A dose of reality: Continuous glucose monitoring simulation in pharmacy education
DOI:
https://doi.org/10.46542/pe.2025.251.514522Keywords:
Continuous glucose monitoring, Diabetes mellitus, Digital health, Pharmacy education, Simulation trainingAbstract
Background: Continuous glucose monitoring (CGM) is recommended for many patients with diabetes. Little is known about how best to teach this topic in pharmacy education. A simulation was developed to improve pharmacy students’ knowledge, empathy, and confidence regarding CGMs.
Methods: Twenty-six third-year pharmacy students enrolled in a diabetes elective attended a 50-minute lecture and completed a 26-item pre-survey assessing knowledge, empathy, and confidence. After using a CGM for up to 14 days, they completed a 2-week post-survey to measure changes in these areas, with a matched control group for comparison.
Results: Twenty-three simulation and five control students completed educational activities and pre- and post-surveys. Knowledge scores improved more in the simulation group (+14.2 percentage points, p = 0.002) than in the control group (+0.4 percentage points, p = 0.475). Both groups showed increases in empathy and confidence, with a larger change in the simulation group, and students reported high satisfaction with the experience.
Conclusion: Simulation students gained knowledge and confidence in counselling and using CGM devices from the CGM-wearing experience, compared to those who only attended lectures. This small study suggests incorporating CGM experience into pharmacy curricula, though a larger sample size is needed to validate the findings.
References
Accreditation Council for Pharmacy Education. (n.d.). Accreditation standards and key elements for the professional program in pharmacy leading to the doctor of pharmacy degree. Retrieved November 13, 2023, from https://www.acpeaccredit.org/pdf/Standards2016FINAL.pdf
ADCES and APhA/APhA Foundation. (2020, December). Personal continuous glucose monitoring implementation playbook. The Association of Diabetes Care & Education Specialists. https://media.pharmacist.com/practice/PERSONAL_CGM_PLAYBOOK_R_3_11_2021.pdf
American Diabetes Association Professional Practice Committee, ElSayed, N. A., Aleppo, G., Bannuru, R. R., Bruemmer, D., Collins, B. S., Ekhlaspour, L., Hilliard, M. E., Johnson, E. L., Khunti, K., Lingvay, I., Matfin, G., McCoy, R. G., Perry, M. L., Pilla, S. J., Polsky, S., Prahalad, P., Pratley, R. E., Segal, A. R., … Gabbay, R. A. (2024). 7. Diabetes technology: Standards of care in diabetes—2024. Diabetes Care, 47(Supplement_1), S126–S144. https://doi.org/10.2337/dc24-S007
Aronson, B. D., Chen, A. M. H., Blakely, M. L., Kiersma, M. E., & Wicker, E. (2022). Evaluation and revision of the Kiersma-Chen empathy scale. American Journal of Pharmaceutical Education, 86(5), 8685. https://doi.org/10.5688/ajpe8685
Barchiesi, M. A., Calabrese, A., Costa, R., Di Pillo, F., D’Uffizi, A., Tiburzi, L., & Zahid, E. (2025). Continuous glucose monitoring in type 2 diabetes: A systematic review of barriers and opportunities for care improvement. International Journal for Quality in Health Care, 37(3), mzaf046. https://doi.org/10.1093/intqhc/mzaf046
Blonde, L., Umpierrez, G. E., Reddy, S. S., McGill, J. B., Berga, S. L., Bush, M., Chandrasekaran, S., DeFronzo, R. A., Einhorn, D., Galindo, R. J., Gardner, T. W., Garg, R., Garvey, W. T., Hirsch, I. B., Hurley, D. L., Izuora, K., Kosiborod, M., Olson, D., Patel, S. B., … Weber, S. L. (2022). American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan—2022 update. Endocrine Practice, 28(10), 923–1049. https://doi.org/10.1016/j.eprac.2022.08.002
Davies, M. J., Aroda, V. R., Collins, B. S., Gabbay, R. A., Green, J., Maruthur, N. M., Rosas, S. E., Del Prato, S., Mathieu, C., Mingrone, G., Rossing, P., Tankova, T., Tsapas, A., & Buse, J. B. (2022). Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia, 65(12), 1925–1966. https://doi.org/10.1007/s00125-022-05787-2
DeSalvo, D. J., Noor, N., Xie, C., Corathers, S. D., Majidi, S., McDonough, R. J., Polsky, S., Izquierdo, R., Rioles, N., Weinstock, R., Obrynba, K., Roberts, A., Vendrame, F., Sanchez, J., & Ebekozien, O. (2023). Patient demographics and clinical outcomes among type 1 diabetes patients using continuous glucose monitors: Data from T1D exchange real-world observational study. Journal of Diabetes Science and Technology, 17(2), 322–328. https://doi.org/10.1177/19322968211049783
Folz, H. N., Lee, S., & Sherrill, C. H. (2025). Student pharmacist counseling performance after hands-on continuous glucose monitoring education: A multi-institutional pragmatic randomised study. Patient Education and Counseling, 131, 108578. https://doi.org/10.1016/j.pec.2024.108578
Folz, H., Sherrill, C. H., & Lee, S. (2023). A dual-site randomised study evaluating patient counseling performance after a hands-on continuous glucose monitoring experience. AACP Pharmacy Education Annual Meeting. https://www.ajpe.org/article/S0002-9459(23)00276-0/abstract
