Tele-education to improve residents' knowledge and quality of care in hospital hyperglycemia: a multicenter randomized clinical trial.

OBJECTIVE

To evaluate the impact of a structured tele-education program on hospital hyperglycemia and diabetes, focusing on residents' medical knowledge and inpatient care.

SUBJECTS AND

METHODS

This open-label, multicenter, randomized clinical trial enrolled internal medicine residents from four university hospitals in southern Brazil. Teams were block-randomized to an intervention group that received an online lecture plus 30 days of tele-education via WhatsApp, or to a control group with no intervention. The primary outcome was medical knowledge, assessed with a validated 10-item questionnaire. Secondary outcomes included quality of insulin prescriptions, hypoglycemia and hyperglycemia rates, and hospital length of stay (LOS). Analyses were performed using SPSS v29 (5% significance).

RESULTS

Fifty residents completed the study. The intervention group achieved higher post-intervention knowledge scores than the control group (median 8 vs. 6 correct answers; p = 0.005) and showed significant improvement from preto post-test (6 to 8; p < 0.001), with consistent gains across centers. Clinical data from 149 hospitalized patients were analyzed (mean age 67.8 years; 55% female); 56% had diabetes, and 44% had hospital-related hyperglycemia. There was a nonsignificant trend toward more appropriate NPH (p = 0.107) and regular insulin (p = 0.203) prescriptions in the intervention group. Median LOS was longer in the intervention group (19 vs. 13 days; p = 0.009).

CONCLUSION

The tele-education program improved residents' knowledge of inpatient hyperglycemia. Larger studies are needed to confirm clinical effects and long-term outcomes of tele-education in hospital glycemic management.