Implementation of a Virtual Cardiology Curriculum to Address the Deficit of Cardiovascular Education in Haiti

Abstract

Background: Cardiovascular disease (CVD) is the leading cause of death in low- and middle-income countries such as Haiti. Our team has demonstrated in a pilot study the implementation of a virtual cardiology curriculum to address the deficit of cardiology education in Haiti among medicine residents.

Objectives: The objective of this study was to determine if cardiology education can be delivered nationwide in Haiti via a virtual platform with quantifiable improvement.

Methods: Over 1 academic year, we recruited internal medicine residents from all residency years and all 4 of the internal medicine training programs in Haiti. They were enrolled in a trimester curriculum of biweekly, synchronous and asynchronous didactic lectures, seminars, and case presentations delivered via an interactive virtual classroom. Pre-trimester and post-trimester assessments were delivered to the students. Knowledge acquisition was analyzed by way of Cohen's r effect sizes with 0.1 to <0.3 interpreted as small, 0.3 to <0.5 as moderate, and >0.5 as large.

Results: A total of 62 residents were enrolled, 26 in their first year, 21 in their second, and 15 in their third year. There was significant improvement in CVD knowledge with all residency classes showing moderate to large effect sizes. There were notable differences in the effect sizes for residency programs in different locations. There was also significant student attrition over time likely due, in part, to political instability.

Conclusions: This study demonstrates that it is possible to virtually deliver cardiology education to trainees in low- and middle-income countries on a national scale to address the deficit of CVD education. Aside from uncontrollable factors like political instability, attrition can be improved by formalization of the curriculum.

Keywords: Haiti; global cardiovascular health; implementation science.

Graphical abstract

Figure 1

Location of Hospital Sites in Haiti

Figure 2

Demographics by Class Year

Figure 3

Residents at Each Hospital HUM = Hôpital Universitaire de Mirebalais; HUJ = Hôpital Universitaire Justinien; La Paix = Hôpital Universitaire de la Paix.

Figure 4

Effect Sizes by Cumulative Units for All Trainees

Figure 5

Effect Sizes by Hospital Abbreviations as in Figure 3.

Figure 6

Effect Size by Class Year

Central Illustration

Implementation of a Virtual Cardiology Curriculum in Haiti ACC = American College of Cardiology; ECG = electrocardiogram.