Educational Method to Promote Recognition, Diagnosis, and Treatment of Eating Disorders: A Cluster-Randomized Study of the Effects of Retrieval Practice Amongst Medical Trainees

Maria D Ash; Cynthia Holland-Hall; Kenneth Jackson; Guy N Brock; Andrea E Bonny

doi:10.7759/cureus.71552

Educational Method to Promote Recognition, Diagnosis, and Treatment of Eating Disorders: A Cluster-Randomized Study of the Effects of Retrieval Practice Amongst Medical Trainees

Cureus. 2024 Oct 15;16(10):e71552. doi: 10.7759/cureus.71552. eCollection 2024 Oct.

Authors

Maria D Ash¹, Cynthia Holland-Hall¹, Kenneth Jackson^{2

3

4}, Guy N Brock^{2

3

4

5}, Andrea E Bonny¹

Affiliations

¹ Adolescent Medicine, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, USA.
² Biomedical Informatics, Ohio State University College of Medicine, Columbus, USA.
³ Center for Biostatistics, Ohio State University Wexner Medical Center, Columbus, USA.
⁴ Biostatistics Resource at NCH (BRANCH), Nationwide Children's Hospital, Ohio State University, Columbus, USA.
⁵ Pediatrics, Nationwide Children's Hospital, Ohio State University, Columbus, USA.

Abstract

Background Eating disorder (ED) education during medical training is lacking. Few medical trainees feel comfortable managing EDs, and an alarming 78% of healthcare providers report feeling insecure in treating EDs. Recognizing EDs early is crucial as the standardized mortality ratio for patients with anorexia nervosa is more than five times higher than that of the general population. Retrieval practice is a powerful tool in producing meaningful learning of complex concepts in education. We investigated the effectiveness of retrieval practice in ED education among medical trainees to improve recognition, diagnosis, and treatment of EDs among adolescent patients. Methods This exploratory, prospective, cluster-randomized trial enrolled residents and medical students over 14, four-week blocks. Participants were randomized by block to either the conventional lecture-based format (control group) or the retrieval-based educational format (intervention group). The control group received case-based lectures. The intervention group received education via 21 case-based quiz questions over the block with immediate feedback. Groups completed nine-item, multiple choice pre (T1)- and post (T2)-rotation knowledge tests, covering recognizing, diagnosing, and treating EDs. All participants also completed pre- and post-rotation surveys designed to measure self-perceived comfort, confidence in training, knowledge, and skills on the topic of EDs. Results The study's primary outcome was the difference between T1 and T2 scores between study groups. The intervention group showed greater improvement from T1 to T2 (5.8 to 7.4, respectively) than the control group (5.1 to 6.0, respectively). The difference between mean T1 and T2 scores in the control group versus the intervention group was significant (p=0.020). Despite the control group reporting improvements in confidence regarding training on EDs, this increased confidence was inversely correlated with scores on T2 (r=-0.502, p=0.011). Conclusions Trainees benefit from retrieval practice to improve knowledge acquisition regarding EDs. Standard lectures may confer false confidence to learners, which may not accurately align with actual knowledge acquisition.

Keywords: adolescent medicine; eating disorders (eds); medical education research; retrieval practice; teaching and training residents and medical students.