Abstract
Background/Introduction: The appropriate selection of diagnostic investigations is crucial for timely diagnosis, cost-effective care, and informed clinical decision- making. Simulation via Instant Messaging for Bedside Application (SIMBA) is a structured, case-based educational model designed to enhance diagnostic reasoning among healthcare professionals. Purpose: This study aimed to assess the concordance between investigations selected by SIMBA participants and those recommended by expert consultants in endocrinology, to identify potential educational gaps that may impact patient outcomes.
Methods: A retrospective analysis was conducted using data from seven SIMBA sessions held between June 2021 and October 2024, encompassing 21 distinct clinical scenarios in diabetes and endocrinology. Participants selected investigations for each case, while expert endocrinologists independently determined recommended investigations based on current clinical guidelines. Discrepancy analysis focused on expert-recommended investigations that were omitted by participants. Investigations were stratified by clinical theme and participant seniority (junior: upto 3 years of speciality training; senior: more than 3 years of specialty training). Descriptive statistics were presented as frequencies and proportions.
Results: A total of 120 unique participants submitted responses for 545 simulated cases. Of these, 53 were junior-level clinicians, 60 were senior, and 7 did not disclose their training level. Overall, 48.3% of expert-recommended investigations were omitted. The highest omission rates were noted in reproductive endocrinology, adrenal, and metabolic bone scenarios. Notable deficiencies included omission rates of 83.7% for FSH-secreting tumours, 61.1% for Congenital Adrenal Hyperplasia, 60.4% for Osteogenesis Imperfecta, and 58.7% for Turner’s Syndrome. Conversely, cases involving obesity-related conditions showed lower omission rates: primary infertility related to obesity (28.0%), idiopathic intracranial hypertension (16.0%), and emotional eating (12.8%).
Conclusion(s): Findings from this SIMBA-based evaluation reveal substantial variation in diagnostic investigation selection, particularly among junior clinicians and in less commonly encountered endocrine conditions. These gaps likely reflect variation in clinical exposure, confidence, and familiarity with guideline-based investigations. There is a clear need for targeted educational strategies to reinforce evidence-based diagnostic reasoning, particularly in complex endocrine disorders. Future work should explore reasons for omissions and tailor curricula accordingly to enhance diagnostic accuracy and reduce delays in patient care.
Methods: A retrospective analysis was conducted using data from seven SIMBA sessions held between June 2021 and October 2024, encompassing 21 distinct clinical scenarios in diabetes and endocrinology. Participants selected investigations for each case, while expert endocrinologists independently determined recommended investigations based on current clinical guidelines. Discrepancy analysis focused on expert-recommended investigations that were omitted by participants. Investigations were stratified by clinical theme and participant seniority (junior: upto 3 years of speciality training; senior: more than 3 years of specialty training). Descriptive statistics were presented as frequencies and proportions.
Results: A total of 120 unique participants submitted responses for 545 simulated cases. Of these, 53 were junior-level clinicians, 60 were senior, and 7 did not disclose their training level. Overall, 48.3% of expert-recommended investigations were omitted. The highest omission rates were noted in reproductive endocrinology, adrenal, and metabolic bone scenarios. Notable deficiencies included omission rates of 83.7% for FSH-secreting tumours, 61.1% for Congenital Adrenal Hyperplasia, 60.4% for Osteogenesis Imperfecta, and 58.7% for Turner’s Syndrome. Conversely, cases involving obesity-related conditions showed lower omission rates: primary infertility related to obesity (28.0%), idiopathic intracranial hypertension (16.0%), and emotional eating (12.8%).
Conclusion(s): Findings from this SIMBA-based evaluation reveal substantial variation in diagnostic investigation selection, particularly among junior clinicians and in less commonly encountered endocrine conditions. These gaps likely reflect variation in clinical exposure, confidence, and familiarity with guideline-based investigations. There is a clear need for targeted educational strategies to reinforce evidence-based diagnostic reasoning, particularly in complex endocrine disorders. Future work should explore reasons for omissions and tailor curricula accordingly to enhance diagnostic accuracy and reduce delays in patient care.
| Original language | English |
|---|---|
| Article number | lvaf168.047 |
| Pages (from-to) | i23-i24 |
| Number of pages | 2 |
| Journal | European Journal of Endocrinology |
| Volume | 193 |
| Issue number | Supplement_1 |
| DOIs | |
| Publication status | Published - 22 Sept 2025 |
| Event | 12th ESE Young Endocrinologists and Scientists (EYES) Meeting - Humanitas Congress Center, Milan, Italy Duration: 26 Sept 2025 → 28 Sept 2025 |
