US Fourth-Year Medical Students: Diabetes Knowledge and Confidence Dissonance

Self-assessed confidence is not a reliable indicator of knowledge levels, as multiple studies have shown; however, it is often used as a measure of knowledge. The purpose of this study is to identify whether the confidence of graduating students in a US medical school to diagnose and treat diabetes is correlated with their diabetes-related knowledge.

We developed a 38-question survey, targeting students' external experiences, knowledge, and confidence related to the diagnosis, treatment, and prevention of diabetes. The survey includes six self-reported confidence questions and 15 multiple choice-style questions, to test diabetes knowledge. The survey was administered electronically using REDCap to the graduating medical school class (n=176) at Upstate Medical University. We calculated mean knowledge scores and confidence scores were calculated. We used Pearson correlation and t tests to assess for correlations and differences in the collected data. We also reviewed diabetes content in the current curriculum.

The response rate was 38%. The mean confidence score was 19.97 out of 30 (SD=3.92) and the mean knowledge score was 9.63 out of 15 (SD=2.09). Total knowledge and confidence scores were not correlated. A positive correlation between confidence in prescribing/adjusting medications to treat patients with type 1 diabetes and knowledge levels was found (R=.325, P=.007). Academic electives, external experiences with diabetes, and demographics did not correlate with knowledge and confidence differences.

Students overestimated their ability to adequately manage people with diabetes. Better approaches are needed to prepare future physicians to diagnose and treat diabetes.