![]() ![]() Although these are modest effects, it encourages further research in this area. This went up to 2.80 immediately after the intervention and to 2.93 3 months afterwards. Their pretest score for overall confidence in ‘managing patients with diabetes’ was 2.73 of a maximum 4. Confidence was rated on five-point scales where 0 was ‘not very confident at all’ and 4 was ‘very confident’. Participants rated confidence in performing the tasks specified in simulated exercises and their overall confidence in managing patients with diabetes requiring insulin treatment. They assessed performance and confidence before, during and 3 months after the workshop. One exception is the study by Conn et al, 3 which involved 15 junior doctors (midway through their first postgraduation year) who undertook two 1 h simulated scenarios workshops on the practical skills required to manage glycemic control of insulin-treated patients. 6 There are many existing resources that aim to impart knowledge to junior doctors about diabetes, 7 but very few focus on practical skills, or encourage learners to articulate how they would manage different scenarios or to visualize themselves in role, despite good evidence that medical trainees learn best through doing. Yet 75% of foundation year 1 (FY1) doctors in a UK study failed an applied knowledge test on this topic. These findings are worrying given that prescribing insulin is considered a high-risk activity, being error prone, and with errors having potentially serious consequences for patient safety. Reported confidence across all diabetes-related domains were lower than in the two similar areas of medicine studied with 66% fully confident in the management of angina and 65% fully confident in the management of asthma, irrespective of stage of training. Confidence in diabetes management ranged from 55% for diagnosing and managing hypoglycemia, to 18% for altering diabetes therapy prior to surgery. They assessed the confidence of respondents using the Royal College of Physicians ‘Confidence Rating’ four-point scale (CR1: ‘not confident’, CR2: ‘satisfactory but lacking confidence’, CR3: ‘confident in some cases’, and CR4: ‘fully confident in most cases’). ![]() 3–5 In 2011, George et al 5 undertook a national online survey of trainee doctors (foundation and specialist trainees) in the UK. Junior doctors, unfortunately, do not feel well prepared to prescribe in general, or for diabetes in particular. As such, they need to make basic decisions about managing patients with diabetes and know when to seek help from more senior or specialist staff. 2 With such a prevalent disease, junior doctors who are the front-line staff in many hospital settings encounter patients with diabetes frequently. According to the WHO, approximately 1.5 million deaths were caused by diabetes in 2012, 1 and the global prevalence of diabetes was around 9% adults in 2014. ![]()
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