The implementation of new diagnostic processes and criteria for the diagnosis of gestational diabetes (GDM) contributed to a dramatic rise in the number of women diagnosed with GDM at RWH, with an increase of 83% between 2014 (414 women) and 2016 (792 women). Traditionally at RWH women with GDM were managed in the Diabetes Clinic. To cope with the dramatically increased workload, management of low risk women with GDM was devolved to Obstetricians in “home teams”. High risk women continued to be managed in multidisciplinary diabetes clinics.
To prepare them for their new role, Obstetricians were upskilled in GDM management in small group training sessions conducted by an Endocrinologist, Diabetes Educator (DNE) and dietician. An on-line training programme was also formulated and uploaded.
The aims of this study were to determine whether the training of Obstetricians met their learning needs, and importantly to guide improvements in ongoing or future training.
A brief 12-point questionnaire was given to 20 Obstetricians and 2 Registrars, with a 100% response rate.
Only 2 doctors (9%) of those currently treating GDM attended initial face-to-face GDM training and no doctors were aware of the online training modules. The majority, despite lack of training, were confident in identifying women who needed to commence insulin therapy, but 50% felt the need to refer to the team DNE for titration of insulin doses. Most Obstetricians (78%) believed they had adequate time to address GDM-related issues. Furthermore, all felt they were adequately supported by DNEs, endocrinologists and dieticians. Most expressed a need for an update in GDM management.
Very significant deficiencies in initial and ongoing training of Obstetricians who manage GDM were identified; further, they were unaware of online training resources. It is vital to provide ongoing education and support for Obstetricians who manage women with GDM at RWH.