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van Zyl S, Kruger WH, Walsh CM. Chronic diseases of lifestyle curriculum: Students' perceptions in primary health care settings. Afr J Prim Health Care Fam Med 2023; 15:e1-e10. [PMID: 36744458 PMCID: PMC9900301 DOI: 10.4102/phcfm.v15i1.3775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/07/2022] [Accepted: 10/15/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Community-based primary health care (PHC) forms the foundation of healthcare in South Africa. Medical programmes need to equip future health practitioners to face the challenges of the rising burden of chronic diseases of lifestyle (CDL) in different communities. Community-based education (CBE) contributes to developing knowledge, skills and attitudes appropriate to the challenges experienced in the PHC context. AIM To explore medical students' perceptions of the current CDL curriculum and related programmes during CBE rotations. SETTING The study was conducted among fourth- and fifth-year medical students at the University of the Free State, South Africa. METHODS Focus group discussions were conducted and data were analysed thematically. RESULTS Themes included perceptions of the CDL curriculum, relevance thereof for the PHC setting and barriers and challenges to implementing PHC programmes. This study identified foundational CDL content that needs to be incorporated or revisited at strategic points. Participants identified the need to contextualise educational programmes and focus on affordable, culturally acceptable and holistic healthcare prevention strategies. Barriers and challenges included high patient load, resource constraints, the lack of continuous care and focus on communicable diseases. Community-based education rotations were described as meaningful opportunities to develop professional attributes, competencies and skills. CONCLUSION This study identified foundational concepts to consider at key points throughout the curriculum. Incorporating creative and reflective learning activities in CDL modules can prepare students for the realities of PHC settings.Contribution: This study provides insight into medical students' perceptions of the CDL curriculum and informs future curriculum content for CDL modules.
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Affiliation(s)
- Sanet van Zyl
- Department of Basic Medical Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Willem H. Kruger
- Department of Community Health, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Corinna M. Walsh
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
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Rahma AT, Ádám B, Abdullahi AS, Sheek-Hussein M, Shaban S, AlShamsi M, AlKhori S, Nauman J, Grivna M. Reflections on medical student evaluations of a public health clerkship. Front Public Health 2023; 11:1121206. [PMID: 36935714 PMCID: PMC10020595 DOI: 10.3389/fpubh.2023.1121206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction The COVID-19 pandemic demonstrated the need for skilled medical practitioners in public health, and outbreak investigations. The College of Medicine and Health Sciences at the United Arab Emirates University (UAEU) introduced a clerkship in public health constituting theoretical and practical sessions to 5th year medical students in 2015. The aim of this study is to explore the satisfaction of the students with the public health clerkship which is crucial for the assessment and reformation of the taught curriculum. Methods A cross-sectional, post-evaluation analysis was conducted from the period 2015-2022. The evaluation questionnaire was conducted via an online university system. The survey contained 5 themes: pre-course instructions, structure of the clerkship, academic staff, activities, and learning outcomes. Ethics approval was secured from the Social-IRB of the UAEU. We used SPSS version 26 to analyze the data using independent t-test and ANOVA. Results One hundred and seventy four students (27.4% response rate) participated in the study. Overall, the students had an average satisfaction score of 2.86 out of 4. The majority of the students reported having a good understanding of public health (93.7%), improving their oral presentation skills (91.2%), and developing new skills (87.2%). Furthermore, more than 9 in 10 students (96.1%) reported that the program expanded their knowledge, skills, and confidence. The mass (90.2%) of students agreed that the clerkship content was covered in sufficient depth, majority of the students agreed that they had received enough information about the clerkship before it started (74.6%), majority of the students agreed that the faculty were interested in their personal development (86.1%) The students who completed the clerkship prior to the COVID-19 pandemic had a statistically significant (P = 0.02) higher average rating (72.8%) than students who completed the clerkship during the pandemic (71.1%). Discussion Medical students at the UAEU were satisfied with the activities and delivery of the public health clerkship and found it rewarding. Conducting needs assessment and proposal writing provided them with the knowledge, skills, and confidence to conduct research in their career. These findings may be useful in helping and support other institutes to plan and develop a clerkship in the public health.
