P3A098: Latching Medical Students onto a Virtual Breastfeeding Elective During the covid-19 Pandemic

Background: Breastfeeding education in medical education is limited, despite Surgeon General and US Breastfeeding Committee calls for increased education for medical trainees. In surveys of health care professionals, various specialties desire more education about lactation. In spring 2020, the COVID-19 pandemic removed medical students from patient care settings; thus, virtual education opportunities were highly sought after for replacing in-person clinical electives and could be an effective way to provide breastfeeding education.

Methods: In spring 2020, a virtual medical student breastfeeding elective with asynchronous and synchronous components was created. Independent learning modules were adapted from an existing family medicine residency breastfeeding curriculum, with components from the American Academy of Pediatrics (AAP) breastfeeding residency curriculum. Small groups of students were enrolled in a 2-week virtual elective that consisted of group didactics, self-paced modules, and virtual shadowing opportunities with lactation consultants (LC). Additional components included: two reflective writing assignments, pre- and post-elective quizzes, and a scholarly product/presentation. A paired-sample t-test was performed to compare pre- and post-elective breastfeeding knowledge and confidence of learners (adapted from the AAP breastfeeding residency curriculum pre- and post-test). Demographic characteristics were collected and a qualitative analysis of reflective writings for common themes was performed.

Results: From 2020-2022, 37 medical students in years 3-5 completed the breastfeeding elective and completed evaluation forms (response rate 97%). The most common specialty of interest included: Pediatrics (16%), OB/GYN (16%), Family Medicine (11%), and Medicine/Pediatrics (5%) (Table 1). All respondents (100%) strongly agreed that they were well engaged in the elective and would recommend to peers. Shadowing lactation consultants’ encounters with patients was highlighted in evaluations as one of the best components of the elective. Over 90% of students felt that the learning objectives were met well/very-well and agreed/strongly agreed that the elective increased their knowledge and confidence in giving anticipatory guidance to breastfeeding parents (Table 2). There was a significant increase in breastfeeding knowledge from pre-test (M=72%, SD 10) to post-test (M=91%, SD 5) following the elective (p < 0.001). The five most common themes represented in reflective writings included: more desire to and comfort in speaking with patients about breastfeeding (46%), lack of prior knowledge or experience with breastfeeding (43%), positive and negative emotions experienced by mothers who are or are attempting to breastfeed (37%), reflection on prior personal or clinical experience with breastfeeding (37%), and socio-cultural and racial differences in beliefs surrounding breastfeeding (31%) (Table 1).

Conclusion: A virtual breastfeeding curriculum for medical students is well-received by participants and improves self-reported knowledge of breastfeeding. There are plans to improve the elective based on student feedback by creating in-person shadowing opportunities in our institution’s Breastfeeding Medicine Clinic and continuing hybrid lactation support groups.