Knowledge, Attitudes, and Decision Making in Hospital Glycemic Management: are Faculty up to Speed?

Abstract

Knowledge and confidence deficits in the management of hospital glucose abnormalities are prevalent among resident physicians. However, it is unclear whether such gaps prevail among faculty within different professional fields. In this study, we examined faculty knowledge and explored perceptions of challenges related to the management of inpatient hyperglycemia and diabetes. We conducted a survey that examined management decisions about inpatient hyperglycemia and diabetes among Medicine, Medicine/Pediatrics, Family and Community Medicine, Surgery, and Neurology faculty clinicians. All participating faculty had teaching and patient care responsibilities. Responses from 69 faculty participants revealed gaps in several areas, including biomedical and contextual knowledge, familiarity with resources, clinical decision making, and self-efficacy. We identified important factors perceived as barriers to optimal glycemic management in the inpatient settings. The results of this study enhance our insight about the limitations existing among faculty related to the management of hyperglycemia and diabetes in hospitalized patients. We suggest that these barriers may impede optimization of patient care. Faculty play a crucial role in the clinical decision-making process and quality of care delivered by trainees. Therefore, attending physicians are likely to impact trainees' clinical performance and competency in the management of inpatient diabetes during training and beyond. Education in this subject should be a priority among trainees and faculty alike.