Objective: Assess whether participation in a well-established tele-education mentorship program, ECHO (Extension for Community Healthcare Outcomes) , improves preclinical providers’ self-efficacy, confidence, and knowledge in managing complex diabetes (DM) .

Methods: Over 3 cycles of ECHO sessions from 2018-2021, we engaged 42 physician assistant students (PAS) in efforts to increase knowledge prior to clinical practice. Using didactics and case-based learning via videoconferencing, the ECHO model allowed participants to receive tele-mentoring from an endocrinologist, a diabetes educator, and rotating specialists. Over 14-16 bimonthly sessions, PAS (n=42) received an evidence-based curriculum on complex DM management. Pre and post course surveys measured self-efficacy (13 questions) , confidence in management (6) , factual knowledge (12) and prescribing practices (11) .

Results: Twenty-three PAS completed at least 50% of sessions; 18 completed both evaluations. On a 7-point Likert scale, self-efficacy increased from 3.18 (slightly competent) pre-intervention to 4.78 (competent) post (p<.0001) . PAS’ belief in their competence to be an endocrinology resource in the community increased from 1.94 to 4. (p<.0001) . Confidence increased from 3.32 (neutral) to 5.33 (somewhat confident) (p<.0001) . PAS answered correctly on 3.78 of 12 knowledge questions before the intervention, increasing to 5.76 after (p<0.01) . Students’ anticipated frequency of prescribing diabetes medication increased from 1.73 (rarely) to 3. (sometimes) (p<.001) and of technology from 1.46 to 2.79 (p<.001) on a 4-point scale.

Conclusion: Our ECHO model is the first to evaluate healthcare trainees. PAS showed improved self-efficacy, knowledge, and confidence in DM management and increased comfort in prescribing. However, overall participation in live sessions was low. Further research is assessing incorporation of pre-recorded ECHO sessions into the PA curriculum.


M.Phelps: None. A.Aldous: None. N.M.Ehrhardt: Advisory Panel; Dexcom, Inc., Novo Nordisk, Research Support; Dexcom, Inc., Merck & Co., Inc., Novo Nordisk.


Merck Foundation, Merck and Novo Nordisk

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