Improving Management of Type 2 Diabetes in a Rural Clinic: Evaluating a Clinician-Led Knowledge Assessment Tool

Abstract

PURPOSE: The purpose of this project was to evaluate the effectiveness of the Diabetes Knowledge Questionnaire (DKQ-24) in improving ability of clinicians to identify knowledge gaps in Type 2 Diabetes Mellitus (T2DM) management and enhance patient education in a rural clinical setting. The project aimed to assess provider confidence, adherence to evidence-based guidelines, and engagement in structured diabetes education. METHODS: A quality improvement initiative was conducted at a rural clinic, Cline Family Medicine, using Kirkpatrick’s Four-Level Evaluation Model. Three clinicians (one nurse practitioner and two physicians assistants) participated in a four-week intervention period. The DKQ-24 tool was implemented and a post-assessment conducted via REDCap surveys. The evaluation framework assessed provider feedback, knowledge acquisition, behavioral changes, and patient impact. RESULTS: Clinicians reported increased confidence in T2DM management following DKQ-24 implementation. Survey responses indicated improved adherence to evidence-based guidelines and greater engagement in structured diabetes education. Positive qualitative feedback supported the usability and effectiveness of the tool. Limitations included a small sample size (n=3), a short study period (4 weeks), and potential bias due to self-reported data. IMPLICATIONS FOR PRACTICE: Findings suggest that the DKQ-24 is a valuable tool for enhancing provider knowledge and improving T2DM management in a rural clinical setting. Long-term integration of the DKQ-24 into clinic workflows and electronic medical record systems could further enhance efficiency. Additional research is needed to assess the tool’s long-term impact on patient health outcomes and investigate implementation barriers, such as provider burden, patient engagement, and EMR integration of the DKQ-24 into practice. Future investigations should include expanding the project to additional rural clinical settings and securing funding for sustained implementation.