Open Access Study protocol

Protocol for a national audit on self-reported confidence levels, training requirements and current practice among trainee doctors in the UK: The Trainees Own Perception of Delivery of Care in Diabetes (TOPDOC) Study

Jyothis T George1, David J McGrane2, David Warriner3, Kavitha S Rozario4, Hermione C Price5, Emma G Wilmot6, Partha Kar7, Edward B Jude8, Gerard A McKay9* and the TOPDOC Study Team

Author Affiliations

1 The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh, UK

2 Inverclyde Royal Hospital, Greenock, UK

3 Barnsley District General Hospital, Barnsley, UK

4 Royal Hospital for Sick Children, Edinburgh, UK

5 Horton Hospital, Banbury, UK

6 University Hospitals of Leicester, Leicester, UK

7 Queen Alexandra Hospital, Portsmouth, UK

8 Tameside General hospital, Ashton-under-Lyne, UK

9 University Medical Unit, Glasgow Royal Infirmary, Glasgow, UK

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BMC Medical Education 2010, 10:54  doi:10.1186/1472-6920-10-54

Published: 27 July 2010



As the incidence and prevalence of diabetes increases across the world, resource pressures require doctors without specialist training to provide care for people with diabetes. In the UK, national standards have been set to ensure quality diabetes care from diagnosis to the management of complications. In a multi-centre pilot study, we have demonstrated a lack of confidence among UK trainee doctors in managing diabetes. Suboptimal confidence was identified in a number of areas, including the management of diabetes emergencies. A national survey would clarify whether the results of our pilot study are representative and reproducible.


Target cohort: All postgraduate trainee doctors in the UK.

Domains Studied: The self reported online survey questionnaire has 5 domains: (1) confidence levels in the diagnosis and management of diabetes, (2) working with diabetes specialists, (3) perceived adequacy of training in diabetes (4) current practice in optimising glycaemic control and (5) perceived barriers to seeking euglycaemia.

Assessment tools: Self-reported confidence is assessed using the 'Confidence Rating' (CR) scale for trainee doctors developed by the Royal College of Physicians. This scale has four points - ('not confident' (CR1), 'satisfactory but lacking confidence' (CR2), 'confident in some cases (CR3) and 'fully confident in most cases' (CR4).

Frequency of aspects of day-to-day practice is assessed using a six-point scale. Respondents have a choice of 'always' (100%), 'almost always' (80-99%), 'often' (50-79%), 'not very often' (20-49%) and 'rarely' (5-19%) or never (less than 5%).


It is anticipated that the results of this national study will clarify confidence levels and current practice among trainee doctors in the provision of care for people with diabetes. The responses will inform efforts to enhance postgraduate training in diabetes, potentially improving the quality of care for people with diabetes.