Improving preparedness of medical students and junior doctors to manage patients with diabetes

Abstract

ObjectiveNew medical graduates are the front-line staff in many hospital settings and manage patients with diabetes frequently. Prescribing is an area of concern for junior doctors, however, with insulin prescribing reported as a particular weakness. This study aimed to produce an educational intervention which aimed to improve preparedness to manage patients with diabetes and evaluate it using a mixed methods approach.Research design and methodsAn e-resource (http://www.diabetesscenariosforjuniordoctors.co.uk) was created to contain commonplace and authentic diabetes decision-making scenarios. –32 junior doctors (n=20) and year 5 students (n=12) in South West England worked through the scenarios while ‘thinking aloud’ and then undertook a semistructured interview. Qualitative data were transcribed verbatim and analyzed thematically. Participant confidence to manage patients with diabetes before, immediately after, and 6 weeks after the educational intervention was also measured using a self-rating scale.ResultsParticipants reported that patients with diabetes were daunting to manage because of the wide array of insulin products, their lack of confidence with chronic disease management and the difficulty of applying theory to practice. The e-resource was described as authentic, practical, and appropriate for the target audience. Junior doctors’ self-rated confidence to manage patients with diabetes increased from 4.7 (of 10) before using the e-resource, to 6.4 immediately afterwards, and 6.8 6 weeks later. Medical students’ confidence increased from 5.1 before, to 6.4 immediately afterwards, and 6.4 6 weeks later.ConclusionsProviding opportunities to work with authentic scenarios in a safe environment can help to ameliorate junior doctors’ lack of confidence to manage patients with diabetes.

A student-implemented elective to improve medical student confidence in providing diabetes self-management support

“… 5 , 6 A study by the University of Exeter Medical School used an online resource to qualitatively improve new doctors’ lack of confidence in managing patients with diabetes. 7 These examples demonstrate a recognized need to improve confidence in clinical diabetes mellitus management.…”

Impact of supplemental training programs on improving medical students’ confidence in providing diabetes self-management education and support

“…A previous study determined that an online bank of diabetes-based clinical cases could address junior doctors’ confidence in managing patients with diabetes. 24 In a study previously published by our group, it was demonstrated that a preclerkship Diabetes Enrichment Elective improved medical students’ confidence in specific aspects of DSMES discussions with patients. 22 The current study differs from our previous one in that it assesses the effectiveness of various training modalities in this area versus a single modality evaluated previously.…”

Prescription Writing in Small Groups as a Clinical Pharmacology Educational Intervention: Perceptions of Preclerkship Medical Students

“…Arguably, this may not necessarily be the best instructional method. Previous studies have stressed the importance of providing opportunities to work with authentic clinical scenarios in a safe environment, which can ameliorate junior doctors’ lack of confidence to manage patients with drugs …”