An assessment instrument to measure physicians' knowledge of diabetes management.

A 57-item multiple choice test to assess physicians' knowledge of current approaches to diabetes management was devised by a multidisciplinary team that developed the test's case studies and questions. This test was revised based on critiques by diabetologists and other specialists at the Washington University Medical Center and its Diabetes Research and Training Center. A pilot test of the instrument was conducted with 95 residents from five accredited residency training programs and 17 medical students, and the results demonstrated consistent gaps in the respondents' knowledge in several major categories of diabetes management. The test was validated by administering it to 20 endocrinologists with known diabetes expertise and 16 nonspecialist family practice and internal medicine physicians. Analysis of these results revealed significant differences in test performance between the nonspecialists and experts. This initial body of data was used to refine the instrument further to the 56-item test presently being administered nationwide by the diabetes center to groups of family practice and internal medicine physicians and to residents and medical students.