after completion of this course, responses received were listed in the table 10. 14 respondents started focusing on the patient education, now they started using leaflets, audio-visual aid in their clinics, counselling and motivating the patients for healthy life style practices which they were not practicing earlier. After completion of this course 4 respondents set up their own diabetes clinic. Some respondents upgraded their laboratory for diabetes related investigations and started using better injection practices and newer drugs for better management of diabetes. Few of the respondents, started using HbA1C as compulsory investigation for the doubtful cases coming to their clinic for treatment and practicing regular foot examination of the diabetic patients for early detection and management of diabetic foot practicing.
Accomplishment of CCEBDM Objectives
Based on the above stated results it is clear that CCEBDM has accomplished its primary objective to develop core skills and competencies in primary care physicians for the practice of evidence based diabetes more efficiently. Through the responses received from the respondents during the evaluation it was found that 92 percent of the sample agreed that this course was successful in building a professional network among the primary care physicians and existing diabetologist/ endocrinologists which is the second aim of CCEBDM (table 11). And all of the respondents were willing to recommend this course to their peer group. Respondents shared their network building experiences with the interviewer and some of them are written below:
Network Building Experiences of the Respondents
Respondent X -
Respondent Y -
Respondent Z -
Respondent M -
With well-known faculty member & fellow practitioners & by group discussion, I have started diabetic screening + awareness/ sensitising camp in many areas of their state
It helped in association with top practicing endocrinologists of this part of the country. It provided me an opportunity to interact with other participants, upgrade my knowledge on diabetes & its management
All physicians have decided to start a common counselling centres for all diabetics including physicians, dietician, physiotherapist which will be free of cost.
There is a Thrissur Diabetic club of which I am a member where consultants come together & discuss.
16
CCEBDM Cycle-III (Feb 2013-Jan 2014)EVALUATION REPORT Certificate Course in Evidence Based Diabetes Management
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The evaluation findings suggests that CCEBDM Cycle-III has been clearly successful in meeting its
goal of improving the knowledge and skills of primary care physicians for the better diabetes
management and building a network among these physicians and already existing diabetic care
centres for better referral mechanism. It is found that the course is beneficial for both strata i.e.
graduates as well as post graduates. On one side graduates learned the treatment approach and
techniques for patient care, on the other sides post graduates learned the importance of patient
education and effective methods to do so, also they updated their knowledge with the latest
evidence based new treatment and diagnostic guidelines in this program. So this course proved to
be beneficial for all of the participants. Also, it highlighted the need of providing the updates and
newer concepts emerging globally in the field of diabetes care. This is especially important for a
country like India which is a leader in the global prevalence of diabetes.
The evaluation revealed that the program was very effective in accomplishing its learning
objectives. All participants agreed that this advanced course added significant knowledge in their
day to day clinical practice. It enabled them to make better diagnoses, effective treatment plans,
modify treatments based on individual patient needs and most importantly, manage the
complications which develop during the course of this chronic disease.
The other very important advantage of this course was the updated pharmacological knowledge
of insulin and other diabetic drugs. It made the participants more confident about selection,
planning and administration of insulin regimens and other drugs to their patients as per patient
needs. This showed that the course helped the participants in enhancing their diabetes
management competencies. The course encouraged general physicians to treat diabetic patients
in their routine practices too.
The interaction with the respondents revealed few improvisations that would help in enhancing
the content of this course even further. The need for more clinical scenario based case studies was
expressed by the majority of physicians. More practical information and updated data was
requested on topics like dietary counseling, surgeries useful in diabetes, diabetic retinopathy, in-
depth discussion over insulin regimen, diabetic nephropathy, cardiac and sexual complications.
The participants strongly suggested real time hospital sessions as part of the curriculum or live
case discussion via audio-visual aids. More emphasis was given by the respondents for inclusion of
recent guidelines developed by different bodies based on evidence based management.
The experiences and feedbacks shared by the respondents, clearly indicates the significance of
such type of evidence based courses to apprise them with the ever evolving, updated and newer
techniques in medical field. This will abreast them to practice these newer advanced clinical
approaches and achieve better patient outcome. This program with active involvement of all the
regional faculty and national experts has proved to be exceedingly successful in training primary
care physicians all across the country. It proved to be an ideal knowledge sharing model in which
physicians have an opportunity to connect with their peers, and at the same time build their clinical
strength.
CONCLUSION1. The current evaluation was limited in its scope as it involved only 185 participants due to time
and budgetary constraints. However, an effort was made to have a representative sample by adopting random sampling techniques for the selection of sampling units.
2. It is difficult for us to quantify the improvement in competencies of the participants in terms of knowledge and diabetes management skills in the absence of baseline data. So in this evaluation process data on improvement in the knowledge and skills were collected on recall basis.
1. International Diabetes Federation (IDF) (Sixth Edition, 2013) THE GLOBAL BURDEN.
2. Mohan, V and Radhika, G and Vijayalakshmi, P and Sudha, V (2010) Can the diabetes/cardiovascular disease epidemic in India be explained, at least in part, by excess refined grain (rice) intake? The Indian journal of medical research, 131 . pp. 369-72.
3. The DCCT Research Group: The effect of intensive treatment of diabetes on the development and progression of long term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993,329:683-9
4. Prasad K, Godwin RC, Muditha IW, Yashasvi SP, Mahesh GJ, Preethi W, David RM and Mohamed HRS. Asia Pac Fam Med. 2011,10:15
5. Sharon B, Margo R, Janine M, Sheryl I, Julie M, Clare L, Erin K, and Teik CO. Transition from specialist to primary diabetes care: A qualitative study of perspectives of primary care physicians. BMC Fam Pract. 2009; 10: 39.
6. Wangnoo SK, Maji D, Das AK, Rao PV, Moses A, Sethi B, Unnikrishnan AG, Kalra S, Balaji V, Bantwal G, Kesavadev J, Jain SM and Mala D. Barriers and solutions to diabetes management: An Indian perspective. Indian J Endocrinol Metab. 2013 Jul-Aug; 17(4): 594–601.
