Experiential CGM training in Primary Care: Mixed-Methods Evaluation of a Nationwide Program in Singapore

Year Submitted: 2025
Published Date: 02 March 2026

Tags: Applied/Translational Research, Mixed-Methods, Training ＆ Education, Experiential Learning, Learning Theories ＆ Framework

About this Content

Aims

1. Assess post-training knowledge, attitudes, and barriers to CGM use.
2. Gather qualitative feedback on CGM training.
3. Identify factors associated with higher self-reported knowledge post-CGM training.

Background

Continuous glucose monitoring (CGM) improves glycemic control, but uptake in primary care is limited by providers lack of experience and confidence. In Singapore, a nationwide training program with didactic and hands-on components (providers wearing CGM devices) was implemented across public primary care to address this gap. We evaluated its impact on providers readiness to adopt CGM.

Methods

Seventy-one providers completed a post-training survey assessing CGM knowledge, confidence, attitudes, barriers, and satisfaction. Additionally, 29 providers participated in focus groups / interviews 1-3 months later to explore experiences. Survey data were analysed descriptively and qualitative data via thematic analysis.

Results

Post-training, 95% of providers reported improved CGM knowledge and 99% felt prepared to use CGM; over 90% intended to integrate CGM into practice. Attitudes were highly positive overall, though about one-third remained hesitant about interpreting CGM data. Time constraints (56%) and patient cost (75%) were the top barriers identified. Nearly all participants were satisfied with the training. Qualitatively, providers described the hands-on experience as eye-opening and empathy-building, and they recommended follow-up support (refresher training, data interpretation tools, patient resources) to sustain CGM use in routine care.

Conclusion

Experiential training effectively empowered primary care teams to adopt CGM, yielding major gains in provider knowledge, confidence, and patient-centred attitudes. However, translating these gains into routine practice requires system-level support such as follow-up education, workflow integration, and addressing time and cost barriers. This initiative offers a scalable model for integrating CGM into primary care.

Lessons Learnt

[1] Experiential learning is transformative for provider confidence and empathy: Requiring healthcare providers to wear CGM devices themselves created a powerful seeing is believing effect. Firsthand experience enhanced technical confidence, deepened empathy for patients, and strengthened the credibility of patient counselling.

[2] Training must extend beyond device application to data interpretation: While hands-on application was highly valued, providers reported ongoing uncertainty in interpreting glucose patterns and translating data into clinical decisions. Structured interpretation modules and case-based learning are essential.

[3] Refresher sessions are critical for sustaining competence: Confidence and skills diminished over time without reinforcement. Regular refresher training and accessible reference materials are needed to maintain proficiency.

[4] Device selection should be contextual and patient-centred: Providers identified clear trade-offs between real-time and intermittently scanned CGM systems (e.g., alarm burden vs. simplicity and cost). Matching device features to patient characteristics and preferences is crucial.

[5] Psychological impact must be addressed proactively.
Continuous glucose feedback can trigger anxiety, alarm fatigue, or distress. Training should prepare providers to counsel patients on emotional responses to CGM use.

[6] Cost and equity considerations shape real-world implementation:
In resource-conscious public primary care settings, affordability and subsidy structures strongly influence adoption. Clear patient selection criteria and cost-aware deployment strategies are necessary for sustainable scale-up.

[7] Training alone is insufficient, system-level integration is required:
Successful implementation depends on workflow integration, troubleshooting support, structured protocols, and ongoing institutional backing.

Keywords

Continuous glucose monitoring, experiential learning, diabetes education, healthcare provider training

Innovators' Details

Connect with this contributor!

Shilpa Tyagi - shilpa.tyagi@moht.com.sg

Project Attachment

report.pdf