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QJM. 2011 Sep;104(9):761-6. doi: 10.1093/qjmed/hcr046. Epub 2011 Apr 21.

Lack of confidence among trainee doctors in the management of diabetes: the Trainees Own Perception of Delivery of Care (TOPDOC) Diabetes Study.

Author information

1
Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK. j.george@ed.ac.uk

Abstract

BACKGROUND:

There is an increased prevalence of diabetes. Doctors in training, irrespective of specialty, will have patients with diabetes under their care.

AIM:

To determine levels of confidence of doctors in training in the management of diabetes and establish their training needs in this area of clinical practice.

DESIGN:

A national online survey of trainee doctors in the UK using a pre-validated questionnaire.

METHODS:

A four-point confidence rating scale was used to rate confidence in the management of diabetes and comparators. A six-point scale was used to quantify how often trainees would contribute to the management of patients with diabetes and trainees were asked about their training in managing diabetes.

RESULTS:

A total of 2149 doctors completed the survey. The percentage 'fully confident' in diagnosing diabetes was 27%, diagnosing and managing hypoglycaemia 55%, diagnosing and managing diabetic ketoacidosis 43%, managing intravenous (IV) insulin 27%, prescribing IV fluids for patients with diabetes 39% and altering diabetes therapy prior to surgery/other procedure 18%. In comparison, 66% and 65% were 'fully confident' in the management of angina and asthma, respectively (P < 0.05). Forty-one percent would take the initiative to optimize glycaemic control for patients under their care >80% of the time. Respectively, 19% and 35% of respondents reported that their undergraduate and postgraduate training had prepared them adequately to optimize treatment of diabetes. The majority (>70%) wanted further training in managing all aspects of diabetes care.

CONCLUSIONS:

Trainee doctors in the UK lack confidence in the management of diabetes, are unlikely to take the initiative to optimize glycaemic control and report a need for further training.

PMID:
21511736
PMCID:
PMC3158855
DOI:
10.1093/qjmed/hcr046
[Indexed for MEDLINE]
Free PMC Article

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