Abstract
Background
Practitioner comfort with diagnosis and management of interstitial lung disease (ILD) remains low despite growing knowledge in the area. Existing educational resources that cater specifically to clinicians and are freely accessible online can provide a valuable tool to address these needs.
Objective
We aimed to catalog the current landscape of practitioner-focused ILD educational materials that are freely accessible online. We discuss the ways in which these resources can be applied to learners at varied levels of practice to address knowledge gaps identified in prior literature.
Methods
A multiphase search was employed to identify educational resources using Google Search, online medical databases, an artificial intelligence tool (ChatGPT), and a survey of Pulmonary Fibrosis Foundation Education Committee members. Resources that required payment for access or were not readily available were excluded. We classified each resource according to content category, ILD topics covered, and educational strategy utilized.
Results
We cataloged 33 ILD educational resources. The majority feature disease overviews on diagnosis and management in a narrative text format. The content ranges from case studies to imaging interpretation and utilizes various delivery methods, from videos to podcasts. Some resources offer learner assessments and free continuing education credits. Peer-reviewed content and clarity on update frequency were lacking.
Conclusions
This review provides a catalog of free online ILD educational resources that can supplement ILD education for non-ILD expert practitioners. These resources address identified knowledge gaps and can be utilized for self-directed learning or integration into formal training curricula.
Keywords: interstitial lung disease, clinical competence, continuing medical education, curriculum, problem-based learning
Introduction
In recent years, definitions and diagnostic criteria for several interstitial lung disease (ILD) subtypes have been revised in light of new insights into pathogenesis, advances in diagnostic techniques, and developments in treatment options. Despite growing knowledge in the field, practitioner comfort with diagnosis and management of ILD remains low across multiple studies.1-4 In a large US-based survey, pulmonary fellows from varied training environments expressed lowest confidence in managing ILD compared to other pulmonary diseases, such as chronic obstructive pulmonary disease or pulmonary vascular disorders. This was matched by the significantly lower rating given by program directors to the ability of graduating fellows to provide longitudinal care to patients with ILD.3 As not all fellowship training programs have access to ILD experts or programs, access to supplemental educational resources could help fellowships include ILD content into their curriculum. Beyond fellows, a survey of practicing healthcare providers, including physicians, advanced practice providers, registered nurses, and respiratory therapists, also identified the need for more educational materials as key in improving comfort in diagnosing and managing ILD.1
Here, we aim to describe the current landscape of practitioner-focused ILD educational materials that are freely accessible online to assist both educators and learners. We cataloged resources identified from medical databases, search engines, and an artificial intelligence (AI) platform, as well as a survey of members of the Pulmonary Fibrosis Foundation (PFF) Education Committee to facilitate supplemental education. The intended audience of learners for the resources in this catalog are non-ILD expert practitioners, including fellows, general pulmonologists, and allied health professionals.
Methods
We defined practitioner-focused ILD educational resources as learning content pertaining to epidemiology, pathophysiology, diagnostic evaluation, and management of ILDs developed by expert physicians for the education of healthcare providers. This working definition, English-language materials, and online accessibility were used as our inclusion criteria. We excluded resources that require payment to access learning content. Our review team consisted of a third-year pulmonary and critical care fellow and two ILD faculty experts from two different tertiary medical centers and PFF Care Center Network sites. All members of the review team independently reviewed each resource.
A multiphase search strategy was implemented from May through December 2024 to identify practitioner-focused ILD educational resources. The initial search queried Google Search and online medical databases, and the expanded search included use of an AI tool as well as a survey.
The initial web search was conducted on the Google search engine using the terms “interstitial lung disease,” “ILD,” “provider,” “practitioner,” “education,” “educational,” “resource,” and “curriculum.” The top 30 search results were individually reviewed, as subsequent results lacked relevance. A search of the online medical databases PubMed, Google Scholar, Web of Science, and MedEd Portal was also performed in collaboration with a medical librarian, using the subject headings and keywords “physicians,” “healthcare providers,” “educational resources,” “learning resources,” “medical education,” “curriculum,” “medical curriculum,” “training,” “educational guidelines,” “interstitial lung disease,” “ILD,” “sarcoidosis,” “alveolitis,” and “pulmonary fibrosis.”