7. Brian K. Christina E, Karen A. The Need for a Community Diabetes Education Curriculum for Healthcare Professionals. The Journal of Continuing Education in Nursing. 2007;Volume 38,Issue 5: 227-231
8. Casebeer L, Brown J, Roepke N, Grimes C, Henson B, Palmore R, Shanette U, Granstaff and Salinas GD. Evidence-based choices of physicians: a comparative analysis of physicians participating in Internet CME and non-participants. BMC Medical Education 2010, 10:42
9. Joshi S, Joshi SK, Mohan V. Methodology and feasibility of a structured education program for diabetes education in India: The national diabetes educator program. Ind JEndMetabolism;2013,Vol
18
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19
LIMITATIONS OF THE STUDY
REFERENCES
The evaluation findings suggests that CCEBDM Cycle-III has been clearly successful in meeting its
goal of improving the knowledge and skills of primary care physicians for the better diabetes
management and building a network among these physicians and already existing diabetic care
centres for better referral mechanism. It is found that the course is beneficial for both strata i.e.
graduates as well as post graduates. On one side graduates learned the treatment approach and
techniques for patient care, on the other sides post graduates learned the importance of patient
education and effective methods to do so, also they updated their knowledge with the latest
evidence based new treatment and diagnostic guidelines in this program. So this course proved to
be beneficial for all of the participants. Also, it highlighted the need of providing the updates and
newer concepts emerging globally in the field of diabetes care. This is especially important for a
country like India which is a leader in the global prevalence of diabetes.
The evaluation revealed that the program was very effective in accomplishing its learning
objectives. All participants agreed that this advanced course added significant knowledge in their
day to day clinical practice. It enabled them to make better diagnoses, effective treatment plans,
modify treatments based on individual patient needs and most importantly, manage the
complications which develop during the course of this chronic disease.
The other very important advantage of this course was the updated pharmacological knowledge
of insulin and other diabetic drugs. It made the participants more confident about selection,
planning and administration of insulin regimens and other drugs to their patients as per patient
needs. This showed that the course helped the participants in enhancing their diabetes
management competencies. The course encouraged general physicians to treat diabetic patients
in their routine practices too.
The interaction with the respondents revealed few improvisations that would help in enhancing
the content of this course even further. The need for more clinical scenario based case studies was
expressed by the majority of physicians. More practical information and updated data was
requested on topics like dietary counseling, surgeries useful in diabetes, diabetic retinopathy, in-
depth discussion over insulin regimen, diabetic nephropathy, cardiac and sexual complications.
The participants strongly suggested real time hospital sessions as part of the curriculum or live
case discussion via audio-visual aids. More emphasis was given by the respondents for inclusion of
recent guidelines developed by different bodies based on evidence based management.
The experiences and feedbacks shared by the respondents, clearly indicates the significance of
such type of evidence based courses to apprise them with the ever evolving, updated and newer
techniques in medical field. This will abreast them to practice these newer advanced clinical
approaches and achieve better patient outcome. This program with active involvement of all the
regional faculty and national experts has proved to be exceedingly successful in training primary
care physicians all across the country. It proved to be an ideal knowledge sharing model in which
physicians have an opportunity to connect with their peers, and at the same time build their clinical
strength.
CONCLUSION1. The current evaluation was limited in its scope as it involved only 185 participants due to time
and budgetary constraints. However, an effort was made to have a representative sample by adopting random sampling techniques for the selection of sampling units.
2. It is difficult for us to quantify the improvement in competencies of the participants in terms of knowledge and diabetes management skills in the absence of baseline data. So in this evaluation process data on improvement in the knowledge and skills were collected on recall basis.
1. International Diabetes Federation (IDF) (Sixth Edition, 2013) THE GLOBAL BURDEN.
2. Mohan, V and Radhika, G and Vijayalakshmi, P and Sudha, V (2010) Can the diabetes/cardiovascular disease epidemic in India be explained, at least in part, by excess refined grain (rice) intake? The Indian journal of medical research, 131 . pp. 369-72.
3. The DCCT Research Group: The effect of intensive treatment of diabetes on the development and progression of long term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993,329:683-9
4. Prasad K, Godwin RC, Muditha IW, Yashasvi SP, Mahesh GJ, Preethi W, David RM and Mohamed HRS. Asia Pac Fam Med. 2011,10:15
5. Sharon B, Margo R, Janine M, Sheryl I, Julie M, Clare L, Erin K, and Teik CO. Transition from specialist to primary diabetes care: A qualitative study of perspectives of primary care physicians. BMC Fam Pract. 2009; 10: 39.
6. Wangnoo SK, Maji D, Das AK, Rao PV, Moses A, Sethi B, Unnikrishnan AG, Kalra S, Balaji V, Bantwal G, Kesavadev J, Jain SM and Mala D. Barriers and solutions to diabetes management: An Indian perspective. Indian J Endocrinol Metab. 2013 Jul-Aug; 17(4): 594–601.
7. Brian K. Christina E, Karen A. The Need for a Community Diabetes Education Curriculum for Healthcare Professionals. The Journal of Continuing Education in Nursing. 2007;Volume 38,Issue 5: 227-231
8. Casebeer L, Brown J, Roepke N, Grimes C, Henson B, Palmore R, Shanette U, Granstaff and Salinas GD. Evidence-based choices of physicians: a comparative analysis of physicians participating in Internet CME and non-participants. BMC Medical Education 2010, 10:42
9. Joshi S, Joshi SK, Mohan V. Methodology and feasibility of a structured education program for diabetes education in India: The national diabetes educator program. Ind JEndMetabolism;2013,Vol
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LIMITATIONS OF THE STUDY
REFERENCES
APPENDIX1:
