Lack of confidence among trainee doctors in the management of diabetes: the Trainees Own Perception of Delivery of Care (TOPDOC) Diabetes Study
Lack of confidence among trainee doctors in the management of diabetes: the Trainees Own Perception of Delivery of Care (TOPDOC) Diabetes Study
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.
761-766
George, J.T.
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Warriner, D.
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Mcgrane, D.J.
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Rozario, K.S.
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Price, H.C.
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Wilmot, E.G.
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Kar, P.
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Stratton, I.M.
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Jude, E.B.
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McKay, G.A.
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on behalf of the TOPDOC Diabetes Study Team
September 2011
George, J.T.
be1608ea-a900-4594-98f9-02f2bf3c5636
Warriner, D.
1ae8e956-b9ba-429c-b5db-e84f4aa1c44f
Mcgrane, D.J.
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Rozario, K.S.
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Price, H.C.
aa1077c0-a908-493e-839e-92aa3cebaaee
Wilmot, E.G.
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Kar, P.
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Stratton, I.M.
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Jude, E.B.
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McKay, G.A.
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George, J.T., Warriner, D., Mcgrane, D.J., Rozario, K.S., Price, H.C., Wilmot, E.G., Kar, P., Stratton, I.M., Jude, E.B. and McKay, G.A.
,
on behalf of the TOPDOC Diabetes Study Team
(2011)
Lack of confidence among trainee doctors in the management of diabetes: the Trainees Own Perception of Delivery of Care (TOPDOC) Diabetes Study.
QJM, 104 (9), , [hcr046].
(doi:10.1093/qjmed/hcr046).
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.
Text
hcr046
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e-pub ahead of print date: 15 April 2011
Published date: September 2011
Additional Information:
Funding Information: this work was supported by the Association of British Clinical Diabetologists (ABCD) through a competitive audit prize administered and adjudicated independently by the ABCD but supported by Eli Lily and Co. Ltd. The study design and the collection, analysis, interpretation of data, the writing of this article and the decision to submit it for publication, are all independent of the funding body. Initial pump-priming funding for this study was provided by Sanofi-aventis UK as an unrestricted educational grant.
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Local EPrints ID: 487038
URI: http://eprints.soton.ac.uk/id/eprint/487038
ISSN: 1460-2725
PURE UUID: ea8e99f7-2219-4707-b1e0-7c1e06c3bfaa
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Date deposited: 09 Feb 2024 17:50
Last modified: 18 Mar 2024 04:01
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Contributors
Author:
J.T. George
Author:
D. Warriner
Author:
D.J. Mcgrane
Author:
K.S. Rozario
Author:
H.C. Price
Author:
E.G. Wilmot
Author:
P. Kar
Author:
I.M. Stratton
Author:
E.B. Jude
Author:
G.A. McKay
Corporate Author: on behalf of the TOPDOC Diabetes Study Team
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