Given a paucity of results from the initial search strategy, we subsequently expanded our methods to query the AI tool ChatGPT with the phrase, “What are free online education resources for interstitial lung disease that cater to healthcare practitioners?” Additionally, we conducted a survey of the members of the PFF Education Committee. The survey queried respondents on the practitioner-focused ILD educational resources they use and recommend, their role (fellow versus attending), years in clinical practice or training, their participation in medical education, and practice within the PFF network (Supplement E1).
The resulting resources were classified by the following attributes: specific ILD topics covered, content category, and educational strategy (ie, methods of delivery). Each resource was independently reviewed by all members of the review team for inclusion, exclusion, and attributes described above.
Results
After accounting for duplicates, there were a total of 33 resources that met the working definition of a practitioner-focused ILD educational resources and were not excluded due to paywall restrictions. The initial search yielded 23 results from medical databases, but few of these ultimately met inclusion and exclusion criteria (Figure 1). Of the first 30 results from the Google Web search, only 7 met both inclusion and exclusion criteria.
Figure 1.
Flow diagram of search methods for educational resource identification.
The expanded search yielded another 43 additional results, the majority of which were derived from the PFF Education Committee survey. There were 20 respondents to the survey (response rate 48%), including 18 attending physicians and two third-year pulmonary fellows. The average years practicing post-fellowship for the attending respondents was 7.8 years (range, 1-26 years), and 6 were program directors or associate program directors. All attending respondents had a teaching role in their ILD practice supervising fellows, residents, or advanced practice providers. Seventeen attending respondents work at sites within the PFF network. All 7 results from the ChatGPT query were legitimate resources (ie, no hallucinations).
The final catalog of 33 educational resources from 18 distinct entities is summarized in Table 1, with corresponding web links found in Supplement E2. Among the 18 sponsoring organizations, 4 are respiratory societies (American Thoracic Society [ATS], American College of Chest Physicians [CHEST], European Respiratory Society [ERS], and British Thoracic Society) under which 13 resources are catalogued.5–17 Eighteen resources feature learning content exclusive to ILD.5-8,12-16,18-26 Of the resources that comprise broad pulmonary content, 5 can be filtered to display ILD-specific content,7,11,27-29 and 6 contain a search feature allowing users to enter ILD-related search terms.9,17,30-33 ILD topics are noted to be limited in 7 resources,9,10,12,17,23,32,34 4 of which are podcasts.
Table 1.
Catalog of practitioner-focused educational resources for interstitial lung disease.
| Organization | Resource titlea | ILD topics | Content category | Educational strategy | CME | Peer review | Comments |
|---|---|---|---|---|---|---|---|
| American Society for Clinical Pathology | Case-based Microlearning: Diagnostic Challenges in Respiratory-Fibrosing Interstitial Lung Diseases26 | Histopathology | Histopathology interpretation |
|
Yes |
|
|
| American Thoracic Society (ATS) | ILD Reading List5 |
|
Reading list | Narrative text | No | Yes |
|
| ILD Guidelines and Statements8 |
|
|
Narrative text | No | Yes |
|
|
| ILD Education Center6 |
|
|
|
No | No |
|
|
| Quick Hits7 |
|
Case studies |
|
No | No |
|
|
| Podcasts9 |
|
|
|
No | No |
|
|
