title: Peer-to-Peer, Interactive GP Education can Reduce Barriers to Best Practice in Diabetes Management.
abstract: BACKGROUND
  Perceived difficulties in initiating insulin in patients with type 2 diabetes (T2D) may prevent many general practitioners (GPs) from using insulin even when recommended in guidelines. This paper describes a Royal Australian College of General Practitioners accredited education program on starting insulin in T2D, and its impact on GPs' attitudes and behavior.
  
  
  METHODS
  A faculty comprising GPs with diabetes expertise, Credentialed Diabetes Nurse Educators, and endocrinologist developed and implemented the education program. The program content was highly procedure focussed, emphasizing simple, best-practice processes for starting insulin therapy and focussing on multidisciplinary models of care. The highly interactive format of the workshops included peer-to-peer learning, in which education was led by diabetes-experienced GP educators, as well as case study-based approaches and small group discussions. GP attendees were asked to rate their individual confidence and attitudes at the beginning and end of the meeting. In addition, participants (n = 220) from two workshops in 2013 were sent a survey 3 months after the meeting to gauge the longer-term impact on their clinical practice.
  
  
  RESULTS
  Since 2008, more than 2500 GPs have attended the workshops, and report substantial improvements in confidence; after attending, more GPs were willing to start insulin within their practice. Evaluations at 3 months post-meeting indicate that the increased confidence was associated with behavioral changes in the subgroup evaluated at this time (n = 48). Success of this program was attributed to peer-to-peer education, multidisciplinary input, easily implemented best practice procedures and checklists for starting insulin, and constant adjustment of meeting process and content based on feedback and guideline changes.
  
  
  CONCLUSIONS
  A peer-to-peer, interactive GP education program reduced GPs' perceptions of the difficulties of starting insulin in T2D and achieved changes in attendees' clinical practice. This education program offers an effective approach to overcome the therapeutic inertia that is too common in diabetes management.
authors.affiliation: Mediwell, Coorparoo, QLD, Australia. g.deed@uqconnect.net.
authors.forename: Gary
authors.identifier: http://orcid.org/0000-0001-6914-0982
authors.initials: G
authors.lastname: Deed
authors.affiliation: Seaport Practice, Launceston, TAS, Australia.
authors.forename: Gary
authors.initials: G
authors.lastname: Kilov
authors.affiliation: Queen Elizabeth Specialist Centre, Adelaide, SA, Australia.
authors.forename: Patrick
authors.initials: P
authors.lastname: Phillips
authors.affiliation: Platinum Medical Centre, Chermside, QLD, Australia.
authors.forename: Anita
authors.initials: A
authors.lastname: Sharma
authors.affiliation: University of Adelaide, Adelaide, SA, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Leow
authors.affiliation: Toormina and Sawtell Medical Centre, Coffs Harbour, NSW, Australia.
authors.forename: Ian
authors.initials: I
authors.lastname: Arthur
authors.affiliation: Bankstown Medical Centre, Bankstown, NSW, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Barlow
authors.affiliation: Corio Medical Clinic, Geelong, VIC, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Kennedy
keywords: Australia; Continuing medical education; General practitioners; Insulin therapy; Primary care; Type 2 diabetes mellitus