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Online diabetes management training for junior doctors
Across the NHS knowledge of diabetes amongst junior doctors tends to be suboptimal. This can lead to poor inpatient diabetes care, clinical incidents and at worst, fatalities. Like all trusts, the challenge Barnet and Chase Farm faced was finding a way to educate waves of 150 to 250 new junior doctors up to three times a year. Face-to-face teaching simply doesnt reach enough doctors and a single teaching session is insufficient to cover all care areas.
To address this challenge, the diabetes team developed a web-based diabetes management teaching module for junior doctors.
The aim was to give all junior doctors the knowledge and confidence to treat patients with diabetes safely and effectively, whether their admission was a diabetes emergency (diabetic ketoacidosis) or whether an insulin-treated patient was admitted with an unrelated medical emergency (e.g. pneumonia or gastroenteritis). Knowledge would be evidenced by passing the test at the end of the module, along with a survey to check confidence levels before and after completing the module.
What did they do?
The team developed the learning module in collaboration with MMt Digital Ltd, a company with a track record in the design of e-learning modules .The Diabetes Management module provides all the knowledge a junior doctor requires to safely identify and treat diabetes patients in any clinical scenario. The module covers an explanation of the different types of insulin available (and their modes of action); recognition and management of newly diagnosed diabetes; safe insulin prescribing; insulin infusions and diabetes emergencies. The module includes a 20-question quiz at the end, which requires a score of 100% (true/false questionnaire) before a certificate of completion of the diabetes management module is issued
The trust compared data from the 2009 inpatient audit with the 2010 audit (which was carried out after half the juniors in the trust had completed the module). The findings showed a significant improvement in the number of good diabetes days from 3 out of 7 to 4 out of 7. The use of insulin infusions halved and was more appropriate. Management of hypoglycaemia improved, especially on the orthopaedic wards, which had the highest uptake of the module amongst junior staff.
Knowledge of junior doctors has increased, in all those who completed the module (112 out of 200 junior doctors after four months).
The junior doctors confidence has increased dramatically following completion of the module. FY1 doctors who had previously been ill equipped to handle out-of-hours emergencies in diabetic inpatients, now have the confidence to manage hypoglycaemia and poorly controlled diabetes effectively.
- 112 out of 200 junior doctors completed the online module over 4 months
- Inpatient audit data showed a 15% increase in good diabetes days
- 50% reduction in use of insulin infusions