| Association of Pulmonary and Critical Care Medicine Program Directors (APCCMPD) | Ambulatory Scripts36 |
|
|
|
No | Yes |
|
| Boehringer Ingelheim | Insights in ILD20 |
|
|
|
No | No |
|
| HRCT Gallery21 | CT patterns | Imaging interpretation | Images | No | No | Industry-sponsored | |
| Diseases Directory22 |
|
|
Outlines | No | No |
|
|
| British Thoracic Society (BTS) | Thorax Podcast17 |
|
Expert discussion | Podcast | No | No |
|
| American College of Chest Physicians (CHEST) | CHEST Guidelines & Topic Collections: Interstitial Lung Disease15 |
|
|
|
Yes | Yes |
|
| Guidelines12 |
|
Clinical practice guidelines | Narrative text | Yes | No |
|
|
| ILD Clinician Toolkit13 |
|
|
|
No | Yes | Includes resources for primary care physicians | |
| ILD Process Map14 |
|
|
|
|
|||
| Promoting Diagnostic Excellence Across Medicine: Interstitial Lung Disease16 |
|
Reading list | Narrative text | Yes | Yes | Last webpage update not reported | |
| European Respiratory Society (ERS) | ERS Respiratory Channel: Guidelines11 |
|
|
Narrative text | No | Yes |
|
| ERS Publications Podcast10 |
|
|
|
No | No |
|
|
| The France Foundation | PILOT: Education Transforming Pulmonary Care27 |
|
|
|
Yes | No |
|
| ILD Collaborative | Project ECHO for ILD19 |
|
|
|
Yes | No |
|
| Medscape | Pulmonary Medicine Search31 |
|
|
|
No | No |
|
| Decision Point—Pulmonary28 |
|
|
Video |
|
|||
| InDiscussion: Idiopathic Pulmonary Fibrosis42 |
|
|
|
Specific topics with descriptive titles | |||
| National Institute for Health and Care Excellence (NICE)32 |
|
Guidelines on diagnosis and management | Outlines | No | Yes |
|
|
| Pulm PEEPs | Tagged Archives: Interstitial Lung Disease29 |
|
|
|
No | No |
|
| Pulmonary Fibrosis Foundation (PFF) | Educational Materials23 |
|
|
|
No | Yes |
|
| Position Statements24 |
|
Statements | Narrative text | No | Yes | Date of last content update is reported | |
| PFF Webinar Library25 |
|
|
|
Although the intended audience for most videos are patients, the level of detail presented are appropriate for general practitioners and early learners | |||
| Radiological Society of North America | Fleischner Society: Glossary of Terms for Thoracic Imaging35 | CT patterns | Imaging interpretation |
|
No | Yes | |
| Radiology Assistant | HRCT—Basic Interpretation18 | CT patterns | Imaging interpretation |
|
|||
| Radiopaedia33 |
|
|
|
No | Yes |
|
|
| StatPearls30 |
|
|
Narrative text | Yes | No |
|
|
| University of California, San Diego | Pulse on Pulmonology34 |
|
|
Podcast | No | No | Limited ILD topics at this time |
Abbreviations: AE-ILD, acute exacerbation of ILD; AIP, acute interstitial pneumonia; CE, continuing education; CME, continuing medical education; COP, cryptogenic organizing pneumonia; COVID-ILD, COVID-19-associated ILD; CPFE, combined pulmonary fibrosis and emphysema; CT, computed tomography; CTD-ILD, connective tissue disease–associated ILD; DIP, desquamating interstitial pneumonia; ERJ, European Respiratory Journal; EVALI, e-cigarette or vaping use–associated lung injury; FPF, familial pulmonary fibrosis; GL-ILD, granulomatous–lymphocytic ILD; HP, hypersensitivity pneumonitis; HRCT, high-resolution computed tomography; ILD, interstitial lung disease; IPF, idiopathic pulmonary fibrosis; LAM, lymphangioleiomyomatosis; LIP, lymphoid interstitial pneumonia; NSIP, nonspecific interstitial pneumonia; OP, organizing pneumonia; PAP, pulmonary alveolar proteinosis; PH-ILD, pulmonary hypertension associated with ILD; PLCH, pulmonary Langerhans cell histiocytosis; PPF, progressive pulmonary fibrosis; PPFE, pleuroparenchymal fibroelastosis; RA-ILD, rheumatoid arthritis–associated ILD; RB-ILD, respiratory bronchiolitis–associated ILD; RP-ILD, rapidly progressive ILD; SSc-ILD, systemic sclerosis–associated ILD; UIP, usual interstitial pneumonia.
