Diabetologist's core competence curriculum: A position statement of the amd (Italian association of medical diabetologists)
2019
Background: The management of chronic diseases requires integrated, patient-centered,
medicine, technological and therapeutic innovation, as clearly explained in all chronic
management models, such as the Chronic Care Model (CCM). The Italian association of
medical diabetologists (AMD) started the project “Diabetes Intelligence” (DIA&INT), aiming at
identifying and ranking major competences required by modern diabetologists to implement
the CCM. Methods: A step-based approach was adopted: 1) identification of 25 activities 19
outcomes for optimal practice in diabetology, obtained from national guidelines for diabetes
care; 2) ranking of the activities according to specificity, through digital questionnaires
administered to a set of diabetes specialists; 3) assessment of the Social Return on Investment
(SROI) of the activities to estimate their impact on the outcomes; 4) annotation of the knowledge
and skills requirements for each activity, as reported by the Italian guideline for diabetes care;
5) evaluation of the collective degree of specificity and priority of each activity. Results: All
results are based on the answers provided by 211 AMD diabetologists. The top 4 activities,
educational therapy, personalized therapeutic plan, biomedical evaluation and assessment of
fragility obtained excellent scores in terms of intensity and pervasivity showing a high sphere
of influence. The activities judged as more specific were: the definition and management of
personalized treatment plans, and the diagnostic and specialist evaluation - or the biomedical
assessment. From these results, it emerges that the specific competence of the diabetologist is
strongly associated with the ability to make patients participate and take charge of their own
.condition. Conclusions: This project allowed the definition of a Core Competence Curriculum
for diabetology specialists, formally approved as a position statement by the AMD. This effort
highlights the relationship between assets/knowledge/skills and outcomes in diabetology,
through the application of a rigorous scientific method, as required by the logic of the CCM.
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