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Affiliation(s)
- Azhar T. Rahma
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Balázs Ádám
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- *Correspondence: Balázs Ádám
| | - Aminu S. Abdullahi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Mohamud Sheek-Hussein
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Sami Shaban
- Department of Medical Education, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Mouza AlShamsi
- Department of Statistics, College of Business and Economics, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Salama AlKhori
- Department of Statistics, College of Business and Economics, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Javaid Nauman
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Michal Grivna
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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Malatskey L, Essa-Hadad J, Eldar R, Filipov I, Eilat-Tsanani S, Rudolf MCJ. Medical student lifestyle counselling for non-communicable disease: impact on students' competence and patients' health behaviors. Isr J Health Policy Res 2022; 11:23. [PMID: 35610707 PMCID: PMC9131583 DOI: 10.1186/s13584-022-00532-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 05/09/2022] [Indexed: 11/16/2022] Open
Abstract
Background Promoting healthy lifestyle is key to tackling lifestyle-induced diseases, yet many doctors feel unskilled and medical schools lack its inclusion in their curricula. The impact of a novel elective lifestyle course is described, where students provided 3 months’ coaching to at-risk patients. Methods Students’ attitudes, competence and lifestyle were assessed pre- and post the 18-month course. Patients’ health measures and behaviors were measured. Student and patient views were ascertained. Results Nineteen students, 13 controls, and 29 patients participated. Perception of physicians’ importance as lifestyle consultants increased in coaching students (mean ± SD 3.7 ± 0.4 vs. 3.2 ± 0.5; p = 0.05). Self-perceived competence remained high in coaching students (6.7 ± 1.8 vs. 6.7 ± 1.2; p = 0.66). Controls’ competence increased but did not attain coaching students’ levels (3.6 ± 2.1 vs. 5.5 ± 1.9; p = 0.009). Focus groups of students confirmed self-perceived acquisition of skills. More patients exercised (38% vs. 82.7%; p = 0.001); spent more time in physical activity (median mins/week + IQR) 25 + [0.180] vs. 120 + [45,300]; p = 0.039), and avoided less desirable foods, such as unhealthy snacks, sweets and drinks. LDL cholesterol showed declining trend. Patients highlighted students’ empathy and attentiveness; satisfaction was extremely high. Conclusions The course successfully enhanced students’ counselling skills, with beneficial effects for patients. This model for teaching experience-based lifestyle medicine has potential policy implications in terms of promoting effective lifestyle counselling by future physicians.
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Affiliation(s)
- Lilach Malatskey
- Department of Population Health, Faculty of Medicine, Bar-Ilan University Azrieli, Henrietta Szold 8, POB 1589, 1311502, Safed, Israel
| | - Jumanah Essa-Hadad
- Department of Population Health, Faculty of Medicine, Bar-Ilan University Azrieli, Henrietta Szold 8, POB 1589, 1311502, Safed, Israel.