Web links for resources can be found in Supplement E2.
Most of the resources feature disease overviews on clinical manifestations, diagnosis, and management. Imaging interpretation is the next most common category of content, with 4 resources exclusively focusing on this topic.18,21,26,35 Case studies and expert discussions on ILD-related topics are the next most common type of content. Six resources contain or link to clinical practice guidelines published by the major respiratory societies.6,8,11,12,14,32
With respect to educational strategies, learning content is most often delivered in the form of narrative text or outlines. However, there was still a range of delivery methods, including 11 resources with video content, 8 different podcast shows, and 8 with interactive modules. A total of 6 resources featured learner assessments on content. Only one resource, the Association of Pulmonary and Critical Care Medicine Program Directors (APCCMPD) Ambulatory Scripts,36 is intended to be led by a supervisory facilitator, although this is not necessary for use. Thus, all cataloged resources can be used for self-learning.
Notably, only 8 resources contain peer-reviewed content.5,8,11,12,16,33,35,36 Free continuing education credits can be claimed through 6 of the resources.13,15,16,19,26,27
Discussion
Timely diagnosis of ILD is pivotal to mitigate risk factors, initiate appropriate treatment, prognosticate, and provide tailored patient education. However, delays in diagnosis and misdiagnosis remain common. In 2015, US patients with ILD surveyed by the PFF reported a median time from symptom onset to diagnosis of 7 months, with over half experiencing one or more misdiagnoses.37 Not only do pulmonary fellowship program directors and fellows both express lower confidence in graduating fellows’ ability to provide longitudinal care in ILD, independent practitioners have also identified deficiencies in knowledge of ILD diagnosis and management.1-4,37-40 These highlight a provider-recognized need for more accessible education on this topic. We thus reviewed the current landscape of free online practitioner-focused educational resources to create a catalog that provides easily accessible supplemental learning materials to assist both educators and learners across all training levels and practice settings.
To our knowledge, this is the first peer-reviewed effort to compile and organize currently available practitioner-focused resources on ILD. We aimed to create a comprehensive catalog that is easily accessible to practitioners at all levels of training, hence the inclusion of only free and online resources. We did not exclude any resources based on the quantity of ILD topics available, measures of content rigor (eg, peer review), or user experience. Instead, these qualities are noted within the catalog to allow users to tailor their learning preferences. This catalog is designed to provide a varied selection of educational resources that can be utilized for self-learning or teaching of trainees.
Identifying educational resources by way of traditional search methods through medical databases was challenging. Only one article identified through PubMed referenced an educational resource directly,4 and this resource was ultimately excluded from the final catalog due to content that was behind a paywall. Such traditional search methodology largely yielded research articles rather than practitioner-focused educational resources. An expanded search using alternate search strategies available to the authors, including AI queries, was conducted to maximize identification of available resources for screening. The resources cataloged in this paper were identified using Google search engine, ChatGPT, and a survey of PFF Education Committee members, most of whom are ILD content experts with a teaching role.
