Abstract

Diabetes-related medical errors can lead to excessive morbidity, complications, disability, and even death.1 In the inpatient setting, errors involving insulin therapy have been associated with 33% of deaths that occurred within 48 hours of a medical error.2 There is accumulating evidence that insulin errors can be reduced with increased clinical supervision, along with educational curriculums.3 During the past decade, the endocrinology and diabetes division at Children's National Medical Center (CNMC) in Washington, D.C., implemented a diabetes care pathway to help guide physicians in diabetes management.4 Pathway education was provided to residents via delivery of three 1-hour lectures during the traditional resident core lecture series. Despite transmittal of this information, there continued to be a significant number of diabetes-related errors. Based on analysis, they fell into four categories: insulin dosing and timing, choice of intravenous fluids after pediatric intensive care unit (PICU) transfer, miscommunication between health care professionals, and discharge planning. Pedagogies were altered to embrace a more learner-centered approach that addresses differences in learning styles and requires active engagement on the part of the residents. As a result of this new curriculum, diabetes-related errors decreased significantly.5 This article discusses the curriculum that was developed, focusing on the variety of teaching approaches and their relationship to various styles of learning. ### Curriculum development process The diabetes program director (author FRC) hypothesized that creating a learner-centered curriculum could decrease residents' pathway errors. She received the approval of the director of resident education to go forward with curricular development. Following the general process used in higher education,6 curriculum development by the diabetes program director occurred over a 6-month period with the guidance of authors EG and LG, who serve as education specialists at George Washington University in Washington, D.C. The established goal of the curriculum was to decrease inpatient diabetes-related errors. …

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