P3.037: Breastfeeding Medicine Curriculum for Medical Students in Clinical Years

Background: Physicians in primary care as well as subspecialists have an important role in supporting breastfeeding for their patients. However, multiple studies demonstrate a lack of breastfeeding education throughout physicians’ training. A local needs assessment identified a gap in breastfeeding education for medical students in their clinical years. This study aimed to develop, implement and conduct a preliminary evaluation of a new breastfeeding curriculum for medical students in their clinical years aimed at improving medical student knowledge of breastfeeding and ability to support breastfeeding patients and families.

Methods: We developed a new breastfeeding 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 medical students. The curriculum was implemented as a single small-group discussion with longitudinal integrated clerkship (LIC) students. Pre-work consisted of three short medical knowledge videos from the AAP Breastfeeding Curriculum. The novel case series followed an infant from the nursery through the 12-month well child check with a unique, age-appropriate breastfeeding concern at every visit, mirroring LIC students’ longitudinal clinical experiences. A slide deck with visual representations and a hands-on breastfeeding and pumping setup and demonstration supplemented the discussion. Further medical and community resources were provided for post-session review. A three-question medical knowledge multiple choice pre- and post- test was administered. Students completed a survey with open-ended questions. Evaluation included quantitative analysis of the knowledge test and content analysis of survey data.

Results: Implemented with one cohort (12 students) in a children’s hospital-based LIC. On the pre-test, students averaged 67% correct. Students scored 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 for providing human milk (20%), and others. When students 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 expression of human milk upon return to work. See Table 1 for themes and illustrative quotes.

Conclusion: Students increased their knowledge of breastfeeding medicine and were able to identify ways they will apply new information gained into clinical practice change. This curriculum fills an important content gap, is brief, fits into existing didactic structures, and is effective. The curriculum requires minimal resources to maintain and reproduce, mainly facilitator time and breastfeeding and pumping supplies. Program improvement and enhancement include addition of videos on latching and application of lessons to patients in nursery or primary care clinical settings.