JMIR Form Res. 2026 May 28;10:e89880. doi: 10.2196/89880.
ABSTRACT
BACKGROUND: Environmental factors account for 23% of global deaths and 25% of chronic diseases. In France, the Fourth National Environmental Health Plan prioritizes training health professionals in environmental health. Endocrine-disrupting chemicals (EDCs) are chemical substances that interfere with hormonal systems, contributing to a range of health effects. In 2024, the Primary Care and Environmental Health (PCEH) program at the University of Montpellier-Nîmes introduced an innovative e-learning module on EDCs for first-year family medicine residents.
OBJECTIVE: This study aimed 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-and-after cohort study included all first-year family medicine residents at the University of Montpellier-Nîmes. The module, developed collaboratively by clinicians and educators, integrated interactive images, artificial intelligence-generated virtual rooms, short educational videos, games, and flash cards. Participants were assessed using pretraining and posttraining questionnaires administered immediately before and after the module. These questionnaires evaluated satisfaction (using a 5-point Likert scale), knowledge (using binary “yes” or “no” questions), and behaviors (using a 5-point Likert scale). Statistical analyses included the McNemar test for paired categorical variables and paired 2-tailed t tests for continuous variables, with a significance threshold set at a P value of less than .05.
RESULTS: This study aimed to evaluate the impact of an e-learning module on knowledge and behaviors related to endocrine disruptors. Our findings show significant improvements across all measured domains. 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 (mean 4.1/5, SD 1.0) and module duration (mean 4.2/5, SD 1.0). Knowledge improved significantly, with a mean 55.56 (SD 13.54) increase in correct identification of EDCs across all substances (P<.001). Self-reported behaviors improved by an average of 2.13 points (95% CI 1.71-2.56) on the 5-point scale (P<.001), exceeding those reported in previous PCEH modules. Secondary outcomes showed high posttraining identification of at-risk populations and exposure locations, although recognition of some substances (eg, alkylphenols and phenoxyethanol) remained low.
CONCLUSIONS: This innovative e-learning module significantly improved residents’ knowledge and preventive behaviors related to EDCs. These findings support the integration of environmental health training into medical curricula and highlight the potential of scalable e-learning interventions to strengthen preventive competencies in primary care.
PMID:42207575 | DOI:10.2196/89880
