Assessment of an Interactive Online Asynchronous Pediatric-Focused Toxicology Curriculum

In the United States, poisonings account for the highest number of preventable injury deaths and children disproportionately account for the largest number of poisoning exposures. There is limited exposure to toxicology education. We developed and evaluated an asynchronous case-based, interactive, online pediatric toxicology curriculum to augment foundational knowledge and enable pattern recognition in the diagnosis and management of pediatric toxic exposures.

We developed 12 cases based on cholinergic, anticholinergic, sympathomimetic, sedative-hypnotic, opioid, and serotonergic toxidromes using Rise 360 e-learning application. Participants were recruited from Accreditation Council for Graduate Medical Education-accredited pediatrics, internal medicine-pediatrics, and emergency medicine residencies and pediatric critical care and emergency medicine fellowship programs across the United States. They completed a precurriculum survey including baseline information on their training and prior educational exposure to toxicology as well as a pre- and post-curriculum self-assessment of their comfort level in the recognition, work-up, differential diagnosis, differentiation, and management of a toxic exposure. Participants also completed a 10-question pre- and posttest and provided qualitative feedback on the curriculum.

Of the 238 participants who initially signed up for the course, 152 (64%) completed the pre-curriculum survey and test, and 52 (22%) completed the curriculum, which was available for 6 months. Across all participants, patient encounters were the most common exposure (197, 83%) and an online or web-based curriculum was the least common (11, 5%). Although participants did not have a significant difference in subgroup analysis and test results after completion of the study, collectively study participants demonstrated a significant improvement in comfort across all 5 domains which were assessed.

We developed and evaluated the first pediatric-focused interactive online case-based toxicology curriculum. Self-reported comfort measures on the recognition and management of pediatric toxic exposures improved across various specialties with this curriculum. The curriculum can augment program efforts in improving toxicology education.