title: Deficiencies in postgraduate training for healthcare professionals who provide diabetes education and support: results from the Diabetes Attitudes, Wishes and Needs (DAWN2) study.
abstract: To consider the global provision of self-management diabetes education and training for healthcare professionals using data from the second Diabetes Attitudes, Wishes and Needs (DAWN2) study.
  
  
  
  A total of 4785 healthcare professionals caring for people with diabetes were surveyed in 17 countries to assess diabetes healthcare provision, self-management support and training.
  
  
  
  Of the healthcare professionals surveyed, 33.5% received formal postgraduate training in self-management (19.3-51.4% across countries) and 62.9% received training for medical management of diabetes (47.6-70.6% variation). Training in psychological management was low (19.1%), ranging from 3.6 to 36.5%, while 20.4% (a range of 3.6-36.4% across countries) had received no postgraduate training. Overall, the greatest training need was in the management of psychological aspects of diabetes (59.5%). For some, training in a domain was positively associated with a perceived need for further training. Communication skills, for example, listening (76.9%) and encouraging questions (76.1%), were the skills most widely used. Discussion of emotional issues was limited; 31-60% of healthcare professionals across the different countries reported that this only occurred if initiated by patients. Approximately two-thirds of participants reported a need for major improvements in emotional/psychological support, but few had received training in this area, with consistent findings across professional affiliations.
  
  
  
  The present study shows that healthcare professionals report being insufficiently equipped to provide diabetes self-management education, including emotional and psychological aspects of diabetes, and many are not receiving postgraduate training in any part (including medical care) of the management of diabetes. It is paramount that those responsible for the continuing professional development of healthcare professionals address this skills gap.
authors.affiliation: University Hospitals of Leicester NHS Trust, Leicester, UK.
authors.forename: J L
authors.initials: JL
authors.lastname: Byrne
authors.affiliation: University of Leicester, Leicester, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Davies
authors.affiliation: Diabetes Management Research, Steno Diabetes Centre, Gentofte, Denmark.
authors.forename: I
authors.initials: I
authors.lastname: Willaing
authors.affiliation: Human Development and Health Academic Unit, University of Southampton, Southampton, UK.
authors.forename: R I G
authors.initials: RIG
authors.lastname: Holt
authors.affiliation: University Hospitals of Leicester NHS Trust, Leicester, UK.
authors.forename: M E
authors.initials: ME
authors.lastname: Carey
authors.affiliation: University Hospitals of Leicester NHS Trust, Leicester, UK.
authors.forename: H
authors.initials: H
authors.lastname: Daly
authors.affiliation: Novo Nordisk Psychosocial Research, Bagsvaerd, Denmark.
authors.forename: S
authors.initials: S
authors.lastname: Skovlund
authors.affiliation: Sociology Department, Loyola University Maryland, Baltimore, MD, USA.
authors.forename: M
authors.initials: M
authors.lastname: Peyrot
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003131:Combined Modality Therapy; D017281:Cost of Illness; D003920:Diabetes Mellitus / Q000628:therapy*; D004496:Education, Continuing; D000066498:Emotional Adjustment; D005260:Female; D014943:Global Health; D019538:Health Care Surveys; D058015:Health Communication; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010353:Patient Education as Topic; D000072858:Psychosocial Support Systems; D000073278:Self-Management / Q000193:education; D000078329:Workforce