Asynchronous Medical Toxicology Curriculum Improves Trainee Confidence in Toxicology Topics

A majority of poisoned patients have first contact with emergency medicine (EM) physicians; EM physicians should be appropriately trained in toxicology topics. EM residency training in toxicology is not currently mandatory. Toxicologist presence in EM residency programs is variable. About one quarter of EM residencies do not have a formal toxicology experience and no full time toxicologist. Based on a recent needs-assessment, less than one third of EM residents felt comfortable with toxicology topics. As poisoning continues to be a healthcare concern, it is important that EM resdients are properly educated in toxicology topics. We hypothesized that an asynchronous curriculum (ASYNCH), created by toxicologists, would increase learner confidence in toxicology topics.

This was an online survey study spanning from April 2023-September 2025 following learners on their toxicology rotation. Learners were given access to an ASYNCH consisting of 13 modules, covering various topics. A pre- and post-test of 20 board-style questions was given to learners; scores were recorded. A pre-rotation survey collected demographic information and queried confidence in toxicology topics on a Likert scale (0-not confident, 4-extremely confident). A post-rotation survey included the same confidence queries, and included questions on the ASYNCH. Survey data and assessment scores were analyzed.

There were 130 learners who completed the toxicology rotation in our study period. Response rate was 97.7% for the pre-rotation survey. Learners came from various specialties, a majority being either EM or pediatric emergency medicine. 51% of learners completed the full ASYNCH. 100% of post-rotation survey respondents stated the ASYNCH was helpful to their education and training, with 88.3% extremely satisfied with the content. There was a statistical difference between pre-test and post-test scores (p < 0.001) for all learners. When assessing confidence in identifying toxidromes and answering board style questions, there was a significant difference (p <0.001) between pre-curriculum and post-curriculum surveys.

Our survey data shows that access to ASYNCH was associated with increased learner confidence in recognizing toxidromes and answering board style questions on toxicology topics. Toxicology education, delivered in an online module, is well received by learners.