TABLES AND FIGURESTable 1: State Wise Distribution of Sample
StatesTotal
Number of Participants
CitiesDistribution of
Participants
Andhra Pradesh 10
Hyderabad
Vizag
Kakinada
4
4
2
Assam
Bihar
Chandigarh
Chhattisgarh
Delhi
4
2
2
4
8
Guwahati
Patna
Chandigarh
Raipur
New Delhi
4
2
2
4
8
Gujarat 8
Ahmedabad
Rajkot
Vadodara
4
2
2
HaryanaHisar
Faridabad4
2
2
Jammu and Kashmir Jammu2 2
Jharkhand 4Jamshedpur
Ranchi
2
2
Karnataka
Bangalore
Mysore
Belgaum
6
2
2
Kerela 8
Cochin
Thrissur
Chengannur
Thalassery
2
2
2
2
Madhya Pradesh 8
Gwalior
Indore
Jabalpur
Bhopal
2
2
2
2
Maharashtra 24
Rourkela
Cuttack
10
4Punjab
Rajasthan
Tamil Nadu 27
Pune
Thane
Wardha
Nagpur
Chandrapur
Sangli
Orissa Bhubaneshwar
Chennai
Trichy
Madurai
Salem
Erode
Coimbatore
Tuticorin
Vellore
Amritsar
Ludhiana
Jaipur
Udaipur
Kota
8
Lucknow
Noida
Jhansi
Kanpur
Varanasi
Deoria
Meerut
Agra
Uttar Pradesh 22
Kolkata
SiliguriWest Bengal
2
4
8
8
2
2
2
2
4
2
2
4
2
2
13
2
2
2
2
2
2
2
8
2
2
2
2
2
2
2
14
2
Total: 59 CitiesTotal 19 states + 1 UT
16
Total Sample- 185
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10
APPENDIX1:
TABLES AND FIGURESTable 1: State Wise Distribution of Sample
StatesTotal
Number of Participants
CitiesDistribution of
Participants
Andhra Pradesh 10
Hyderabad
Vizag
Kakinada
4
4
2
Assam
Bihar
Chandigarh
Chhattisgarh
Delhi
4
2
2
4
8
Guwahati
Patna
Chandigarh
Raipur
New Delhi
4
2
2
4
8
Gujarat 8
Ahmedabad
Rajkot
Vadodara
4
2
2
HaryanaHisar
Faridabad4
2
2
Jammu and Kashmir Jammu2 2
Jharkhand 4Jamshedpur
Ranchi
2
2
Karnataka
Bangalore
Mysore
Belgaum
6
2
2
Kerela 8
Cochin
Thrissur
Chengannur
Thalassery
2
2
2
2
Madhya Pradesh 8
Gwalior
Indore
Jabalpur
Bhopal
2
2
2
2
Maharashtra 24
Rourkela
Cuttack
10
4Punjab
Rajasthan
Tamil Nadu 27
Pune
Thane
Wardha
Nagpur
Chandrapur
Sangli
Orissa Bhubaneshwar
Chennai
Trichy
Madurai
Salem
Erode
Coimbatore
Tuticorin
Vellore
Amritsar
Ludhiana
Jaipur
Udaipur
Kota
8
Lucknow
Noida
Jhansi
Kanpur
Varanasi
Deoria
Meerut
Agra
Uttar Pradesh 22
Kolkata
SiliguriWest Bengal
2
4
8
8
2
2
2
2
4
2
2
4
2
2
13
2
2
2
2
2
2
2
8
2
2
2
2
2
2
2
14
2
Total: 59 CitiesTotal 19 states + 1 UT
16
Total Sample- 185
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CCEBDM Cycle-III (Feb 2013-Jan 2014)EVALUATION REPORT Certificate Course in Evidence Based Diabetes Management
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10
Table 2: In-Clinic Facilities Provided by the Respondents
Table 3: Number of Patients Treated in Last Month
S No. In-Clinic facilities Available (Percent)
Not Available (Percent)
1
2
3
4
In-Patient Lab Facility
In-House Dietician
In-House diabetes educator
Patient Education Resources
44
28
21
55
66
72
79
45
S No. Number of Patients Treated Per Month Percent
1
2
3
4
5
More than 3000
2001-3000
1001-2000
501-1000
Less than 500
2
3
14
17
64
S No. Number of Diabetic Patients Treated Per Month
1
2
3
4
5
6
More than 800
401-800
201-400
101-200
51-100
Less than 50
3
7
11
14
14
51
Percent
Curriculum and Knowledge Based Improvements
Knowledge Enhanced
Value Addition in routine treatment
Strongly Agree (Percent)
Agree (Percent)
Neither Agree nor Disagree
Disagree (Percent)
Strongly Disagree (Percent)
92
88
5
10
1
2
0
0
0
2
Table 4: Curriculum Based Knowledge Improvement and Value Addition of Course to Clinical Practice
Value Addition of Course to Clinical Practice
Could suggest life style modification
advice to diabetic patient
Strongly Agree (Percent)
Agree (percent)
Neither Agree nor Disagree
Disagree (Percent)
Strongly Disagree (Percent)
91
35
84
73
72
Referral for management of some
type of diabetes cases
Able to manage hypoglycaemic
patients
Improved ability for clinical
management of infection and
complication
Able to manage patients on
insulin therapy
9
34
16
25
25
0
9
0
1
2
0
11
0
1
1
0
11
0
0
0
Value Addition In Managing Most Common Complications
Peripheral Neuropathy
Nephropathy
Retinopathy
Cardiac Complications
Diabetic Foot
Skin Complications
Any Other (skin lesions and infections)
Strongly Agree (Percent)
Agree (Percent)
Neither Agree nor Disagree
Disagree (Percent)
Strongly Disagree (Percent)
60
50
57
80
72
53
51
37
42
35
18
25
38
41
2
4
4
1
2
7
4
1
3
2
1
1
2
3
0
1
2
0
0
0
1
Table 5: Knowledge Enhancement in Management of Diabetes Related Complications
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Table 2: In-Clinic Facilities Provided by the Respondents
Table 3: Number of Patients Treated in Last Month
S No. In-Clinic facilities Available (Percent)
Not Available (Percent)
1
2
3
4
In-Patient Lab Facility
In-House Dietician
In-House diabetes educator
Patient Education Resources
44
28
21
55
66
72
79
45
S No. Number of Patients Treated Per Month Percent
1
2
3
4
5
More than 3000
2001-3000
1001-2000
501-1000
Less than 500
2
3
14
17
64
S No. Number of Diabetic Patients Treated Per Month
1
2
3
4
5
6
More than 800
401-800
201-400
101-200
51-100
Less than 50
3
7
11
14
14
51
Percent
Curriculum and Knowledge Based Improvements
Knowledge Enhanced
Value Addition in routine treatment
Strongly Agree (Percent)
Agree (Percent)
Neither Agree nor Disagree
Disagree (Percent)
Strongly Disagree (Percent)
92
88
5
10
1
2
0
0
0
2
Table 4: Curriculum Based Knowledge Improvement and Value Addition of Course to Clinical Practice
Value Addition of Course to Clinical Practice
Could suggest life style modification
advice to diabetic patient
Strongly Agree (Percent)
Agree (percent)
Neither Agree nor Disagree
Disagree (Percent)
Strongly Disagree (Percent)
91
35
84
73
72
Referral for management of some
type of diabetes cases
Able to manage hypoglycaemic
patients
Improved ability for clinical
management of infection and
complication
Able to manage patients on
insulin therapy
9
34
16
25
25
0
9
0
1
2
0
11
0
1
1
0
11
0
0
0
Value Addition In Managing Most Common Complications
Peripheral Neuropathy
Nephropathy
Retinopathy
Cardiac Complications
Diabetic Foot
Skin Complications
Any Other (skin lesions and infections)
Strongly Agree (Percent)
Agree (Percent)
Neither Agree nor Disagree
Disagree (Percent)
Strongly Disagree (Percent)
60
50
57
80
72
53
51
37
42
35
18
25
38
41
2
4
4
1
2
7
4
1
3
2
1
1
2
3
0
1
2
0
0
0
1
Table 5: Knowledge Enhancement in Management of Diabetes Related Complications
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Table 6: Respondents Feedback on the Course Curriculum
Course Curriculum
Added Value To Knowledge
Added Value To Skills About Diabetes
Management
Strongly Agree (Percent)
Agree (Percent)
Neither Agree nor Disagree
Disagree (Percent)
Strongly Disagree (Percent)
92
71
5
26
1
2
0
1
2
0
Structure of Curriculum
Up-to-date
Relevant Topics Included
Appropriate Time Given
Ideal for Learning
Adequate Case Studies
