Ролевые игры в обучении врачей улучшают контроль диабета у пациентов

When physicians receive intensive training that includes role-playing, their patients with type 2 diabetes (T2D) have better glycemic control, according to study findings published in JAMA Network Open. To identify a strategy to help close the gap between evidence-based guidelines for the treatment of T2D and clinical practice, researchers examined whether role-playing-based training for physicians could improve glycemic control in patients with T2D.  This cluster-randomized study, called the Chinese Endocrinologists Health Education Study (CREATION), was conducted at diabetes centers in China that were part of the Metabolic Management Center (MMC) project.  The first phase of the trial included physicians who were randomly assigned to 2 groups: intensive training that included role-playing patients’ experiences with diabetes management or regular training without role-playing.  These findings suggest that the role-playing-based on-site experiential training effectively bridges the guideline-implementation gap in diabetes care and reaffirms the importance of human-centered offline training. In the second phase, each physician enrolled an average of 10 patients with T2D with inadequate glycemic control using noninsulin hypoglycemic medications. Median duration of diabetes was 4 years; mean body mass index (BMI) was 26.8; and mean glycated hemoglobin (HbA1c) was 8.7%. The primary study endpoint was the achievement of an HbA1c level below 7.0% after 6 months of follow-up. The first phase included 205 physicians (mean age, 36.2 years; 75.6% women). In the second phase, 2017 patients with type 2 diabetes were enrolled (mean age, 53.0 years; 35.3% women), with a median diabetes duration of 4.0 years, a mean BMI of 26.8, and a mean baseline HbA1c of 8.7%. The researchers found that the endpoint was met significantly more frequently among patients managed by physicians who underwent intensive training with role-playing than among patients managed by physicians who underwent regular training without role-playing (58.0% vs 42.9%, respectively; adjusted between-group difference, 16.6%; P <.001). The difference between groups was maintained at 12 months (17.0%; P <.001). Intensive training with role-playing was associated with other benefits for patients, including significantly greater reductions in BMI (-0.3), waist circumference (-1.4 cm), waist-to-hip ratio (-1.0%), fasting blood glucose (-6.3 mg/dL), and systolic blood pressure (BP; -1.5 mm Hg). All patients, regardless of physician group, had reductions in 2-hour postprandial blood glucose, diastolic BP, and lipid levels. Patients receiving treatment from physicians who completed intensive training with role-playing also had improvements in lifestyle habits, including lower alcohol intake, more fruit and vegetable consumption, and more sleep. For physicians, intensive training increased diabetes-related knowledge and was associated with a reduction in BMI and an increase in fruit and vegetable consumption. The rate of serious adverse events was similar in the intensive and regular training groups (2.6% and 2.4%, respectively). Study limitations include the small number of patients (n=2017) enrolled by each physician for phase 2, potential selection bias, and the open-label design of the trial. The study authors concluded that, “These findings suggest that the role-playing-based on-site experiential training effectively bridges the guideline-implementation gap in diabetes care and reaffirms the importance of human-centered offline training in digital health care systems for medical education.” References: Zhang Y, Peng Y, Chen Y, et al. Role-playing-based physician training and metabolic outcomes among patients with type 2 diabetes: a cluster randomized clinical trial. JAMA Netw Open. Published online August 6, 2026. doi:10.1001/jamanetworkopen.2026.27376