For the past three years, we have taught fourth-year undergraduate medical students about how to care for patients with diabetes by using simulation training. This training consists of a pre-simulation home visit to a patient with a recent diagnosis of type 2 diabetes, a simulated patient (SP) encounter, and an extended medical educator-led debriefing session with all participants of the encounter, including the SP. The training includes the technical aspects of managing diabetes, such as the clinical features and diet, but has an emphasis on developing the essential verbal and non-verbal communication skills required to facilitate the empowerment of patient adherence to management plans [1,2].
Since the outbreak of COVID-19, we have moved all teaching to online delivery. Facing this extra-ordinary situation, we collaboratively created an activity aligned with the previous simulation training. In this activity, students have an interactive online SP encounter in which a diagnosis of type 2 diabetes is revealed through taking a history. After this encounter, we maintained an extended medical educator-led debriefing session by having an online discussion between the SP and the students. The SP history and debriefing discussion were by talking to the SP directly or online chat.
Planning an online activity usually takes between 6 and 9 months [3], but we only had two weeks to plan and implement this simulation activity. Although we have encountered technical difficulties such as poor internet connection and the lack of computers, students perceived it as a good learning opportunity, which allowed more active participation compared with the other online teaching that was provided by the medical school.
We consider that our online teaching activity has enabled students to discuss the technical aspects of managing a patient with diabetes but developing the essential non-verbal communication skills may be more difficult because of the online environment. In many cultures, non-verbal communication is key for facilitating patient adherence to management plans and this may only be feasible in face-to-face encounters.
Declaration of competing interest
Regarding letter: “Moving online: challenges and benefits of teaching Diabetes during COVID-19” the authors have no conflict to declare.
Acknowledgements
The authors would like to thank Professor John Sandars for his feedback on the final version of the article and editorial help. This research was partially funded by FAPESP – São Paulo Research Foundation [Young Investigator Grant number 2018/15642-1] awarded to Dario Cecilio-Fernandes. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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