Strongly Agree (Percent)
Agree (Percent)
Neither Agree nor Disagree
Disagree (Percent)
Strongly Disagree (Percent)
57
66
75
81
57
43
22
20
15
32
0
3
0
2
1
0
8
4
1
8
0
3
1
1
2
Table 7: Respondents Feedback on the Teaching Methods and Teaching Environment
Teaching Methods
Effective
Relevant
Additional Material Shared
Interactive & Informative
Strongly Agree (Percent)
Agree (Percent)
Neither Agree nor Disagree
Disagree (Percent)
Strongly Disagree (Percent)
83
84
11
12
2
1
2
2
2
1
81 19
92 5 1 1 1
Session Conduction Rating
Environment
Support Provided
Strongly Agree (Percent)
Agree (Percent)
Neither Agree nor Disagree
Disagree (Percent)
Strongly Disagree (Percent)
92
89
5
5
1
0
1
1
1
5
Preferred Modules for Knowledge Enrichment
Introductory overview of diabetes mellitus
Presentation and initial evaluation of patients with T2DM
Non pharmacological management of T2DM
Strongly Agree (Percent)
Agree (Percent)
Neither Agree nor Disagree
Disagree (Percent)
Strongly Disagree (Percent)
79
89
84
89
78
75
61
64
56
62
18
11
15
11
21
24
37
32
36
29
3
1
1
0
1
1
2
4
7
6
0
0
0
0
0
0
0
0
1
3
0
0
0
0
0
0
0
0
0
0
Approach to pharmacotherapy of T2DM
Acute complications of T2DM
Chronic complications of T2DM
Other complications of T2DM
Special topics in care of patients with T2DM
Other types of DM
Conclusions and take home messages
Table 9: Most Useful Topics in Curriculum
Most Useful Topics in Curriculum
Approach to pharmacotherapy of T2DM
Chronic complications of T2DM
Acute complications of T2DM
Presentation and initial evaluation of patients with T2DM
Cumulative Percentage
68
40
38
30
Table 8: Respondents' Preference of the Modules for Knowledge Enrichment
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Table 6: Respondents Feedback on the Course Curriculum
Course Curriculum
Added Value To Knowledge
Added Value To Skills About Diabetes
Management
Strongly Agree (Percent)
Agree (Percent)
Neither Agree nor Disagree
Disagree (Percent)
Strongly Disagree (Percent)
92
71
5
26
1
2
0
1
2
0
Structure of Curriculum
Up-to-date
Relevant Topics Included
Appropriate Time Given
Ideal for Learning
Adequate Case Studies
Strongly Agree (Percent)
Agree (Percent)
Neither Agree nor Disagree
Disagree (Percent)
Strongly Disagree (Percent)
57
66
75
81
57
43
22
20
15
32
0
3
0
2
1
0
8
4
1
8
0
3
1
1
2
Table 7: Respondents Feedback on the Teaching Methods and Teaching Environment
Teaching Methods
Effective
Relevant
Additional Material Shared
Interactive & Informative
Strongly Agree (Percent)
Agree (Percent)
Neither Agree nor Disagree
Disagree (Percent)
Strongly Disagree (Percent)
83
84
11
12
2
1
2
2
2
1
81 19
92 5 1 1 1
Session Conduction Rating
Environment
Support Provided
Strongly Agree (Percent)
Agree (Percent)
Neither Agree nor Disagree
Disagree (Percent)
Strongly Disagree (Percent)
92
89
5
5
1
0
1
1
1
5
Preferred Modules for Knowledge Enrichment
Introductory overview of diabetes mellitus
Presentation and initial evaluation of patients with T2DM
Non pharmacological management of T2DM
Strongly Agree (Percent)
Agree (Percent)
Neither Agree nor Disagree
Disagree (Percent)
Strongly Disagree (Percent)
79
89
84
89
78
75
61
64
56
62
18
11
15
11
21
24
37
32
36
29
3
1
1
0
1
1
2
4
7
6
0
0
0
0
0
0
0
0
1
3
0
0
0
0
0
0
0
0
0
0
Approach to pharmacotherapy of T2DM
Acute complications of T2DM
Chronic complications of T2DM
Other complications of T2DM
Special topics in care of patients with T2DM
Other types of DM
Conclusions and take home messages
Table 9: Most Useful Topics in Curriculum
Most Useful Topics in Curriculum
Approach to pharmacotherapy of T2DM
Chronic complications of T2DM
Acute complications of T2DM
Presentation and initial evaluation of patients with T2DM
Cumulative Percentage
68
40
38
30
Table 8: Respondents' Preference of the Modules for Knowledge Enrichment
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CCEBDM Cycle-III (Feb 2013-Jan 2014)EVALUATION REPORT Certificate Course in Evidence Based Diabetes Management
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Table 10: Improvisation in the Clinical Practices by Respondents after Completion of this Course
Changes in Facilities Provided after Completion of Course
Started Focusing on Patient Education
Set Up Their own Diabetic Clinic
Started Using HbA1C and Foot Examination
Upgraded Their Clinics with Improved Lab Facilities, Using
Better Injection Practices and New Drugs
Number of Respondent
14
4
3
5
Table 11: Professional Network
Professional Networking Strongly Agree (percent)
Agree (percent)
Neither agree nor disagree
Disagree (percent)
Strongly Disagree (percent)
Professional Network Building
74 18 3 4 1
Recommending the Course to Peers
Figure. 1 Gender Distribution
28.1
71.9
25.9
1.1
3.8
1.1
44.9
23.2
DM;MD
DNB
DNB;MD
MD
Other withMBBS
MBBS
Figure. 2 Participants’ Qualification
Figure. 3 Sector Affiliation
53.5
3.2
1.6
41.6Private
Other
Non-profit
Government
26
CCEBDM Cycle-III (Feb 2013-Jan 2014)EVALUATION REPORT Certificate Course in Evidence Based Diabetes Management
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95 5 0 0 0
Table 10: Improvisation in the Clinical Practices by Respondents after Completion of this Course
Changes in Facilities Provided after Completion of Course
Started Focusing on Patient Education
Set Up Their own Diabetic Clinic
Started Using HbA1C and Foot Examination
Upgraded Their Clinics with Improved Lab Facilities, Using
Better Injection Practices and New Drugs
Number of Respondent
14
4
3
5
Table 11: Professional Network
Professional Networking Strongly Agree (percent)
Agree (percent)
Neither agree nor disagree
Disagree (percent)
Strongly Disagree (percent)
Professional Network Building
74 18 3 4 1
Recommending the Course to Peers
Figure. 1 Gender Distribution
28.1
71.9
25.9
1.1
3.8
1.1
44.9
23.2
DM;MD
DNB
DNB;MD
MD
Other withMBBS
MBBS
Figure. 2 Participants’ Qualification
Figure. 3 Sector Affiliation
53.5
3.2
1.6
41.6Private
Other
Non-profit
Government
26
CCEBDM Cycle-III (Feb 2013-Jan 2014)EVALUATION REPORT Certificate Course in Evidence Based Diabetes Management
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95 5 0 0 0
APPENDIX 2:
CONSENT FORM
Principal Investigator: Dr. Sandeep Bhalla
Name of Organization: Public Health Foundation of India
Name of Sponsor: MSD Pharmaceuticals Private Ltd., India
Name of the Project: End-line Evaluation Survey for the Cycle- III of CCEBDM
PURPOSE OF STUDY: In this interview we aim to take a feedback from you as a participant of the Cycle III of CCEBDM. Your answers to questions in the questionnaire will tell us about your experiences and guide us to improve this course both in terms of content and delivery.
