JMIR Publications

ABSTRACT

Background:

Environmental factors account for 23% of global deaths and 25% of chronic diseases. In France, the 4th National Health and Environment Plan prioritizes training health professionals in environmental health. Endocrine disruptors (EDCs) are chemical substances that interfere with hormonal systems, contributing to a range of health effects. In 2024, the Primary Care Environment and Health (PCEH) program at the University of Montpellier–Nimes introduced an innovative e-learning module on EDCs for first-year family medicine residents.

Objective:

To evaluate the impact of the PCEH e-learning module on participants’ satisfaction, knowledge, and self-reported behaviors regarding EDCs in household environments.

Methods:

This monocentric, matched before–after cohort study included all first-year family medicine residents. The module, developed collaboratively by clinicians and educators, integrated interactive images, AI-generated virtual rooms, short educational videos, games, and flashcards. Participants were assessed using pre- and post-training questionnaires, administered immediately before and after the training. These questionnaires evaluated satisfaction (using a 5-Likert scale), knowledge (with binary yes/no questions), and behaviors (using a 5-point Likert scale). Statistical analyses used McNemar’s test for qualitative variables and paired t-tests for quantitative variables (p < .05).

Results:

Of 148 eligible residents, 78 (52.7%) completed both assessments over a 17-day period. Overall satisfaction was high (mean 4.0/5, SD 0.9), with positive ratings for the e-learning format (4.1/5, SD 1.0) and duration (4.2/5, SD 1.0). Knowledge improved significantly, with a mean 56% increase in correct identification of EDCs across all substances (p < .001). Self-reported behaviors improved by 2.13 points (95% CI 1.71–2.56) on the 5-point scale (p < .001), exceeding gains reported in previous PCEH modules. Secondary outcomes showed high post-training identification of at-risk populations and exposure locations, though recognition of some substances (e.g., alkylphenols, phenoxyethanol) remained lower.

Conclusions:

This innovative e-learning module significantly improved residents’ knowledge and preventive behaviors related to EDCs. Findings support integration into curricula and potential replication in other health professions.