P0331 - Implementation and Evaluation of a Breastfeeding Medicine Curriculum in Undergraduate Medical Education

Background: Breastfeeding improves lifelong health outcomes for both the mother and the infant. The American Academy of Pediatrics recommends exclusive breastfeeding in the first 6 months of life. However, breastfeeding rates in the U.S. are sub-optimal and disparities are stark. Physician breastfeeding education has been shown to improve breastfeeding outcomes. Breastfeeding education in undergraduate and graduate medical education is recommended so that physicians can adequately support breastfeeding initiation and maintenance. Education on breastfeeding is however not a core element of most medical school curricula. Challenges to integration into existing curriculum include time, faculty expertise, and multi-specialty support.

Objective: To design, integrate and evaluate a breastfeeding medicine curriculum into undergraduate medical education
Design/

Methods: Faculty in the Division of Community Pediatrics in collaboration with the Pediatric Clerkship Director developed and implemented a new medical student curriculum on breastfeeding medicine using the Wellstart International Lactation Management Self-Study Level 1 Modules and supplemental video and reading materials. The materials are designed to be completed in one half day. The curriculum was integrated as a requirement into the third year Pediatric Clerkship and fourth year Community Pediatrics elective. It was evaluated using the Wellstart assessment tool for knowledge and additional questions assessed acceptability and potential for impact on practice.

Results: 196 students completed the curriculum as part of their required pediatric clerkship and 9 as part of an elective in academic year 2018-2019. Participants of this study were largely third year medical students (85.5%). Of the 134 students who took the pre-test, 89.6% reported less than 2 hours of prior breastfeeding medicine education. 76 students took both the pre and post-tests. Mean total scores increased from 19.0 (67.9%) to 24.16 (86.3%) out of 28.0 (p<0.001) as well as in each knowledge category (Anatomy & Physiology, Clinical Assessment & Anticipatory Guidance, Public Health & Policy and Diagnosis, Management & Pathophysiology) (p<0.001). Of the 80 students who took the post test, 95% thought the content was at the appropriate learning level, 91% said they are at least sometimes likely to use what they learned, and 56% said it will at least moderately change the way they practice medicine.

Conclusion: Development and integration of a focused breastfeeding medicine curriculum into clinical rotations in undergraduate medical education is feasible and effective. This study demonstrates significant improvement in knowledge, curriculum acceptance and intention to change clinical practice after completing the curriculum. This model is easily replicable in other medical school settings and can have an important impact on maternal and infant health.