Education of Clinicians Regarding Chikungunya Virus in South Florida: Utility of a Train-the-Trainer Model

Background: From late 2013 through 2015, chikungunya virus spread rapidly throughout Central and South America and the Caribbean. It remains a direct threat to the United States and specifically to South Florida as both the Aedes agypti and Aedes albopictus vectors are present in the region. We sought to educate clinicians in South Florida regarding chikungunya virus using a train-the-trainer model.

Methods: A total of five lectures were given throughout South Florida. The lecture was approximately 35 minutes and covered clinical aspects of chikungunya virus. A pre and post lecture quiz and survey consisting of 12 questions regarding the clinical aspects of chikungunya virus as well as self-reported confidence with recognizing and managing these patients was distributed to the participants and collected after the lecture. The pre and post lecture quiz and survey were compared to assess the impact of the educational lecture.

Results: A total of 121 clinicians were trained. The percentage of correct answers increased from pre-lecture to post-lecture from 947 to 1120 (65% to 77%). Large knowledge gaps were identified in viral immunity, disease prognosis, and disease reporting. Knowledge increased significantly post-lecture in the categories of viral immunity and disease prognosis but not in the category of disease reporting (37% to 83%, 18% to 43%, and 20% to 26% respectively). In the categories of epidemiology, clinical manifestations, and differential diagnosis, the baseline knowledge was good and did show modest increases post-lecture (74% to 93%, 76% to 93% and 74% to 90% respectively). Self reported confidence on a scale of 0-10 in recognizing and treating chikungunya virus increased from 3.1 to 6.6 and 3.5 to 7 respectively post-lecture.

Conclusion: The train-the-trainer model is an effective tool at educating clinicians on clinical aspects of chikungunya virus. We found large knowledge gaps in the categories of viral immunity, disease prognosis and disease reporting. The largest increases post-lecture were in the categories of viral immunity and disease prognosis. Baseline knowledge levels were good in epidemiology, clinical manifestations and differential diagnosis and further increases were seen post-lecture. Participants also reported large increases in their confidence in recognizing and treating chikungunya virus post-lecture.