Eating Disorders Awareness Week is yet again upon us. In past years, we’ve used the occasion to think more deeply about how to spot an eating disorder, recovery, and advocacy. This year, in the midst of a pandemic that has hastened the shift towards remote learning, we’re introducing PreparED, an online eating disorder educational program for healthcare trainees.
Eating disorders affect up to 4% of the population, depending on the disorder. Despite popular misconceptions, these disorders do not discriminate. They have serious implications on morbidity and mortality. Early identification and intervention is associated with improved outcomes, and therefore essential.
Eating disorders education has historically been limited in curricula for health care trainees. For example, a UK national medical school survey determined that, on average, medical students received less than two hours of teaching about eating disorders, and 20% of programs did not cover the topic at all. This is not so far from some realities here in the U.S. A survey of medical residents and fellows at an academic medical center in the U.S. similarly found that many trainees had limited exposure to and knowledge of eating disorders. A national survey of accredited programs in internal medicine, pediatrics, family medicine, psychiatry, and child and adolescent psychiatry found that trainees specializing in caring for children and teens are receiving the most eating disorder education, either in the form of lectures or clinical experience, relative to other groups; but, a whopping 80% of programs did not offer any scheduled or elective eating disorder rotations.
Inadequate training can have a number of downstream effects on practitioner comfort and self-confidence in working with people with eating disorders. In a 2012 survey of generalist psychiatrists, only 15% felt confident in their ability to clinically manage eating disorders. Limited education in eating disorders can also impact clinician perception of and attitudes towards affected individuals, and patient safety.
Is there any good news here? Believe it or not – yes, we think so.
Recently, there have been a number of concerted efforts by advocates, researchers and clinicians in the field to get information into the hands of those who need it. For example, organizations like the National Eating Disorders Association and the National Center for Excellence for Eating Disorders have hubs that provide vetted resources about eating disorders and their treatment.
Also, research tells us that for healthcare trainees, knowledge about eating disorders improves not just with direct clinical experience, but with education. Even before the pandemic hit, remote learning was gaining popularity among health care trainees and now, it is becoming the custom. Remote learning provides us with an opportunity to fill a critical gap in training and to level the playing field by increasing access to education by experts, regardless of a students’ geography or institutional access.
To address this gap, Evelyn Attia MD, Nikki Pagano LCSW, and I spent much of 2020 designing an online eating disorders curriculum, PreparED. We had a medical student volunteer, Simon Liebling, guiding us with stakeholder feedback at each step of the way, and our whole Columbia team contributing content and feedback.
PreparED is freely available. It provides a broad overview of basic but essential information in six stand-alone, online modules: diagnosis, assessment, risk factors, medical complications, treatment, and relationship to obesity. It is interactive, with quiz questions embedded, and (we hope!) engaging to the learner. There are downloadable learning tools for students to have as a future reference. Though we aimed the curriculum at healthcare students, early feedback suggests it may also find an audience in post-graduate healthcare providers (and perhaps some eager undergraduate students).
In addition to the publicly available version, those wishing to receive a certificate of completion for PreparED can access it through the NY State Psychiatric Institute’s Center for Practice Innovation.
Needless to say, as clinical researchers, we are not quite satisfied to stop here. As 2021 unfolds, we aim to survey some of the medical students, nursing students, and medical residents across the country who are trying PreparED. We will be collecting information on how trainees like the content, what they learn, and if the education impacts their comfort with and confidence in providing care for people with eating disorders.
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