Lack of confidence among trainee doctors in the management of diabetes

The Trainees Own Perception of Delivery of Care (TOPDOC) Diabetes Study

J. T. George, D. Warriner, D. J. Mcgrane, K. S. Rozario, H. C. Price, E. G. Wilmot, P. Kar, I. M. Stratton, E. B. Jude, G. A. McKay, B. McGovan, J. C. Thow, Stephen Atkin, A. Abbas, R. Ahluwalia, J. Anthony, M. Atkin, R. Baburaj, A. Balasanthiran, A. Banarjee & 18 others R. Bhake, N. Black, A. Chakera, R. A. Chudleigh, C. Diacon, C. Fifri, A. C.E. Fountain, R. Herring, R. A. Maitland, Y. Nathan, D. Noimark, C. Otti, D. Patel, S. Phillip, C. J. Schofield, M. Shekar, P. Vas, A. Vijayaraman

Research output: Contribution to journalArticle

46 Citations (Scopus)

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.

Original languageEnglish
Article numberhcr046
Pages (from-to)761-766
Number of pages6
JournalQJM
Volume104
Issue number9
DOIs
Publication statusPublished - Sep 2011
Externally publishedYes

Fingerprint

Diabetic Ketoacidosis
Hypoglycemia
Asthma
Insulin
Surveys and Questionnaires
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

George, J. T., Warriner, D., Mcgrane, D. J., Rozario, K. S., Price, H. C., Wilmot, E. G., ... Vijayaraman, A. (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), 761-766. [hcr046]. https://doi.org/10.1093/qjmed/hcr046

Lack of confidence among trainee doctors in the management of diabetes : The Trainees Own Perception of Delivery of Care (TOPDOC) Diabetes Study. / 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.; McKay, G. A.; McGovan, B.; Thow, J. C.; Atkin, Stephen; Abbas, A.; Ahluwalia, R.; Anthony, J.; Atkin, M.; Baburaj, R.; Balasanthiran, A.; Banarjee, A.; Bhake, R.; Black, N.; Chakera, A.; Chudleigh, R. A.; Diacon, C.; Fifri, C.; Fountain, A. C.E.; Herring, R.; Maitland, R. A.; Nathan, Y.; Noimark, D.; Otti, C.; Patel, D.; Phillip, S.; Schofield, C. J.; Shekar, M.; Vas, P.; Vijayaraman, A.

In: QJM, Vol. 104, No. 9, hcr046, 09.2011, p. 761-766.

Research output: Contribution to journalArticle

George, JT, Warriner, D, Mcgrane, DJ, Rozario, KS, Price, HC, Wilmot, EG, Kar, P, Stratton, IM, Jude, EB, McKay, GA, McGovan, B, Thow, JC, Atkin, S, Abbas, A, Ahluwalia, R, Anthony, J, Atkin, M, Baburaj, R, Balasanthiran, A, Banarjee, A, Bhake, R, Black, N, Chakera, A, Chudleigh, RA, Diacon, C, Fifri, C, Fountain, ACE, Herring, R, Maitland, RA, Nathan, Y, Noimark, D, Otti, C, Patel, D, Phillip, S, Schofield, CJ, Shekar, M, Vas, P & Vijayaraman, A 2011, 'Lack of confidence among trainee doctors in the management of diabetes: The Trainees Own Perception of Delivery of Care (TOPDOC) Diabetes Study', QJM, vol. 104, no. 9, hcr046, pp. 761-766. https://doi.org/10.1093/qjmed/hcr046
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. ; McKay, G. A. ; McGovan, B. ; Thow, J. C. ; Atkin, Stephen ; Abbas, A. ; Ahluwalia, R. ; Anthony, J. ; Atkin, M. ; Baburaj, R. ; Balasanthiran, A. ; Banarjee, A. ; Bhake, R. ; Black, N. ; Chakera, A. ; Chudleigh, R. A. ; Diacon, C. ; Fifri, C. ; Fountain, A. C.E. ; Herring, R. ; Maitland, R. A. ; Nathan, Y. ; Noimark, D. ; Otti, C. ; Patel, D. ; Phillip, S. ; Schofield, C. J. ; Shekar, M. ; Vas, P. ; Vijayaraman, A. / Lack of confidence among trainee doctors in the management of diabetes : The Trainees Own Perception of Delivery of Care (TOPDOC) Diabetes Study. In: QJM. 2011 ; Vol. 104, No. 9. pp. 761-766.
@article{79cbd1c4d8534aa493eadca3bf46bea5,
title = "Lack of confidence among trainee doctors in the management of diabetes: The Trainees Own Perception of Delivery of Care (TOPDOC) Diabetes Study",
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.",
author = "George, {J. T.} and D. Warriner and Mcgrane, {D. J.} and Rozario, {K. S.} and Price, {H. C.} and Wilmot, {E. G.} and P. Kar and Stratton, {I. M.} and Jude, {E. B.} and McKay, {G. A.} and B. McGovan and Thow, {J. C.} and Stephen Atkin and A. Abbas and R. Ahluwalia and J. Anthony and M. Atkin and R. Baburaj and A. Balasanthiran and A. Banarjee and R. Bhake and N. Black and A. Chakera and Chudleigh, {R. A.} and C. Diacon and C. Fifri and Fountain, {A. C.E.} and R. Herring and Maitland, {R. A.} and Y. Nathan and D. Noimark and C. Otti and D. Patel and S. Phillip and Schofield, {C. J.} and M. Shekar and P. Vas and A. Vijayaraman",
year = "2011",
month = "9",
doi = "10.1093/qjmed/hcr046",
language = "English",
volume = "104",
pages = "761--766",
journal = "QJM - Monthly Journal of the Association of Physicians",
issn = "1460-2725",
publisher = "Oxford University Press",
number = "9",

}

TY - JOUR

T1 - Lack of confidence among trainee doctors in the management of diabetes

T2 - The Trainees Own Perception of Delivery of Care (TOPDOC) Diabetes Study

AU - George, J. T.

AU - Warriner, D.

AU - Mcgrane, D. J.

AU - Rozario, K. S.

AU - Price, H. C.

AU - Wilmot, E. G.

AU - Kar, P.

AU - Stratton, I. M.

AU - Jude, E. B.

AU - McKay, G. A.

AU - McGovan, B.

AU - Thow, J. C.

AU - Atkin, Stephen

AU - Abbas, A.

AU - Ahluwalia, R.

AU - Anthony, J.

AU - Atkin, M.

AU - Baburaj, R.

AU - Balasanthiran, A.

AU - Banarjee, A.

AU - Bhake, R.

AU - Black, N.

AU - Chakera, A.

AU - Chudleigh, R. A.

AU - Diacon, C.

AU - Fifri, C.

AU - Fountain, A. C.E.

AU - Herring, R.

AU - Maitland, R. A.

AU - Nathan, Y.

AU - Noimark, D.

AU - Otti, C.

AU - Patel, D.

AU - Phillip, S.

AU - Schofield, C. J.

AU - Shekar, M.

AU - Vas, P.

AU - Vijayaraman, A.

PY - 2011/9

Y1 - 2011/9

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=80052246178&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052246178&partnerID=8YFLogxK

U2 - 10.1093/qjmed/hcr046

DO - 10.1093/qjmed/hcr046

M3 - Article

VL - 104

SP - 761

EP - 766

JO - QJM - Monthly Journal of the Association of Physicians

JF - QJM - Monthly Journal of the Association of Physicians

SN - 1460-2725

IS - 9

M1 - hcr046

ER -