Purpose: The literature suggests up to 80% of major and 70% of minor amputations can be prevented in patients with diabetes and foot complications who receive appropriate care¹. However, the success rates vary, depending on which wound centres patients attend. We suggest that the level of clinician expertise treating these patients is a significant contributing factor to the variations in outcomes. There are no specific clinical competency standards documented to manage the diabetes foot. We will present an outline of clinical competencies for clinicians to obtain expert status to assess, diagnose and manage people with diabetes related foot ulcers with the aim of establishing minimum standards of expertise for clinicians to manage these patients.
Methods: Expert podiatrists collated information relating to requirements to appropriately assess, diagnose and manage patients with diabetes related foot ulcers. Information was drawn from International Working Group on the Diabetic Foot consensus documents and systematic reviews; articles relating to obtaining expertise and; clinical experience.
Results: A comprehensive outline of the necessary skills and expertise was developed as a checklist to evaluate current expertise of clinicians working with this patient group.
Discussion and key points
     a. Expert care is linked to good patient outcomes².
     b. Expertise requires at least 7 years of clinical experience working with an expert in the area.
     c. To assess whether a clinician has these clinical objectives requires a clinical expert in the area.
Further study is required to develop specific teaching tools for clinicians to obtain:
     a. Knowledge of the clinical topic.
     b. Critical thinking skills.
     c. Objective measure of clinical skill.
Conclusion: We hope that this work initiates the development of a culture that promotes the standardized training of expert wound clinicians, so that patients can receive appropriate evidence based care regardless of which wound treatment centre they attend.