S1533 Development of an Online Learning Module on Gastroenterology Issues in Global Health

Abstract

Introduction: Global health (GH) education is expanding and 23.1% of US medical students acquire international health experience prior to postgraduate training. Digestive diseases carry a high global burden. However, few GH programs and professional societies consider the inclusion of gastroenterology into their standard curriculum. In addition, travel restrictions during the COVID-19 pandemic have brought traditional GH rotations to a halt and spurred new educational approaches. Our goal is to develop a comprehensive online learning module on gastroenterology issues in GH for medical students undertaking GH electives. Methods: A team of faculty and residents was convened between the Center for Community and Global Health and the Division of Gastroenterology. GH curricula across institutions and core competencies across 2 professional societies were examined via literature review. A survey was conducted among 2nd (MS2) and 3rd year medical students (MS3) interested in GH to assess attitudes toward GI-related issues in GH curriculum. An online learning module was developed consisting of 10, video-based lessons each addressing specific GH competencies (Figure 1). Results: In total, 41% (28/69) of MS2 and MS3 interested in GH responded to the survey, with a similar distribution of MS2 (13/28) and MS3 (15/28). Nearly all (92.8%) reported that learning GI conditions in a GH curriculum is moderately or very important (Table 1). A majority (78.5%) also reported feeling at least somewhat anxious or more about managing GI conditions during GH electives. Few medical students reported feeling moderately or extremely prepared to identify risk factors for GI conditions in different settings (21.5%) and to define approaches to therapy in resource-limited settings (14.3%). Interestingly, a majority (71.4%) reported feeling not at all prepared or slightly prepared to deliver cost-effective care to challenging populations. Conclusion: Our survey responses demonstrated an unmet need for GI-related training and cost-conscious care in the GH curriculum. Developing an online learning module on GI conditions to supplement GH curriculum may be useful and feasible. A randomized controlled trial is underway to examine the effect of this online learning module on medical student knowledge and preparedness to address GI conditions in GH electives.Figure 1.: Online learning module. Alignment of CUGH global health competencies* and ASTMH clinical competencies** with module lessons. *: Consortium of Universities for Global Health (CUGH) Competency Domains 1-11, Jogerst et al. “Identifying interprofessional global health competencies for 21st-century health professionals.” Annals of global health vol. 81,2 (2015); **: American Society of Tropical Medicine & Hygiene (ASTMH), Certificate of Knowledge in Clinical Tropical Medicine and Travelers' Health Domains 1-7 (CTropMed Examination). Table 1. - Medical students’ attitudes and self-reported preparedness with regards to global health elective (N=28) Survey Item Responses, n (%) Perceived importance of GI-related lessons in a global health curriculum Not important at all Not very important Somewhat important Moderately important Very important 0 (0) 1 (3.6) 1 (3.6) 6 (21.4) 20 (71.4) Anxiety level about managing GI conditions during global health elective Not at all anxious Slightly anxious Somewhat anxious Moderately anxious Extremely anxious 1 (3.6) 5 (17.9) 9 (32.1) 11 (39.3) 2 (7.1) Preparedness to perform the following item during global health elective: Not at all prepared Slightly prepared Somewhat prepared Moderately prepared Extremely prepared Carry out a physical exam 0 (0) 3 (10.7) 9 (32.1) 11 (39.3) 5 (17.9) Cite differential diagnoses 1 (3.6) 8 (28.6) 11 (39.3) 4 (14.3) 4 (14.3) Deliver cost-effective care to challenging patient populations 4 (14.3) 16 (57.1) 6 (21.4) 1 (3.6) 1 (3.6) Identify risk factors for GI conditions in different settings 3 (10.7) 9 (32.1) 10 (35.7) 5 (17.9) 1 (3.6) Identify prevalence of GI conditions in different settings 8 (28.6) 13 (46.4) 5 (17.9) 2 (7.1) 0 (0) Define approaches to therapy in resource-limited settings 3 (10.7) 13 (46.4) 8 (28.6) 3 (10.7) 1 (3.6) Consider influence of cultural and religious practices on a patient’s treatment choices 3 (10.7) 7 (25.0) 8 (28.6) 9 (32.1) 1 (3.6) Recognize my own clinical limitations 0 (0) 1 (3.6) 5 (17.9) 15 (53.6) 7 (25.0)