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

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