Feasibility and acceptability of the use of flash glucose monitoring encountered by Indigenous Australians with type 2 diabetes mellitus: initial experiences from a pilot study.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is highly prevalent within the Indigenous Australian community. Novel glucose monitoring technology offers an accurate approach to glycaemic management, providing real-time information on glucose levels and trends. The acceptability and feasibilility of this technology in Indigenous Australians with T2DM has not been investigated. OBJECTIVE: This feasibility phenomenological study aims to understand the experiences of Indigenous Australians with T2DM using flash glucose monitoring (FGM). METHODS: Indigenous Australians with T2DM receiving injectable therapy (n = 8) who used FGM (Abbott Freestyle Libre) for 6-months, as part of a clinical trial, participated in semi-structured interviews. Thematic analysis of the interviews was performed using NVivo12 Plus qualitative data analysis software (QSR International). RESULTS: Six major themes emerged: 1) FGM was highly acceptable to the individual; 2) FGM's convenience was its biggest benefit; 3) data from FGM was a tool to modify lifestyle choices; 4) FGM needed to be complemented with health professional support; 5) FGM can be a tool to engage communities in diabetes management; and 6) cost of the device is a barrier to future use. CONCLUSIONS: Indigenous Australians with T2DM had positive experiences with FGM. This study highlights future steps to ensure likelihood of FGM is acceptable and effective within the wider Indigenous Australian community.

Beyond Selection: The Use of Situational Judgement Tests in the Teaching and Assessment of Professionalism.

PROBLEM: Professionalism is a critical attribute of medical graduates. Its measurement is challenging. The authors sought to assess final-year medical students' knowledge of appropriate professional behavior across a broad range of workplace situations. APPROACH: Situational judgement tests (SJTs) are used widely in applicant selection to assess judgement or decision making in work-related settings as well as attributes such as empathy, integrity, and resilience. In 2014, the authors developed three 40-item SJTs with scenarios relevant to interns (first-year junior doctors) and delivered the tests to final-year medical students to assess aspects of professionalism. As preparation, students discussed SJT-style scenarios; after the tests they completed an evaluation. The authors applied the Angoff method for the standard-setting process, delivered electronic individualized feedback reports to students post test, and provided remediation for students failing to meet the cut score. OUTCOMES: Evaluation revealed that the tests positively affected students' learning and that students accepted them as an assessment tool. Validity and reliability were acceptable. Implementation costs were initially high but will be recouped over time. NEXT STEPS: Recent improvements include changes to pass requirements, question revision based on reliability testing, and provision of detailed item-level feedback. Work is currently under way to expand the item bank and to introduce tests earlier in the course. Future research will explore correlation of SJT performance with other measures of professionalism and focus on the impact of SJTs on professionalism and interns' ability to deal with challenging workplace situations.