1. Getting the Message Across: Teaching Diabetes Management Through Text Messages Scott Bragg, PharmD Kristen Hood Watson, MD Medical University of South Carolina (MUSC)

2. Disclosures No financial relationships or conflicts of interest to report

3. Background Rural clerkship students placed throughout South Carolina Clerkship orientation provides: diabetic education from a physician & pharmacist

4. Background Text messaging offers: –Easy communication with students –Evidence of teaching benefits with undergraduate learners –Low cost intervention –Active learning

5. Objectives Sending text messages will: –Increase student scores on difficult diabetes questions –Improve student satisfaction with teaching –Not impact scores on diabetes questions on the fmCASES national exam

6. Methods Parallel group, randomized, controlled trial Students offered $5 gift card Criteria –No exclusions –Inclusion: complete orientation, able to send & receive text messages

7. Methods Control Group –Will receive a handout of all messages Experimental Group –Will receive 15 text messages over the course of the clerkship

8. Text Message Example A 45 y/o man has a blood sugar of 305 in the ED. His A1c is 12%. He weighs 250lbs. How much basal insulin would you start?

9. Assessment Measures Independently created post test Survey regarding self perception of knowledge 3 rd party review of diabetes questions on fmCASES exam

10. Example Assessment Question Mr. Smith a 68-year-old man with long-standing type II diabetes has worsening control of his blood sugars. His hemoglobin A1c increases from 7.6% to 10.2% over 4 months. He takes metformin 1000 mg twice daily. You inform him it’s time to start taking insulin, but you would like to continue his metformin. Why is metformin recommended to continue for this patient?

11. Example Assessment Question Why is metformin recommended to continue for this patient? Please select all that are true. Metformin will lower his insulin requirements to control his blood sugars Metformin is associated with decreased cardiovascular risk Metformin will help selectively control pre-meal blood sugars based on it’s mechanism while basal insulin will control fasting blood sugars Cost of metformin make it a preferred option Metformin poses little risk of hypoglycemia when combined with insulin

12. Future Plan Currently awaiting IRB approval Applying for grant for gift card funding Initiate study in July 2015

13. Limitations Scores may change between first and last clerkship –Students will be compared to each other within their clerkship group Variability in how the students use text messages

14. Limitations Confounding with memorization of the handout prior to examination –Hope that questions are high level enough this will not be a factor

15. QUESTIONS?

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