PROCEDURES: The interviewer will talk to you and seek answers to questions to the questionnaire. The process should take about 20-25 minutes.
RISKS/DISCOMFORTS: No risk or discomfort will be experienced. You are free not to participate, not to answer or decline to answer. BENEFITS: Will be to participate in the next cycle who will learn through the revised a course
CONFIDENTIALITY: All information collected for this study will be kept strictly confidential. This means that your answers to the questions will not be shared with anyone in the community or with anyone outside of the evaluation team. All identifiers are removed. Your answers are thus anonymous for the people outside the CCEBDM secretariat. All confidential data will be stored in locked files or password protected electronic records at the CCEBDM Program Secretariat. Your name will not appear on any of the study data in any way or in any reports or publications associated with this study.
PUBLICHEALTHFOUNDATIONOF INDIA
(February 2013 – January 2014)Consent Form
EVALUATION OF CERTIFICATE COURSE OF EVIDENCE BASED DIABETES MANAGEMENT -CYCLE-III
COMPENSATION: There will be no financial compensation for participating in this study.
RIGHT TO WITHDRAW: Your participation in this assessment is voluntary. You are not obligated to participate in this. You are free to withdraw your consent at any time. Refusal to participate will not have any bearing in any way to the results, but your insights will be critical for us in bringing out further improvements in the content and delivery of CCEBDM.
If you agree to participate in the evaluation study, please sign below:
Name of Participant: Name of Interviewer
_______________________ _______________________
Signature Signature
Date:
For further information please contact:Dr. Sandeep Bhalla (Principal Investigator)Public Health Foundation of IndiaIndian Institute of Public Health, Delhi Plot No. 34, Sector-44, Institutional Area, Gurgaon-122002, Haryana, India Mob. No. +91 9891090418, Contact No. +91 124 4722965, +91 11 43421906
28
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APPENDIX 2:
CONSENT FORM
Principal Investigator: Dr. Sandeep Bhalla
Name of Organization: Public Health Foundation of India
Name of Sponsor: MSD Pharmaceuticals Private Ltd., India
Name of the Project: End-line Evaluation Survey for the Cycle- III of CCEBDM
PURPOSE OF STUDY: In this interview we aim to take a feedback from you as a participant of the Cycle III of CCEBDM. Your answers to questions in the questionnaire will tell us about your experiences and guide us to improve this course both in terms of content and delivery.
PROCEDURES: The interviewer will talk to you and seek answers to questions to the questionnaire. The process should take about 20-25 minutes.
RISKS/DISCOMFORTS: No risk or discomfort will be experienced. You are free not to participate, not to answer or decline to answer. BENEFITS: Will be to participate in the next cycle who will learn through the revised a course
CONFIDENTIALITY: All information collected for this study will be kept strictly confidential. This means that your answers to the questions will not be shared with anyone in the community or with anyone outside of the evaluation team. All identifiers are removed. Your answers are thus anonymous for the people outside the CCEBDM secretariat. All confidential data will be stored in locked files or password protected electronic records at the CCEBDM Program Secretariat. Your name will not appear on any of the study data in any way or in any reports or publications associated with this study.
PUBLICHEALTHFOUNDATIONOF INDIA
(February 2013 – January 2014)Consent Form
EVALUATION OF CERTIFICATE COURSE OF EVIDENCE BASED DIABETES MANAGEMENT -CYCLE-III
COMPENSATION: There will be no financial compensation for participating in this study.
RIGHT TO WITHDRAW: Your participation in this assessment is voluntary. You are not obligated to participate in this. You are free to withdraw your consent at any time. Refusal to participate will not have any bearing in any way to the results, but your insights will be critical for us in bringing out further improvements in the content and delivery of CCEBDM.
If you agree to participate in the evaluation study, please sign below:
Name of Participant: Name of Interviewer
_______________________ _______________________
Signature Signature
Date:
For further information please contact:Dr. Sandeep Bhalla (Principal Investigator)Public Health Foundation of IndiaIndian Institute of Public Health, Delhi Plot No. 34, Sector-44, Institutional Area, Gurgaon-122002, Haryana, India Mob. No. +91 9891090418, Contact No. +91 124 4722965, +91 11 43421906
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APPENDIX 3:
PARTICIPANT INTERVIEW RESPONSE
PUBLICHEALTHFOUNDATIONOF INDIA
(February 2013 – January 2014)Participant Interview Response
EVALUATION OF CERTIFICATE COURSE OF EVIDENCE BASED DIABETES MANAGEMENT -CYCLE-III
1. Name of Interviewer
2. ID of Interviewer
3. Date of Visit
DD YYMM
BASIC INFORMATION:
First Name Middle Name Last Name
4. Name of Participant
5. ID of Participant
6. Sex Male Female
7. Age (in years)
8. Qualification MBBS Post Graduate
M.D D.N.B D.M
Other Degrees
Please Specify:-
9. ID of Regional Center
10. Type of practice (Please tick the appropriate option below)
A. Government B. Private
C. Private for Non Profit/Charitable D. Other___________________________
CLINICAL PRACTICE:
11. Years of clinical experience
Post MBBS Post MD/DM Total
12. Number of places of practice/Clinics
13. Facilities provided at your clinic (Please observe and confirm by checking X the appropriate box): (Optional if applicable)
1. Your own laboratory, lab Analysis
2. Samples taken and sent to another lab Yes / No
3. In-house Dietician Yes / No
4. Diabetes Nurse Educator Yes / No
If own lab then,
Internal/In-house
External (Sample sent/ collaboration with External Lab No
14. You have said that you provide lab facility in your clinic, please tell us which tests are conducted in your labs?
15. For which tests, samples are sent outside your lab?:
16.Where do you actually send the samples?
