567 - The Development and Assessment of a Native American Health Curriculum for Pediatric Residents

Saturday, April 29, 2023

3:30 PM – 6:00 PM ET

Poster Number: 567
Publication Number: 567.23

Melissa E. Day, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Ndidi Unaka, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Kenna Sheak, Cincinnati Children's Hospital Medical Center, Mason, OH, United States

Presenting Author(s)

Melissa E. Day, MD (she/her/hers)

Clinical Fellow, Pediatric Infectious Diseases
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, United States

Background: Native Americans (NA) comprise 2.9% of the United States population and experience significant health inequities. However, curricula highlighting these disparities in medical education is mostly absent. While pediatric residents at Cincinnati Children’s Hospital Medical Center (CCHMC) have opportunities to travel to various reservations as elective experiences, prior to the 2020-21 academic year, there were no formal education sessions on NA culture, health disparities, nor the infrastructure of the Indian Health Service (IHS) prior to participating in these rotations.

Objective: To develop and assess the impact of a NA health curriculum on the understanding of NA health inequities in pediatric residency education at CCHMC.

Design/Methods: We conducted a needs assessment of CCHMC pediatric residents via an electronic survey to elucidate their curriculum content and delivery preferences. We also obtained stakeholder input from physicians and leaders across various IHS clinics within Cherokee (North Carolina) and Navajo (Arizona and New Mexico) Nation regarding curriculum content. We then created a 1-hour curriculum and delivered these sessions during resident advocacy rotations. We assessed residents’ knowledge and comfort in caring for this population with pre- and post-surveys distributed electronically, including a 10-question knowledge assessment with questions adapted from literature used to develop course material.

Results: Six 1-hour sessions were conducted during the 2021-22 academic year, involving a total of 57 pediatric residents as part of their advocacy rotation. Out of all pretests (n = 48), average comfort score was 2.3 (out of 5) and average quiz score was 62%. Out of all post-tests (n = 31), average comfort score was 3.2 (out of 5) and average quiz score of 77%. Twenty-eight completed both pre- and post-test surveys. Nineteen out of 28 (68%) reported increased ratings of comfort on a 5-point Likert scale in providing care to NA patients after having participated in the curriculum. 17 out of 28 (61%) showed improvement in knowledge in NA health. The overwhelming majority of residents had received no prior education or had no baseline knowledge of indigenous health and history.

Conclusion(s): Pediatric trainee knowledge of and comfort with caring for the medical and social needs of NA children was improved via a targeted NA health curriculum. Next steps include surveying trainees rotating at IHS clinics and stakeholders to update and provide culturally appropriate and relevant clinical information.