499 - Breastfeeding Medicine Curriculum for Medical Students in Clinical Years

Publication Number: 499.4176

Ellen M. Ribar, University of Colorado School of Medicine, Denver, CO, United States; Maya Bunik, Children's Hospital Colorado, Aurora, CO, United States; Meghan Treitz, University of Colorado School of Medicine, Aurora, CO, United States

Background: Primary care physicians and subspecialists have an important role in supporting breastfeeding for their patients. However, studies demonstrate a lack of breastfeeding education throughout training. A local needs assessment identified a gap in breastfeeding education for medical students (MS) in their clinical years.

Objective: To develop, implement and conduct a preliminary evaluation of a new breastfeeding curriculum for MSs aimed at improving knowledge of breastfeeding and ability to support breastfeeding patients and families.

Design/Methods: We developed a new curriculum using Kern’s six-step approach. Topics were selected based on review of the American Academy of Pediatrics’ (AAP) Breastfeeding Curriculum and input from clerkship directors, breastfeeding medicine experts, and MSs. Implemented as a single small-group discussion with longitudinal integrated clerkship (LIC) MSs. Pre-work entailed three short videos. The novel case series followed an infant from the nursery to the 12-month well child check with a unique breastfeeding concern at every visit, mirroring LIC MSs’ longitudinal clinical experiences. A slide deck and hands-on breastfeeding and pumping setup supplemented the discussion. Medical and community resources were provided. A multiple choice pre- and post- test was administered. MSs completed a survey with open-ended questions. Evaluation included quantitative analysis of the test and content analysis of survey data.

Results: Implemented with one cohort (12 MSs) in a children’s hospital-based LIC. MSs averaged 67% correct on the pre-test and 100% on the post-test. Ten completed the survey (83% response rate). All were able to identify three things they learned, including: contraindications to breastfeeding (60%), cannabis use in lactation (40%), medications and procedures during lactation (40%), recommended duration of breastfeeding (30%), LGBTQ+ considerations (20%) and others. When MSs described a change they will make in their clinical setting, the most common response was applying guidelines for recommended duration of breastfeeding (50%). Other changes included providing breastfeeding resources and supporting milk expression upon return to work. See Table 1 for themes and illustrative quotes.

Conclusion(s): MSs increased their knowledge of breastfeeding and identified ways they will apply information gained into clinical practice change. This curriculum fills an important content gap, uses minimal resources, and is effective. Program improvement and enhancement include addition of latching videos and application of lessons to patients in nursery or primary care clinical settings.

Themes and illustrative quotes from medical student answers to free-response questions on evaluating the breastfeeding curriculum
PAS Table BF LIC.pdf