title: Training tomorrow's doctors in diabetes: self-reported confidence levels, practice and perceived training needs of post-graduate trainee doctors in the UK. A multi-centre survey.
abstract: OBJECTIVE
  To assess the confidence, practices and perceived training needs in diabetes care of post-graduate trainee doctors in the UK.
  
  
  METHODS
  An anonymised postal questionnaire using a validated 'Confidence Rating' (CR) scale was applied to aspects of diabetes care and administered to junior doctors from three UK hospitals. The frequency of aspects of day-to-day practice was assessed using a five-point scale with narrative description in combination with numeric values. Respondents had a choice of 'always' (100%), 'almost always' (80-99%), 'often' (50-79%), 'not very often' (20-49%) and 'rarely' (less than 20%). Yes/No questions were used to assess perception of further training requirements. Additional 'free-text' comments were also sought.
  
  
  RESULTS
  82 doctors completed the survey. The mean number of years since medical qualification was 3 years and 4 months, (range: 4 months to 14 years and 1 month). Only 11 of the respondents had undergone specific diabetes training since qualification.4(5%) reported 'not confident' (CR1), 30 (37%) 'satisfactory but lacked confidence' (CR2), 25 (30%) felt 'confident in some cases' (CR3) and 23 (28%) doctors felt fully confident (CR4) in diagnosing diabetes. 12 (15%) doctors would always, 24 (29%) almost always, 20 (24%) often, 22 (27%) not very often and 4 (5%) rarely take the initiative to optimise gcaemic control. 5 (6%) reported training in diagnosis of diabetes was adequate while 59 (72%) would welcome more training. Reported confidence was better in managing diabetes emergencies, with 4 (5%) not confident in managing hypoglycaemia, 10 (12%) lacking confidence, 22 (27%) confident in some cases and 45 (55%) fully confident in almost all cases. Managing diabetic ketoacidosis, 5 (6%) doctors did not feel confident, 16 (20%) lacked confidence, 20 (24%) confident in some cases, and 40 (50%) felt fully confident in almost all cases.
  
  
  CONCLUSIONS
  There is a lack of confidence in managing aspects of diabetes care, including the management of diabetes emergencies, amongst postgraduate trainee doctors with a perceived need for more training. This may have considerable significance and further research is required to identify the causes of deficiencies identified in this study.
authors.affiliation: York Hospital, York, UK. drjtgeorge@yahoo.co.uk
authors.forename: Jyothis T
authors.initials: JT
authors.lastname: George
authors.forename: David A
authors.initials: DA
authors.lastname: Warriner
authors.forename: Jeffrin
authors.initials: J
authors.lastname: Anthony
authors.forename: Kavitha S
authors.initials: KS
authors.lastname: Rozario
authors.forename: Sinu
authors.initials: S
authors.lastname: Xavier
authors.forename: Edward B
authors.initials: EB
authors.lastname: Jude
authors.forename: Gerard A
authors.initials: GA
authors.lastname: McKay
mesh_terms: D000328:Adult; D003920:Diabetes Mellitus / Q000517:prevention & control*; D004501:Education, Medical; D004502:Education, Medical, Continuing / Q000706:statistics & numerical data* / Q000639:trends; D004521:Educational Measurement; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008511:Medicine / Q000706:statistics & numerical data; D017145:Models, Educational; D020380:Needs Assessment / Q000639:trends*; D005791:Patient Care; D013038:Specialization; D011795:Surveys and Questionnaires; D006113:United Kingdom