Lower Extremity Wound Healing Curriculum for Medical Students

Abstract Body: Formal (i.e. other than bedside) wound healing evaluation and management is not routinely taught in medical schools, even though chronic wounds are a burden to healthcare systems. At a single institution medical school, a lower extremity wound healing curriculum is incorporated into a two-week infectious disease intensive block for medical students during their clinical years. The curriculum is a 4-hour workshop with on-line modules prior to the in-person workshop. During the workshop, students rotate through stations that provide case-based and hands-on teaching: soft tissue diagnosis, vascular studies, debridement and deep tissue culture techniques, offloading, compression wrapping, and wound product selection. The students work through social determinants of health that present as barriers to care. The curriculum requires a total of 8 faculty comprised of wound healing physicians, physician assistants and prosthetists. The workshop has been launched three times since April 2019. 203 of 233 (87%) students responded to a pre-course survey. Of these responders, they rated their confidence in wound assessment and treatment on average to be 2.91/5 (1 is “really not confident” and 5 is “very confident”) while at the same time 84% percent stated they had exposure to chronic wounds in their rotations thus far. The pre-course quiz scores revealed that they struggled most with the pathophysiology of wounds, arterial disease presentation, and wound bed description. For the first two sessions, the final exam questions indicated that students continued to struggle with culture methods, compression wrapping choice, and social determinants of health. Modifications to the third launch November 2019 were made to address these struggles and a simulation lab of a patient with an arterial ulcer was added. This evidence-based lower extremity wound healing course fills a medical school knowledge gap in lower extremity wound healing assessment and basic treatment. Data continues to be collected to refine the process and evaluate the effectiveness. Future aims include sharing via MedEd portal or another educational portal site.