Pediatric [ME/CFS]: A Diagnostic and Communication Case Study for Health Care Providers in Training, 2025, Brimmer, Unger+

Educational Objectives
By the end of this session, learners will be able to:

1. Recognize importance of a full medical and psychosocial evaluation for adolescents or children presenting with symptoms of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

2. Identify specific symptoms of ME/CFS and possible abnormal physiologic and laboratory findings.

3. Describe the complexities of illness presentation in pediatric patients with ME/CFS.

4. Demonstrate confidence in communicating with pediatric patients with ME/CFS.

 

The presentation and the videos are in the Appendix. I’m not able to download them on my phone, are anyone able to add them here? At least the powerpoint and the survey?

 

Table 1. Pre- and Posttest Survey Questions


In addition to knowledge, student attitudes towards ME/CFS changed after viewing the videos and slides. For example, qualitative responses indicated that after experiencing this activity, students were more aware of the definition of PEM. In the pretest, students generally had an incomplete understanding of PEM: “feeling tired or worn out after exerting oneself.” While this was not an inaccurate answer, in the posttest the descriptions were more detailed, such as “fatigue, pain, illness, or general discomfort that occurs after exercise, emotion, or other physical or mental exertion.” Qualitative responses also indicated that overall, students changed from a mindset of jumping to a differential diagnosis when a patient complained of fatigue to asking more probing questions about the fatigue and understanding the effect of fatigue on daily life (Table 2).

Table 2. Qualitative Themes From Student Group Two: Confidence in Managing Pediatric ME/CFS


When prompted for items to know about pediatric ME/CFS, they showed an understanding of the complexity of ME/CFS by mentioning the “variety of symptoms” and “how the condition can affect lifestyle” (Table 3). Some students pointed out how the video illustrated how to “be there for a patient even if all the answers are not yet known” and how to conduct “effective communication with another health professional and the school nurse who is part of the patient's care team” (Table 3).

Table 3. Qualitative Themes From Student Group Two: What to Know About Pediatric ME/CFS


From the discussion:
Before completing the educational activity, more students in both groups considered ME/CFS to be both a medical and psychiatric condition. After completion of the educational activity, results showed an increase in the number of students who considered ME/CFS a medical condition, as opposed to a combined medical and psychiatric condition. This change in belief that ME/CFS is a medical condition is important, as for far too long many patients with ME/CFS (including family members of pediatric patients) have commented that health care providers often do not take the illness seriously, with anecdotes of health care professionals commenting that it was “all in your head.”14 An educational activity that impacts attitudes and beliefs is just as important as one that increases knowledge, as health care provider perspectives about patients impact the quality of care and management.

 

ME Research UK:

Findings from a study by a team of researchers in the USA have reinforced the need for medical schools – and related health care professional training programmes, to include up-to-date, evidence-based educational materials on ME/CFS which not only reflect the physical nature of the disease, but also consider how it can differ between groups of the population, including by age, by sex, and by ethnic group.

Read more: https://bit.ly/4kRA2N1