Most doctors get limited education on eating disorders. This online training helps fill the gap

Person using computer in bed
With the pandemic and most programs shifting to remote learning, the course, which contains six modules and runs less than two hours long, has become even more relevant and timely, its developers say. (Getty/Capuski)

Physician training to diagnose and treat eating disorders is limited within U.S. medical schools, and this lack of education can be a barrier for patients to get effective care.

Data from the National Eating Disorder Association indicate that 10 million American women suffer from eating disorders, and 10% to 15% of all Americans suffer from some type of serious eating disorder.

Eating disorders have the highest mortality rate of any mental illness. But training provided within residency programs to address the needs of these patients is sparse, according to one study that evaluated more than 600 residency programs.

Evelyn Attia, M.D., director of the Center for Eating Disorders at Columbia University Medical Center, and Deborah Glasofer, Ph.D., associate professor of clinical medical psychology at the center, have long been paying attention to the widespread lack of training in eating disorders among medical students, residency programs and general practitioners.  

They led a group at Columbia University Medical Center, teaming up with a learning technology company, to develop a training course on eating disorders. The course, called preparED, is free and publicly available. The Center for Eating Disorders and the New York State Psychiatric Institute worked together with eLearning Brothers to develop and launch the course in the summer of 2020. The enthusiastic feedback about it thus far has been “tremendous,” Attia and Glasofer told Fierce Healthcare.

The program recently received a bronze award in the best advance in custom content category from research and analyst firm Brandon Hall Group.

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This coming academic year marks the first time the course will be integrated with several institutions' curricula: the Yale School of Medicine, Atrium Health in Charlotte, North Carolina, and Columbia University. The course's development was funded by the New York State Comprehensive Care Centers for Eating Disorders.

With the infrequent exposure trainees receive to these types of disorders, they may feel inclined to refer patients to specialists, who aren’t always accessible to patients or necessary, Attia told Fierce Healthcare.

Though patients with eating disorders are a “complex, important population,” Attia said, even knowing some basic fundamentals is critical to avoid potentially unnecessary patient referrals. Generalists also need to be able to spot undiagnosed eating disorders, as they are often the first point of care for these patients.  

With the pandemic and most programs shifting to remote learning, the course, which contains six modules and runs less than two hours long, has become even more relevant and timely, the developers said.

By using custom animation, graphics and short online modules, the courses break down complex, sensitive topics in an engaging and informative way.

Developing it, though, was not without its challenges, according to Attia and Glasofer. Several factors had to be considered, such as the best way to make the course introductory and yet not elementary, ensure it appeals to a broad audience and to the “21-century learner,” someone who prefers information in smaller segments.

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André Chatelain, vice president of custom solutions at eLearning Brothers, noted that during the creation process, the company, which has developed courses on sensitive topics before, thought not only about the best way to keep the topic light for users but also how to “improve their empathy toward the people they might be treating.”  

Though the course is based on realistic patient scenarios, the developers also intentionally avoided using real photos of people wherever possible, instead using illustrations that are faceless and focusing on the story behind each character.

Because eating disorders impact people of all genders, race and age, the illustrations aim to reflect that universality in their body types, skin tones and appearance. In some cases, the course shows medical images such as x-rays, but otherwise real photos are kept to a minimum.

Knowledge checks throughout each module keep the content interactive and give users an opportunity to test their knowledge. So far, the developers are measuring the course’s impact by conducting assessments before and after its completion among users.