Diabetes is the fastest growing chronic condition in Australia. In 2015-2016 the Australian Institute of Health and Welfare found 1,053,700 patients were hospitalised with diabetes as an additional diagnosis and 50,000 hospitalisations as the principal diagnosis. Traditionally, insulin education of junior doctors occurs in a didactic form often limited to intern orientation. Junior doctors are not confident in managing insulin with George et all finding only 18% of junior doctors were comfortable adjusting diabetic medications pre-operatively.
Spaced education is an online education form that uses repetition of core principles often in multiple-choice questions. Forty-three doctors from a tertiary hospital were enrolled to participate in a spaced education program which involved 15 questions covering common inpatient insulin management issues. Two questions were provided in each session and two sessions were given each week. Questions were repeated after 7 days if answered incorrectly and after 13 days if answered correctly. Two attempts of the question had to be answered correctly before a question was retired and a maximum of three attempts were given to each question.
The program had an 83.7% participation rate. In all categories participants improved their knowledge with repeat questioning except on insulin management in TPN which had initial correct response of 100%. The greatest improvement occurred in learning types of insulin and insulin management in steroid therapy. Engagement levels varied depending on the level of training of the participant. A survey of participants found the program easy to use.
Our project shows the utility of online education tools to assist in education of junior doctors. As technology improves strategies to improve doctors knowledge needs to be adapted. We have found that a spaced education online tool is effective and easy to use in the education of insulin for junior doctors.