Investigating the fluid and electrolyte prescribing knowledge of Foundation Year doctors

Changes to the medical curriculum have been advocated to improve knowledge on fluid and electrolytes. We aimed to determine the contemporary level of knowledge of trainee doctors on different aspects of fluid and electrolyte prescribing.

An online survey was distributed to Foundation Year doctors working throughout the United Kingdom. The first part determined demographic information, where participants studied and currently work, and probed their perceptions of their knowledge on fluid and electrolytes. The second part tested knowledge on a wide variety of aspects of fluid and electrolyte management using 20 multiple-choice questions.

In total, 190 responses were received. Trainee doctors remain responsible for much of the fluid and electrolyte management of patients, and often practise independently. Overall, the average 'score' of each respondent was suboptimal (52%), with no significant difference found between doctors in the first or second year of postgraduate medical practice. Many participants were unable to correctly identify the components of common intravenous fluid products. Understanding of daily electrolyte requirements was also demonstrated poorly, although most showed a good understanding of the daily requirements of water and glucose. The amount of time in medical school allocated to the topic remains low, as do doctors' confidences in their abilities to prescribe fluid and electrolytes.

Knowledge surrounding fluid and electrolyte prescribing remains suboptimal, and Foundation Year doctors are frequently undertaking this responsibility independently. These findings reflect previous research performed over the past 20 years, and little improvement appears to have been made.