Exploring educational gaps in myelodysplastic syndromes in medical students and internal medicine residents: A dual-institution survey.

Abstract

7118 Background: Myelodysplastic syndromes (MDS) are a heterogeneous and poorly understood group of disorders. Prior studies have focused on patient and provider understanding of these disorders; however, no study to our knowledge has been conducted to explore educational gaps of medical students and medicine residents. The hypothesis of this work is that MDS are poorly understood by trainees, but this could be improved after education. Methods: A nine question survey pertaining to definition, diagnosis, risk assessment and survival in MDS was sent to medical students and medicine residents a week prior to a lecture on MDS. At Duke, the lecture was a senior resident talk; at Rush, it was a medicine grand rounds by a hematology attending. The survey was resent to the initial groups 15 days after the lectures, but only those who attended the lecture were invited to take it. Results: At Duke, the response rate was 141 out of 255 (55%); at Rush, it was 65 out of 414 (16%). Responses for the questions were similar at both institutions with no statistical difference in the percent of correct responses by institution. 83.7% said that anemia was not a normal consequence of aging. 82.4% acknowledged that a bone marrow biopsy is required to diagnose MDS. 57.6% said anemia was the most common hematologic manifestation of MDS. 40.4% said that a hemoglobin of <10 should be referred to hematology. 36.1% said the bone marrow in MDS is hypercellular. 17.6% said MDS transforms to AML in 30% of cases. 11.2% identified MDS as a cause of macrocytic anemia. Only 11.1% identified MDS as a malignancy, and 5.5% identified the average survival of high-risk IPSS stage MDS as 0.4 years. In post-lecture surveys (n= 23), knowledge largely improved. However, given low number of responses, this reached statistical significance in only four of nine questions. Conclusions: MDS are poorly understood by both medical students and residents, especially in regard to the definition as a malignancy, prognosis, and risk of AML evolution. We propose that educational efforts aimed at early trainees would improve these knowledge deficits, in addition to the medical care of patients with MDS. The study is limited by the post-survey completion rate.