METABOLIC DYSFUNCTION-ASSOCIATED FATTY LIVER DISEASE (MAFLD) AND CARDIOMETABOLIC HEALTH EDUCATIONAL INITIATIVE WITH INTERNAL MEDICINE RESIDENTS

Abstract

Therapeutic Area: Metabolic Syndrome Background: Metabolic dysfunction-associated fatty liver disease (MAFLD) is one of the most common causes of cirrhosis in the United States, and cardiovascular disease is a leading cause of mortality in patients with MAFLD. The presentation is usually asymptomatic leading to under-diagnosis. Weight loss is the cornerstone of MAFLD management as risk factors for MAFLD include obesity, metabolic syndrome, and type 2 Diabetes Mellitus. Gamification is an expanding learning tool in the literature. We launched a longitudinal curriculum spanning multiple topics in cardiometabolic health led by our chief-residents. In this session, we compared gamification to standard case-based learning in teaching internal medicine residents the workup and management of MAFLD. Methods: For our forty-five minute MAFLD educational initiative, we administered a pre- and post-lecture survey to assess a self-reported level of comfort working up transaminitis and level of confidence referencing guidelines on cardiometabolic health on a 5-point Likert scale. We also administered six board-style questions. PGY1-3 residents at one program are randomly assigned to clinic firms of 20 residents at start of residency. Two clinic firms received a case-based virtual lecture (non-gamified group, n=48), and 3 firms received a lecture via a points-based game called ‘Kahoot!’ (gamified group, n=67). Residents completed pre (n=71) and post-session (n=48) surveys. We performed a dependent t-test comparing each resident's performance before and after the session, where each resident served as their own control (matched analysis). Results: In both our gamified (n=22) and non-gamified (n=19) cohorts, residents reported a statistically significant increased comfort working up transaminitis (gamified mean 3.77 vs. 3.32, p<0.001; non-gamified mean 3.95 vs. 3.16, p<0.001) and an increased level of confidence referencing guidelines on cardiometabolic health (gamified mean 3.59 vs. 2.41, p<0.001; non-gamified mean 3.47 vs. 2.32, p<0.001) following the session. [Table 1] There was no statistically significant difference in performance on the board-style questions in our cohorts. Conclusions: Our data supports that both gamified and standard case-based format increased resident comfort with transaminitis workup and confidence in referencing guidelines on cardiometabolic health. However, we only observed modest increases in knowledge-based scores using validated board-questions which were not statistically significant.