The attitudes, experiences, and self-competencies of pediatric endocrinology fellows and attending physicians regarding diabetes technology: the Turkey experience

Abstract

Background Unlike in Western countries, the use of diabetes technologies has been limited in Turkey, or at least until the last few years. This low adoption frequency may be attributed to the lack of experience of pediatric diabetes teams in working with new technologies. The aim of this study is to evaluate the attitudes, experiences and self-efficacies of pediatric endocrinology fellows and attending physicians in terms of use of continuous subcutaneous insulin infusion (CSII) therapy and continuous glucose monitoring (CGM) systems. Methods The questionnaire used in this study consisted of 63 questions including 10 questions evaluating the demographic characteristics and experience of the participants, 33 Likert-type questions related to self-competency, 17 yes/no questions and 3 open-ended questions which evaluated attitudes towards our study area. This questionnaire was e-mailed to pediatric endocrinology fellows and attending physicians working in Turkey. Results A total of 24 fellows and 28 attending physicians working in the field of pediatric endocrinology participated in the survey. Of the respondents, 61% reported that there was no formal training curriculum regarding diabetes technology at their institutions. The mean scores obtained from the Likert scale questions measuring self-competency in using CSII and CGM were 3.8 and 3.3 out of 5, respectively. Of the respondents, 55% judged themselves to be under-skilled in interpreting pump reports while 39% of the respondents reported themselves as being under-skilled in interpreting CGM reports. Conclusions While it is true that training programs for using diabetes technology have been established by the National Pediatric Endocrinology Association in Turkey, the development of a specific curriculum for institutions that provide pediatric endocrinology fellowship training in this framework will increase the self-confidence of pediatric endocrinologists in this matter and this will ultimately contribute to the improvement of the metabolic control of children with diabetes.

Use of continuous glucose monitors in low‐ and middle‐income countries: A scoping review

“…China contributed with seven studies, [16][17][18][19][20][21][22] Colombia with five, [23][24][25][26][27] India with four, [28][29][30][31] Brazil [32][33][34] and Turkey [35][36][37] with three each, and Argentina, 38 Bosnia and Herzegovina, 39 Georgia, 40 Malaysia 41 and Mexico, 42 with one study each (Table 1). Only one report was published in 2002, 32 and the number of reports per year increased steadily, reaching eight reports in 2021, [17][18][19]22,26,31,40,42 and five reports up to July 2022.…”

“…Only one report was published in 2002, 32 and the number of reports per year increased steadily, reaching eight reports in 2021, [17][18][19]22,26,31,40,42 and five reports up to July 2022. 20,30,34,36,38 Overall, seven reports presented results of experimental studies (five randomized trials and two quasiexperimental [pre-post]) 16,17,19,22,27,41,42 ; two reports focused on cost-effective analysis 23,37 and the remaining 18 were observational in nature. The number of participants in the studies varied between 20 and 5072, whereas follow-up time ranged from 14 days to 18 months.…”

“…24 One study reported improvement in quality of life for both parents and children after children started using CGMs, and the device was considered of great help for decision-making, especially when children did physical activity. 40 Finally, a study assessing knowledge about technology in diabetes among T1DM endocrinology fellows and attending physicians, 36 reported that 35% acquired knowledge from the institution where they had received training, 16% acquired knowledge from their patients and 30% acquired knowledge from technology company representatives. Moreover, 33% of the fellows and attending physicians thought their knowledge was adequate.…”

Self-reported skills and self-confidence in point-of-care ultrasound: a cross-sectional nationwide survey amongst Finnish emergency physicians

“…However, the self-assessed competence does seem to correlate with self-confidence [18][19][20] which has been shown to have a positive influence in adapting new skills [21]. The higher the selfconfidence, the more likely that this will be reflected in higher POCUS use, which in turn enhances learning and potentially results in a better patient outcome [22]. As far as we are aware, there are no published studies evaluating how learners self-evaluate their POCUS skills.…”