Diabetic Ketoacidosis Topic Discussion

Date: January 24, 2025

Length of Activity: 1 hour

Prep Time: ~4 hours

Learners: 5 pharmacy students, 1 pharmacy resident

Comfort Level: High

Teaching Goals Addressed: 

   SMART Goal 2: Improve my small group discussion skills through leading five topic discussions over the residency year.

Teaching Materials: DKA handout

Method Used to Assess Learner Understanding: I utilized a pre-test to determine the students' baseline knowledge of DKA to help guide my discussion. I also asked questions during the discussion to assess understanding and to keep the students engaged in the discussion. At the end of the topic discussion, I asked the students to fill out a survey about how well they understood different aspects of the topic. 

Feedback from the students: The students gave me lots of positive feedback from the post-discussion survey. Some of them mentioned that they really liked the organization of the handout provided. Several mentioned that they enjoyed being asked questions throughout the discussion to test their knowledge. Lastly, a couple of the students said that they appreciated how I made DKA easy to understand compared to their lecture in school which made DKA confusing. 

Feedback from my TCP peer: The feedback from my peer stated that I explained the pathophysiology of DKA really well, especially when discussing the electrolyte abnormalities that patients have in this disease state. Constructive criticism included having a better understanding of when and how subcutaneous insulin is used for the treatment of DKA. This is a new update in the latest guidelines, and I didn't have a great explanation for the proper way to use subcutaneous insulin as the initial insulin therapy in DKA. He also recommended that I include a post-test to evaluate understanding of the topic after the discussion. Overall, my peer said I did a great job explaining the treatment of DKA from a pharmacist's perspective and that I answered the students' questions very well. 

Feedback from my preceptor: The feedback from my preceptor highlighted the fact that I needed to talk more slowly, especially when explaining the pathophysiology of DKA. He said that even though I talked quickly during the pathophysiology, I did a good job at referencing the pathophysiology throughout the discussion. The items he marked me strongly in were the organization of the discussion and handout, providing evidence-based information, clinical knowledge of the subject, and providing a positive learning environment. The items he marked that I could improve in were explanation of the pathophysiology and providing examples or case scenarios to enhance the understanding of DKA.

Reflection: I really enjoy teaching in a small group setting. I liked using a pre-test to assess the students' knowledge prior to the discussion because it allowed me to focus on the areas where the students demonstrated lack of understanding. For example, none of the students correctly answered the question asking when it is appropriate to transition from IV insulin to SQ insulin in the treatment of DKA. This informed me that I needed to focus on how we can determine that a patient's DKA has completely resolved based off of several different labs and the clinical status of the patient. During this discussion, I made sure to ask questions throughout in order to keep the students engaged and to assess their understanding. If they answered the questions correctly, I knew I didn't need to harp on that particular part of the discussion, but if they answered incorrectly, I took more time to explain the answers and reasoning behind them. Overall, I felt very confident teaching this topic and enjoyed the discussion that we had.