Junior Physicians, Are They Equipped to Manage Diabetes? Situation Analysis at Kasr El-Aini Hospital, Cairo University

Abdelaziz, Shaimaa; Elderwi, Douaa; Abou Hashima, Fatma; Elshaikh, Yosra

doi:10.21608/jhiph.2010.20624

Junior Physicians, Are They Equipped to Manage Diabetes? Situation Analysis at Kasr El-Aini Hospital, Cairo University

Document Type : Original Article

Authors

¹ Department of Public Health and Community Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt

² Department of Public Health and Community Medicine, Faculty of Medicine, Helwan University Hospital, Helwan, Egypt

10.21608/jhiph.2010.20624

Abstract

Background: Diabetes is a chronic illness that requires continuing medical care and patient self management education to prevent acute complications and to reduce the risk of long-term complications. Objective: Toassess junior physicians' competencies (knowledge, attitude and skills) as regards care of diabetic patients and to evaluate efficacy of the existing system in the form of gap analysis for Faculty of Medicine curricula and practical training courses. Methods: A cross sectional study was conducted on 310 junior physicians, working at Kasr El-Aini Hospital, Faculty of Medicine, Cairo University. Two hundred and fifty house officers attending the rotations of internal medicine and general surgery and sixty residents from these departments were included.Research instrument was a questionnaire that inquired about four discrete areas: demographic data, knowledge, attitude and practice (KAP) domains in the field of diabetes and its complications. A scoring system was developed for every question. These scores were then converted into percentages and a mean of the total scores was calculated for each domain. Cut-off level of 60% or more was identified as the acceptable level. The undergraduate curricula courses specifications and intended learning outcomes (ILOs) for the subjects studied in the six years of medical education (year 2008-2009) were reviewed. Results: In our study 53.6% of the house officers and 55% of the residents were males. Two thirds of both groups had family history of diabetes. Regarding knowledge, the mean percent score of residents was significantly higher than that of house officers (41.4±6.4 and 38.1±6.0 respectively, p<0.001). Yet, both groups could not reach the 60% acceptable level of correct answers on any of the four areas of the knowledge domain. Our results revealed that the junior physicians had good attitudetowards management of diabetes and its complications with a mean percent score of 81.2±5.7. A significant positive linear relationship was observed between knowledge and attitude scores of the junior physicians (r=0.093, p<0.001). The majority of them had undesirable practice abilities. Mean percent score of the residents’ practices was significantly higher than that of the house officers (p<0.05). Reviewing the undergraduate curricula ILOs and postgraduate log book for the house officers and comparing them with the international guidelines revealed that the six years undergraduate curricula of Faculty of Medicine covered all the topics and acquired skills about diabetes and its complications, while there was shortage in the house officers’ training log book regarding management skills for diabetes. Conclusion: This study has explored several aspects of diabetes related KAP of junior physicians. It highlights the need for improvement in their practices for treating and educating diabetics.

Keywords