The inclusion of medical students in the primary prevention of coronary artery disease

Abstract Background Implementing and maintaining primary preventive methods to enhance health- related behavioral outcomes for coronary artery disease (CAD) can be challenging, especially in unexpected circumstances such as the Covid-19 outbreak. The aim of this study is to compare the feasibility and the effectiveness of an online-enhanced teaching and follow-up program to a face-to-face structured program run by medical students in terms of behavioral outcomes for CAD prevention. Methods CAD primary prevention project (SCAD-PPI) was designed as a longitudinal study and utilized medical school students to conduct the project under the supervision of professors. It had two different education and training phases. In the first phase, each school year, third/fourth year medical students engaged in a year-long, specially designed training program on primary prevention of CAD. In the second phase, a series of conferences regarding the primary prevention for CAD were organized. Participants were prospectively assigned to an intervention where pre- and post-conference knowledge was collected and assessed. Every intervention was conducted by specially trained medical students and an education booklet, which was specially designed for the study, was given to the participants. Every other month thereafter, for 6 months, each participant was followed-up via phone calls. At the 6 months follow -up, data was collected to assess the impact of the program on behavioral outcomes. During the Covid-19 pandemic, face-to-face interactions were discontinued, and the study was re-designed (CAD online primary prevention project: SCAD-OPP) to use Microsoft Teams and online tools until the restrictions were lifted. Six-month data was compared between the groups to assess the feasibility and effectiveness of a face-to-face versus online program administered by medical students in terms of behavioral outcomes for CAD prevention. Results There were 172 participants in the SCAD-PPI and 72 in the SCAD-OPP group. SCAD-OPP were older (45±13 vs 40±11.9 yrs., p=0.005) and had a higher level of education level. The rest of the demographic characteristics were comparable. Overall knowledge on CAD risk factors, primary prevention measures, diet and daily exercise habits were very poor in both groups. After the enhanced education and follow-up program there was a significant improvement on the knowledge of CAD risk factors and primary prevention measures in both groups. At 6-month follow-up, the decrease in body mass index was greater in the SCAD-PPI (p=0.019). Conclusion This study showed that medical students may be utilized to administer an online or face-to-face enhanced education and follow-up program for primary prevention of CAD with similar successful outcomes. In addition to serving the public interest, utilizing trained medical students in prevention programmes—whether in-person or online—encourages medical students to interact with patients early in their careers.