Hojat, M., Louis, D. Z., Markham, F. W., Wender, R., Rabinowitz, C., & Gonnella, J. S. (2011). Physiciansʼ empathy and clinical outcomes for diabetic patients. Academic Medicine, 86(3), 359–364. https://doi.org/10.1097/ACM.0b013e3182086fe1
Kelley, K. A., Williams, V. L., & Chen, A. M. H. (2023). The challenge of curricular overload in the pharmacy academy. American Journal of Pharmaceutical Education, 87(9), 100079. https://doi.org/10.1016/j.ajpe.2023.100079
Knezevich, E., Fuji, K. T., Larson, K., & Muniz, G. (2022). A cross-sectional survey study examining the provision of continuous glucose monitoring education in U.S. Doctor of Pharmacy programs. Pharmacy, 10(6), 174. https://doi.org/10.3390/pharmacy10060174
Korayem, G. B., Alshaya, O. A., Kurdi, S. M., Alnajjar, L. I., Badr, A. F., Alfahed, A., & Cluntun, A. (2022). Simulation-based education implementation in pharmacy curriculum: A review of the current status. Advances in Medical Education and Practice, 13, 649–660. https://doi.org/10.2147/AMEP.S366724
Litten, K., Folz, H., Lobkovich, A., Sherrill, C. H., & Berlie, H. (2025). Integrating continuous glucose monitoring into Doctor of Pharmacy curricula. JACCP: Journal of the American College of Clinical Pharmacy, 8(2), 129–135. https://doi.org/10.1002/jac5.2076
Lobkovich, A., Dabish, R., Gavrilidis, A. M., Globerman, B., & Berlie, H. D. (2025). Continuous glucose monitoring user-wear experience fosters empathy and learning. American Journal of Pharmaceutical Education, 89(6), 101410. https://doi.org/10.1016/j.ajpe.2025.101410
Medina, M. S., Farland, M. Z., Conry, J. M., Culhane, N., Kennedy, D. R., Lockman, K., Malcom, D. R., Mirzaian, E., Vyas, D., Stolte, S., Steinkopf, M., & Ragucci, K. R. (2023). The AACP Academic Affairs Committee’s Final 2022 Curricular Outcomes and Entrustable Professional Activities (COEPA) for Pharmacy Graduates to Replace 2013 CAPE and 2016 EPAs. American Journal of Pharmaceutical Education, 87(8), 100558. https://doi.org/10.1016/j.ajpe.2023.100558
Nimer, S., Schumacher, C., & Bolch, C. (2021). Describing the application and barriers of PHARMACIST‐LED professional continuous glucose monitoring in the ambulatory care setting. JACCP: Journal of the American College of Clinical Pharmacy, 4(12), 1554–1563. https://doi.org/10.1002/jac5.1527
Ong, K. L., Stafford, L. K., McLaughlin, S. A., Boyko, E. J., Vollset, S. E., Smith, A. E., Dalton, B. E., Duprey, J., Cruz, J. A., Hagins, H., Lindstedt, P. A., Aali, A., Abate, Y. H., Abate, M. D., Abbasian, M., Abbasi-Kangevari, Z., Abbasi-Kangevari, M., Abd ElHafeez, S., Abd-Rabu, R., … Vos, T. (2023). Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: A systematic analysis for the Global Burden of Disease Study 2021. The Lancet, 402(10397), 203–234. https://doi.org/10.1016/S0140-6736(23)01301-6
Oser, T. K., Hall, T. L., Dickinson, L. M., Callen, E., Carroll, J. K., Nease, D. E., Michaels, L., & Oser, S. M. (2022). Continuous glucose monitoring in primary care: Understanding and supporting clinicians’use to enhance diabetes care. The Annals of Family Medicine, 20(6), 541–547. https://doi.org/10.1370/afm.2876
Parker, D., Fontem, A., Ojong, E., & Pope, J. (2019). Impact of diabetes simulation on empathy in pharmacy students. American Journal of Pharmaceutical Education, 83(1), 6432. https://doi.org/10.5688/ajpe6432
Sears, L., Imrisek, S. D., Hoy-Rosas, J. R., Lavaysse, L. M., Lee, M., Chapman, M. R., & Dachis, H. (2022, June). CGM attitudes and adoption among people with type 2 diabetes using one drop. Diabetes, 71(Supplement_1), 705–P. https://doi.org/10.2337/db22-705-P
Sherrill, C. H., Lee, S., & Bradley, C. L. (2022). Design and development of a continuous glucose monitoring educational module for students and practicing pharmacists. Currents in Pharmacy Teaching and Learning, 14(1), 62–70. https://doi.org/10.1016/j.cptl.2021.11.021
Stewart, M. P., Loera, L. J., Onwukwe, B., Reveles, K. R., & Lin, K. P. (2025). Assessing the accessibility and accuracy of pharmacist counseling for continuous glucose monitoring: A secret shopper study of community pharmacies. Journal of the American Pharmacists Association, 102493. https://doi.org/10.1016/j.japh.2025.102493
Ulrich, H., & Bowen, M. (2021). The clinical utility of professional continuous glucose monitoring by pharmacists for patients with type 2 diabetes. Journal of the American Pharmacists Association, 61(6), e76–e82. https://doi.org/10.1016/j.japh.2021.05.013
Walker, A. F., Hood, K. K., Gurka, M. J., Filipp, S. L., Anez-Zabala, C., Cuttriss, N., Haller, M. J., Roque, X., Naranjo, D., Aulisio, G., Addala, A., Konopack, J., Westen, S., Yabut, K., Mercado, E., Look, S., Fitzgerald, B., Maizel, J., & Maahs, D. M. (2021). Barriers to technology use and endocrinology care for underserved communities with type 1 diabetes. Diabetes Care, 44(7), 1480–1490. https://doi.org/10.2337/dc20-2753