17.Availability of patient education resourcesYes/No Yes/No Please specify_________
Printed Video Others
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APPENDIX 3:
PARTICIPANT INTERVIEW RESPONSE
PUBLICHEALTHFOUNDATIONOF INDIA
(February 2013 – January 2014)Participant Interview Response
EVALUATION OF CERTIFICATE COURSE OF EVIDENCE BASED DIABETES MANAGEMENT -CYCLE-III
1. Name of Interviewer
2. ID of Interviewer
3. Date of Visit
DD YYMM
BASIC INFORMATION:
First Name Middle Name Last Name
4. Name of Participant
5. ID of Participant
6. Sex Male Female
7. Age (in years)
8. Qualification MBBS Post Graduate
M.D D.N.B D.M
Other Degrees
Please Specify:-
9. ID of Regional Center
10. Type of practice (Please tick the appropriate option below)
A. Government B. Private
C. Private for Non Profit/Charitable D. Other___________________________
CLINICAL PRACTICE:
11. Years of clinical experience
Post MBBS Post MD/DM Total
12. Number of places of practice/Clinics
13. Facilities provided at your clinic (Please observe and confirm by checking X the appropriate box): (Optional if applicable)
1. Your own laboratory, lab Analysis
2. Samples taken and sent to another lab Yes / No
3. In-house Dietician Yes / No
4. Diabetes Nurse Educator Yes / No
If own lab then,
Internal/In-house
External (Sample sent/ collaboration with External Lab No
14. You have said that you provide lab facility in your clinic, please tell us which tests are conducted in your labs?
15. For which tests, samples are sent outside your lab?:
16.Where do you actually send the samples?
17.Availability of patient education resourcesYes/No Yes/No Please specify_________
Printed Video Others
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18. Approximate number of patients treated in last month?
19. Approximate number of individuals with Diabetes treated in last month?
CCEBDM CURRICULUM
Given below are few statements which ask your perception about the course & your change in practice/knowledge after the course. Kindly rate your level of agreement or disagreement with each statement and explain your answer in the box provided.
20. “This course has helped you in increased diagnosis of Diabetes”
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
21. “This course has added value to your routine treatment for diabetes patients”
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
22. “You now refer to specialists for other types of diabetes (eg. Secondary diabetes, MODY, advanced type-1 diabetes etc.”
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
23. “This course improved your knowledge in providing life style modification advise to patients”
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
24. “You are better equipped to manage patients on oral hypoglycemic drugs (in terms of dosage, dose adjustements & side-effects)”
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
25. “You are now better equipped to handle insulin therapy (in terms of initiation, dose adjustment, titration & Side effects)”
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
26. This course has improved your ability for clinical management of infections in diabetes ?
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
27. This Course has better equipped you to handle peripheral neuropathy
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
If you agree, what kind of complications do you feel can be managed by you?
28. This Course has better equipped you to handle nephropathy
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
29. After this course you refer for retinopathy
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
30. You are more aware of cardiac complications of diabetes mellitus.
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
31. You are better equipped to prevent and manage foot complications of diabetes mellitus
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
32. You are more equipped to manage skin complications
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
33. Any Other Complication (Skin lesions & infections)
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
34. “ The various course modules have helped you in enriching your knowledge and skills in the following areas”
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
I. Introductory Overview of Diabetes Mellitus
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
II. Presentation and Initial Evaluation of patients with Type 2 Diabetes
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
III. Non Pharmacological Management of Type 2 Diabetes
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
IV. Approach to Pharmacotherapy of Type 2 Diabetes
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
V. Acute Complications of Type 2 Diabetes
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
VI. Chronic complications of Type 2 Diabetes
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18. Approximate number of patients treated in last month?
19. Approximate number of individuals with Diabetes treated in last month?
CCEBDM CURRICULUM
Given below are few statements which ask your perception about the course & your change in practice/knowledge after the course. Kindly rate your level of agreement or disagreement with each statement and explain your answer in the box provided.
20. “This course has helped you in increased diagnosis of Diabetes”
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
21. “This course has added value to your routine treatment for diabetes patients”
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
22. “You now refer to specialists for other types of diabetes (eg. Secondary diabetes, MODY, advanced type-1 diabetes etc.”
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
23. “This course improved your knowledge in providing life style modification advise to patients”
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
24. “You are better equipped to manage patients on oral hypoglycemic drugs (in terms of dosage, dose adjustements & side-effects)”
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
25. “You are now better equipped to handle insulin therapy (in terms of initiation, dose adjustment, titration & Side effects)”
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
26. This course has improved your ability for clinical management of infections in diabetes ?
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
27. This Course has better equipped you to handle peripheral neuropathy
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
If you agree, what kind of complications do you feel can be managed by you?
28. This Course has better equipped you to handle nephropathy
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
29. After this course you refer for retinopathy
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
30. You are more aware of cardiac complications of diabetes mellitus.
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
31. You are better equipped to prevent and manage foot complications of diabetes mellitus
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
32. You are more equipped to manage skin complications
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
33. Any Other Complication (Skin lesions & infections)
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
34. “ The various course modules have helped you in enriching your knowledge and skills in the following areas”
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
I. Introductory Overview of Diabetes Mellitus
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
II. Presentation and Initial Evaluation of patients with Type 2 Diabetes
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
III. Non Pharmacological Management of Type 2 Diabetes
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
IV. Approach to Pharmacotherapy of Type 2 Diabetes
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
V. Acute Complications of Type 2 Diabetes
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
VI. Chronic complications of Type 2 Diabetes
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0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
VII. Other complications of type 2 Diabetes
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
VIII. Special topics in care of patients with Type 2 Diabetes
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
IX. Other Types of Diabetes Mellitus
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
X. Module 12 (Conclusions & Take home messages) adequately & appropriately summarizes the course.
35.Following the completion of this course could you share with us any special case in your everyday practice which you were able to effectively diagnose, treat and manage due to the additional knowledge/ skill for treatment covered in the modules of this course ?
36. Please rank top three modules in this course that were found most useful.
1..................................... 2..................................... 3.....................................
37. Please mark three modules in this course that were found least useful.
1..................................... 2..................................... 3.....................................
38. Please suggest three suggestions/any specific topics that you wish should be added and / or deleted for this educational course?
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
40. The curriculum has added value to your knowledge about diabetes
39. Did you make any particular changes in facilities provided by you in your place of practice after completion of this course? (probe for additions in lab facilities, IEC material, updated softwares etc.)
1..................................... 2..................................... 3.....................................
