Postgraduate Diploma in Clinical Paediatric Diabetes

Purpose

The purpose of this qualification is to allow practising doctors to develop foundational skills in clinical paediatric diabetes management to ensure safe practice in a resource-scarce setting.

This qualification is therefore aimed at African trainees to improve the care of children and adolescents with diabetes. It is intended to train paediatricians with an interest in diabetes to become proficient in the diagnosis, classification, recognition and management of diabetic emergencies, long term care and the education of children and their families, thereby building capacity to improve child health in Africa. This enables and empowers these working professionals to undertake advanced reflection and development in this sub-area of their practice by means of training which is targeted at current thinking, practice and research methods in the area of paediatric diabetes management, and allows these skilled workers to use their knowledge gained to lobby for improving child health.

Rationale

The Department of Paediatrics has been training general practitioners from other African countries in terms of the African Paediatric Fellowship Programme (APFP) for some years. These trainees benefit from greater support and resources whereby they are able to demonstrate that they have acquired a recognised qualification. However, previously these trainees were not awarded any certification, thus the process needed to be structured so that the trainees leave with a measurable and certified outcome. It is envisaged that the qualification may also be useful to South African doctors in resource-challenged health care settings, and that even paediatricians who are not necessarily exposed to these skills and techniques would also find the training helpful.

Those doctors who wish to and qualify for admission to a speciality or sub-speciality training programme (of 4 and 2 years respectively) may apply for admission to such qualifications. It has been noted that many doctors and specialists cannot leave their jobs in the public health care sector in their home countries for extended periods of time, and furthermore they have no desire to specialise or do research, however, there is a critical need for doctors in Africa, particularly those in resource-poor areas to gain skills in diagnosing and managing (often through referral) the most acute paediatric diseases. This Diploma aims to help address that need.

It must also be pointed out that a full sub-specialisation requires massive investment in infrastructure and this is not possible in some countries. Thus the emphasis in the Diploma would be on core diagnostic skills required at the point of first contact with health care facilities in resource-limited areas.

Recognition of Prior Learning (RPL)

RPL will be possible whereby specific existing knowledge and skills will be assessed in one or more of the courses, against the outcomes of the course and in line with the assessment procedures of the qualification.

Entry Requirements

For admission to this qualification, a learner must be

• Qualified with a Bachelor in medicine (MBBS, MBChB/equivalent qualification).
• Have experience working in paediatrics.
• Registered with the HPCSA.

This qualification consists of 2 compulsory modules at NQF Level 8, totalling 120 Credits.

• Clinical Management of Paediatric Diabetes, 90 Credits.
• Essay: Transition and Translation of Knowledge, 30 Credits.

1. Understand the definition, practices, diagnosis and classification of diabetes.
2. Manage hypoglycaemia in the diabetic.
3. Awareness of associated conditions and other complications.

Associated Assessment Criteria for Exit Level Outcome 1

• Awareness of the prevalence of children with diabetes in Africa is demonstrated and the challenges to correct diagnosis is applied and implement care is displayed.
• The presentation and phases of diabetes is understood.
• Knowledge of current recommended international guidelines relevant to practice in the field is demonstrated and applied.

Associated Assessment Criteria for Exit Level Outcome 2

• Translate knowledge to own practice in home country is understood.
• The essential biochemical screens are understood and the results in managing insulin treatment are interpreted and the different insulin regimens are administered.
• The assessment and monitoring of glycaemic control is understood.
• Diabetes education is provided.
• The role and implications of exercise and diabetes is understood.
• Nutritional management of the diabetic is communicated to patient.
• An appropriate clinical management approach to diabetes care and puberty and adolescent care is displayed.

Associated Assessment Criteria for Exit Level Outcome 3

• Knowledge of microvascular and macrovascular complications of diabetes is understood.
• Diabetic ketoacidosis is managed accordingly.
• Knowledge of ambulatory diabetes care is understood.
• Knowledge of the psychological issues affecting the child with diabetes is understood.

Integrated Assessment

Assessment is both formative and summative. Formative assessment is built on continuous feedback on both knowledge and clinical competence. Knowledge is then applied and such application will be assessed in an extended essay. As well as completion of logbook with varied diabetes related problems must be completed. A formal assessment will be undertaken at three- monthly intervals to gauge the learner`s progress.

An exit examination will consist of a clinical examination in an ambulatory setting and a portfolio based oral examination.