The cataloged resources can address the existing knowledge gaps in various ways. For example, resources such as the ATS ILD Education Center and Boehringer Ingelheim (BI) Insights in ILD comprise overviews of various ILDs in outline format that offer foundational knowledge for early learners as well as quick refreshers for practicing providers.6,20 Fellowship programs seeking to create an ILD curriculum can incorporate content from APCCMPD Ambulatory Scripts and Project ECHO, resources that are structured as yearly curricula.19,36 Certain resources can provide more focused learning within ILD diagnosis and management. For instance, Radiopaedia and the BI HRCT [high-resolution computed tomography] Gallery teach interpretation of chest imaging and can be coupled with imaging-focused case-based learning like ATS Quick Hits.7,21,33 These serve as learning tools not only for trainees, but also for practitioners without access to a dedicated chest radiologist. Lack of access to multidisciplinary specialists or to ILD multidisciplinary conferences, which are broadly accepted as the gold standard for ILD diagnosis worldwide, also poses a challenge to accurate and timely diagnosis. Resources that feature discussions with rheumatologists (eg, France Foundation PILOT), review of histopathology (eg, American Society for Clinical Pathology Case-based Microlearning), or process maps for ILD management (eg, CHEST ILD Process Map) can be valuable to incorporate multidisciplinary educational content relevant to ILD.14,26,27 For further guidance on ILD management, clinicians can turn to the ERS ILD Guidelines or the ATS ILD Reading List for peer-reviewed clinical practice guidelines.5,11
Overall, the methods utilized by these resources align with several key principles of Knowles and colleagues’ adult learning theory41 that is pertinent to our target audience, including self-directed learning, a problem-centered approach (particularly in case-based resources), and direct relevance to clinical decision-making. Less well represented in the resources we identified are other tenets of andragogy, such opportunities for reflection, feedback, and facilitated learning opportunities. Some of these gaps can be overcome in a medical education setting, however, if the resources are integrated into sessions with live teachers who can supplement the foundational content with additional teaching tools.
We acknowledge that the content and breadth of educational materials will grow as field of ILD continues to develop. While the resources compiled here are current at the time of writing, this is the first attempt to provide practitioners with an accessible and peer-reviewed catalog that may serve a reference for future efforts to create a living document.
A common limitation observed across all but one resource is lack of clarity on when the webpages were last updated and, as such, potentially outdated content.5,6,8,11,12,14,16,20,22,23 Also of note, the majority of resources are not peer-reviewed; peer-reviewed content is limited primarily to guidelines and reading lists. Several resources are sponsored by the pharmaceutical industry, raising concern for inherent bias in the focus of presented material presented by commercial entities.6,20-23,26 None of these industry-sponsored resources contain reviews of medications affiliated with the industry sponsor, which may mitigate the main conflict of interest. Variability was observed in user interface and ease of navigability among the resources. For example, even resources that allowed use of a search feature to narrow for ILD-related content at times had irrelevant results that required further manual filtering. Finally, it is possible that there are other resources that meet our inclusion criteria but were not identified using our search methods.
In conclusion, this catalog provides a wealth of free and accessible information catering to healthcare practitioners on ILD diagnosis and management. These resources vary in ease of use, quality control by peer review, and lack of clarity about timing of last update. Although these resources can be used to support self-directed learning or be incorporated into facilitated ILD curricula within pulmonary and critical care training programs, there remains a need for up-to-date, user-friendly, peer-reviewed educational resources to meet the needs of adult learners and practitioners.
Supplementary Material
Acknowledgments
We would like to acknowledge Caroline Marshall, MLS, AHIP, who contributed to the data collection in her assistance with the medical database search.
Contributor Information
Josephine Hwang, Email: johwang0201@gmail.com, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States.
Giuliana Cerro Chiang, Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Yale School of Medicine, New Haven, CT, United States.
Tristan J Huie, Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, National Jewish Health, Denver, CO, United States.
Maryl E Kreider, Division of Pulmonary, Allergy and Critical Care, Department of Medicine, University of Pennsylvania, PA, United States.
Tanzira Zaman, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States.
Author contributions
JH, GCC, TJH, MEK, and TZ contributed to the conception and study design, data interpretation, and the writing of the manuscript. All contributed to the drafting and review process.
Supplementary material
Supplementary material is available at ATS Scholar online.
Conflicts of interest
Please see the ICMJE disclosure forms, which have been provided as supplementary material. All authors declare that they have no conflicts of interest.
Funding
None declared.
Data availability
This article has a data supplement, which is accessible at the Supplements tab.
Artificial intelligence disclaimer
No artificial intelligence tools were used in writing this manuscript.
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Supplementary Materials
Data Availability Statement
This article has a data supplement, which is accessible at the Supplements tab.