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
41. The curriculum has not added value to your skills about diabetes management
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
42. The curriculum was updated in its content
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
43. Topics relevant to diabetes management were not covered
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
44. Appropriate time was allotted for content in all sessions
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
45. The structure of the curriculum was not ideal for learning
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
46. The case studies were adequate in initiating discussions for replicating real-life clinical scenarios
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
47. Do you feel this course has not helped you to connect with other diabetes management physicians in your area ?
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
48. Would you recommend this course to your fellow colleagues?
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CCEBDM Cycle-III (Feb 2013-Jan 2014)EVALUATION REPORT Certificate Course in Evidence Based Diabetes Management
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0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
VII. Other complications of type 2 Diabetes
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
VIII. Special topics in care of patients with Type 2 Diabetes
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
IX. Other Types of Diabetes Mellitus
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
X. Module 12 (Conclusions & Take home messages) adequately & appropriately summarizes the course.
35.Following the completion of this course could you share with us any special case in your everyday practice which you were able to effectively diagnose, treat and manage due to the additional knowledge/ skill for treatment covered in the modules of this course ?
36. Please rank top three modules in this course that were found most useful.
1..................................... 2..................................... 3.....................................
37. Please mark three modules in this course that were found least useful.
1..................................... 2..................................... 3.....................................
38. Please suggest three suggestions/any specific topics that you wish should be added and / or deleted for this educational course?
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
40. The curriculum has added value to your knowledge about diabetes
39. Did you make any particular changes in facilities provided by you in your place of practice after completion of this course? (probe for additions in lab facilities, IEC material, updated softwares etc.)
1..................................... 2..................................... 3.....................................
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
41. The curriculum has not added value to your skills about diabetes management
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
42. The curriculum was updated in its content
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
43. Topics relevant to diabetes management were not covered
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
44. Appropriate time was allotted for content in all sessions
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
45. The structure of the curriculum was not ideal for learning
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
46. The case studies were adequate in initiating discussions for replicating real-life clinical scenarios
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
47. Do you feel this course has not helped you to connect with other diabetes management physicians in your area ?
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
48. Would you recommend this course to your fellow colleagues?
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FACULTY AND TEACHING METHODS/ENVIORNMENT
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
49. The teaching methods adopted by the faculty were ineffective
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
50. The faculty brought relevant personal clinical experience to the teaching session
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
51. The faculty shared additional teaching material during the sessions
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
52. The sessions were neither interactive nor informative
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
53. The training environment was conducive to learning (e.g. quiet, well-lit, air-conditioning, Ventilation)
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
54. The faculty was unable to address your concerns/questions regarding clinical problems related to diabetes cases and management in your practice.
55. Please feel free to share any other feedback/suggestions.
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
56. “The faculty, teaching you, was able to understand your learning requirements.”
57. Are you using “HABITS” software in your daily practice? Yes No
59. Any suggestions for making “HABITS” software more useful
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
58. “The ‘HABITS’ software was useful in better management of diabetes care.”
60. Has this course helped you in networking and how?
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
61. Would you like to attend similar courses related to Diabetes in near future? ( e.g. Gestational Diabetes Management, Diabetic foot, Peripheral neuropathy, Retinopathy.)
Total time taken to complete interview:_______________________________________________
Thank you!
Name of participant:
………………………………Signature
Name of Interviewer
………………………………Signature
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FACULTY AND TEACHING METHODS/ENVIORNMENT
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
49. The teaching methods adopted by the faculty were ineffective
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
50. The faculty brought relevant personal clinical experience to the teaching session
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
51. The faculty shared additional teaching material during the sessions
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
52. The sessions were neither interactive nor informative
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
53. The training environment was conducive to learning (e.g. quiet, well-lit, air-conditioning, Ventilation)
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
54. The faculty was unable to address your concerns/questions regarding clinical problems related to diabetes cases and management in your practice.
55. Please feel free to share any other feedback/suggestions.
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
56. “The faculty, teaching you, was able to understand your learning requirements.”
57. Are you using “HABITS” software in your daily practice? Yes No
59. Any suggestions for making “HABITS” software more useful
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
58. “The ‘HABITS’ software was useful in better management of diabetes care.”
60. Has this course helped you in networking and how?
0 Strongly Disagree
1 2 3 4Slightly Disagree
Neither Agree nor Disagree
Slightly Agree Strongly Agree
61. Would you like to attend similar courses related to Diabetes in near future? ( e.g. Gestational Diabetes Management, Diabetic foot, Peripheral neuropathy, Retinopathy.)
Total time taken to complete interview:_______________________________________________
Thank you!
Name of participant:
………………………………Signature
Name of Interviewer
………………………………Signature
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S No. Name of Module
1
2
3
4
5
6
7
8
9
10
11
12
Introductory Overview of Diabetes Mellitus
Presentation And Initial Evaluation of Type 2 Diabetes
Non-Pharmacological Management of Type 2 Diabetes
Approach to Pharmacotherapy of Type 2 Diabetes - Part 1
Approach to Pharmacotherapy of Type 2 Diabetes - Part 2
Acute Complications of Type 2 Diabetes
Chronic Complications of Type 2 Diabetes Part-I
Chronic Complications of Type 2 Diabetes Part-II
Other Complications of Type 2 Diabetes
Special Topics In Care of Patients With Type 2 Diabetes
Other Types of Diabetes Mellitus
Conclusion And Take Home Messages
TEAM OF EVALUATORS
LIST OF CCEBDM MODULES
Sr. No.
APPENDIX 4:
Name of Evaluators Designation
1 Dr. B.M. Vashisht Professor, Preventive and Social Medicine, PGIMS Rohtak
2 Dr. Brijender Singh Dhillon Associate Professor and Head, Rohtak Medical College
3 Dr. Dilip Kumar Das Professor & HOD,Dept of community medicine, North Bengal Medical college, Darjeeling
4 Dr. Haresh Chandwani Associate Professor, Department of Community Medicine, Medical college, Vadodara
5 Dr. Hemalatha Somsekhar Ex Academic Coordinator, PHFI
6 Dr. Jamal Masood Professor, Department of Community Medicine, King George’s Medical University, U.P.
7 Dr. K.N. Patni Tutor- Community medicine: Hind Institute of Medical sciences, Barabanki
8 Dr. M. Logaraj Professor, Community Medicine, SRM Medical college & Hospital, Kattankulathur, Kancheepuram, Tamil Nadu
9 Dr. Meera Ramanath Professor, Dept of community medicine, PSG Institute of medical sciences & Research, Coimbatore
10 Dr. Narendra Nath V Prof. & Head-Hospital Administration & Chief Administrator, M.S. Ramaiah Hospital, Bangalore, Karnataka
11 Dr. Pradnya Kadam Associate Professor, PDVVPM Medical College, Ahmednagar
12 Dr. Rakesh Mehra Assistant Program Coordinator- CCEBDM
13 Dr. Ratan Srivastava Professor & Head, Department of Community Medicine, Institute of Medical Sciences, Varanasi, U.P
14 Dr. Reshma Masood Deputy Director, U.P. State AIDS Control Society, Lucknow, Uttar Pradesh
15 Dr. S. Pruthvish Professor, Dept of community medicine, M.S Ramaiah, medical college
16 Dr. Sairu Philip Professor, Dept of community medicine, T.D. Medical college, Alappuzha, Kerala
17 Dr. Sameer Pathan Program Coordinator- CCGDM
18 Dr. Sandeep Bhalla Program Director- CCEBDM
19 Dr. Sanjay Dixit Vice Dean,Professor & Head, Department of Preventive and Social Medicine, MGM Medical College
Sr. No. Name of Evaluators Designation
20 Dr. Shifalika Goenka Associate Professor, IIPH, Delhi
21 Dr. Shivangi Vats Monitoring & Evaluation Coordinator- CCEBDM
22 Dr. Shreyas Sharma Assistant Monitoring & Evaluation Coordinator- CCEBDM
23 Dr. Shyam Sunder Deepti Associate Professor,Department of Community Medicine, Govt Medical college, Amritsar
24 Dr. Sourabh Sinha Senior Program Coordinator- ACMDC
25 Dr. Variyata Bagre Assistant Monitoring & Evaluation Coordinator- CCEBDM
26 Mr. Manoj Joshi Senior Monitoring & Evaluation Coordinator- ACMDC
27 Mr. Ritesh Tyagi Senior ICT officer- CCEBDM
28 Mr. Sanjay Singh Panwar Assistant Program Coordinator- CCEBDM
29 Mr. Santosh Choudhary Data Manager- CCEBDM
30 Ms. Megha Sharma Assistant Monitoring & Evaluation Coordinator- CCGDM
31 Ms. Riddhi Singh Assistant Program Coordinator- CCGDM
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APPENDIX 5:
S No. Name of Module
1
2
3
4
5
6
7
8
9
10
11
12
Introductory Overview of Diabetes Mellitus
Presentation And Initial Evaluation of Type 2 Diabetes
Non-Pharmacological Management of Type 2 Diabetes
Approach to Pharmacotherapy of Type 2 Diabetes - Part 1
Approach to Pharmacotherapy of Type 2 Diabetes - Part 2
Acute Complications of Type 2 Diabetes
Chronic Complications of Type 2 Diabetes Part-I
Chronic Complications of Type 2 Diabetes Part-II
Other Complications of Type 2 Diabetes
Special Topics In Care of Patients With Type 2 Diabetes
Other Types of Diabetes Mellitus
Conclusion And Take Home Messages
TEAM OF EVALUATORS
LIST OF CCEBDM MODULES
Sr. No.
APPENDIX 4:
Name of Evaluators Designation
1 Dr. B.M. Vashisht Professor, Preventive and Social Medicine, PGIMS Rohtak
2 Dr. Brijender Singh Dhillon Associate Professor and Head, Rohtak Medical College
3 Dr. Dilip Kumar Das Professor & HOD,Dept of community medicine, North Bengal Medical college, Darjeeling
4 Dr. Haresh Chandwani Associate Professor, Department of Community Medicine, Medical college, Vadodara
5 Dr. Hemalatha Somsekhar Ex Academic Coordinator, PHFI
6 Dr. Jamal Masood Professor, Department of Community Medicine, King George’s Medical University, U.P.
7 Dr. K.N. Patni Tutor- Community medicine: Hind Institute of Medical sciences, Barabanki
8 Dr. M. Logaraj Professor, Community Medicine, SRM Medical college & Hospital, Kattankulathur, Kancheepuram, Tamil Nadu
9 Dr. Meera Ramanath Professor, Dept of community medicine, PSG Institute of medical sciences & Research, Coimbatore
10 Dr. Narendra Nath V Prof. & Head-Hospital Administration & Chief Administrator, M.S. Ramaiah Hospital, Bangalore, Karnataka
11 Dr. Pradnya Kadam Associate Professor, PDVVPM Medical College, Ahmednagar
12 Dr. Rakesh Mehra Assistant Program Coordinator- CCEBDM
13 Dr. Ratan Srivastava Professor & Head, Department of Community Medicine, Institute of Medical Sciences, Varanasi, U.P
14 Dr. Reshma Masood Deputy Director, U.P. State AIDS Control Society, Lucknow, Uttar Pradesh
15 Dr. S. Pruthvish Professor, Dept of community medicine, M.S Ramaiah, medical college
16 Dr. Sairu Philip Professor, Dept of community medicine, T.D. Medical college, Alappuzha, Kerala
17 Dr. Sameer Pathan Program Coordinator- CCGDM
18 Dr. Sandeep Bhalla Program Director- CCEBDM
19 Dr. Sanjay Dixit Vice Dean,Professor & Head, Department of Preventive and Social Medicine, MGM Medical College
Sr. No. Name of Evaluators Designation
20 Dr. Shifalika Goenka Associate Professor, IIPH, Delhi
21 Dr. Shivangi Vats Monitoring & Evaluation Coordinator- CCEBDM
22 Dr. Shreyas Sharma Assistant Monitoring & Evaluation Coordinator- CCEBDM
23 Dr. Shyam Sunder Deepti Associate Professor,Department of Community Medicine, Govt Medical college, Amritsar
24 Dr. Sourabh Sinha Senior Program Coordinator- ACMDC
25 Dr. Variyata Bagre Assistant Monitoring & Evaluation Coordinator- CCEBDM
26 Mr. Manoj Joshi Senior Monitoring & Evaluation Coordinator- ACMDC
27 Mr. Ritesh Tyagi Senior ICT officer- CCEBDM
28 Mr. Sanjay Singh Panwar Assistant Program Coordinator- CCEBDM
29 Mr. Santosh Choudhary Data Manager- CCEBDM
30 Ms. Megha Sharma Assistant Monitoring & Evaluation Coordinator- CCGDM
31 Ms. Riddhi Singh Assistant Program Coordinator- CCGDM
38
CCEBDM Cycle-III (Feb 2013-Jan 2014)EVALUATION REPORT Certificate Course in Evidence Based Diabetes Management
39
APPENDIX 5:
CENTRE LOCATION MAP, CCEBDM CYCLE III
APPENDIX 6:
40
CCEBDM Cycle-III (Feb 2013-Jan 2014)EVALUATION REPORT
CENTRE LOCATION MAP, CCEBDM CYCLE III
APPENDIX 6:
40
CCEBDM Cycle-III (Feb 2013-Jan 2014)EVALUATION REPORT
Program Secretariat – CCEBDMPublic Health Foundation of IndiaPlot – 47, Sector 44, Institutional Area, Gurgaon – 122002, IndiaTel: +91 – 124 – 4781400 (Extn. 4518), Fax: +91 – 124 – 4722971 Email: [email protected] Web: www.ccebdm.org
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