| | - Reut Eldar
- Department of Population Health, Faculty of Medicine, Bar-Ilan University Azrieli, Henrietta Szold 8, POB 1589, 1311502, Safed, Israel
| | | | - Sophia Eilat-Tsanani
- Department of Population Health, Faculty of Medicine, Bar-Ilan University Azrieli, Henrietta Szold 8, POB 1589, 1311502, Safed, Israel.,Clalit Health Services, Safed, Israel
| | - Mary C J Rudolf
- Department of Population Health, Faculty of Medicine, Bar-Ilan University Azrieli, Henrietta Szold 8, POB 1589, 1311502, Safed, Israel
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Educational Studies Examining Knowledge of Substance Use Disorders and Career Aspirations Among Medical Trainees in an Inner-City Hospital. J Addict Med 2022; 16:72-76. [PMID: 33758117 PMCID: PMC8443688 DOI: 10.1097/adm.0000000000000830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Gaps in addiction medicine training are a reason for poor substance use care in North America. Hospital addiction medicine consult services (AMCS) provide critical medical services, including screening and treatment of substance use disorders. Although these programs often feature an educational component for medical learners, the impact of AMCS teaching on objective knowledge and career aspirations in addiction medicine has not been well described. METHODS The authors report findings from two sequential studies conducted at a large academic hospital in Vancouver, Canada. The first study assessed the impact of an AMCS clinical rotation on medical trainee addiction medicine objective knowledge using an online survey of 6 true/false questions before and after the rotation. The second study examined the impact of an AMCS rotation on career aspirations using 4 seven-point Likert-type questions. One-sample t tests on mean differences (MD) with Benjamini-Hochberg adjustment for multiple comparisons were employed for statistical analyses. RESULTS Between May 2017 and June 2018, knowledge scores were significantly higher postrotation (MD = 4.78, standard deviation [SD] = 19.5, P = 0.034) among 115 medical trainees. Between July 2018 and July 2019, aspirations to practice addiction medicine were significantly more favorable postrotation (MD = 3.48, SD = 3.15, P < 0.001) among 101 medical trainees. CONCLUSIONS AMCS rotations appear to improve addiction medicine knowledge and aspirations to practice addiction medicine among medical trainees. Larger-scale evaluations and outcomes research on integrating substance use disorders teaching in these settings will help move the discipline forward.
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Meta-analysis and machine learning-augmented mixed effects cohort analysis of improved diets among 5847 medical trainees, providers and patients. Public Health Nutr 2021; 25:281-289. [PMID: 34176552 PMCID: PMC8883775 DOI: 10.1017/s1368980021002809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objective: We sought to produce the first meta-analysis (of medical trainee competency improvement in nutrition counseling) informing the first cohort study of patient diet improvement through medical trainees and providers counseling patients on nutrition. Design: (Part A) A systematic review and meta-analysis informing (Part B) the intervention analysed in the world’s largest prospective multi-centre cohort study on hands-on cooking and nutrition education for medical trainees, providers and patients. Settings: (A) Medical educational institutions. (B) Teaching kitchens. Participants: (A) Medical trainees. (B) Trainees, providers and patients. Results: (A) Of the 212 citations identified (n 1698 trainees), eleven studies met inclusion criteria. The overall effect size was 9·80 (95 % CI (7·15, 12·45) and 95 % CI (6·87, 13·85); P < 0·001), comparable with the machine learning (ML)-augmented results. The number needed to treat for the top performing high-quality study was 12. (B) The hands-on cooking and nutrition education curriculum from the top performing study were applied for medical trainees and providers who subsequently taught patients in the same curriculum (n 5847). The intervention compared with standard medical care and education alone significantly increased the odds of superior diets (high/medium v. low Mediterranean diet adherence) for residents/fellows most (OR 10·79, 95 % CI (4·94, 23·58); P < 0·001) followed by students (OR 9·62, 95 % CI (5·92, 15·63); P < 0·001), providers (OR 5·19, 95 % CI (3·23, 8·32), P < 0·001) and patients (OR 2·48, 95 % CI (1·38, 4·45); P = 0·002), results consistent with those from ML. Conclusions: The current study suggests that medical trainees and providers can improve patients’ diets with nutrition counseling in a manner that is clinically and cost effective and may simultaneously advance societal equity.
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Downing MA, Bazzi MO, Vinicky ME, Lampasona NV, Tsvyetayev O, Mayrovitz HN. Dietary views and habits of students in health professional vs. non-health professional graduate programs in a single university. J Osteopath Med 2021; 121:377-383. [PMID: 33694352 DOI: 10.1515/jom-2020-0178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 08/21/2020] [Indexed: 11/15/2022]
Abstract
CONTEXT Students enrolled in health professional (HP) programs receive varying amounts of credit hours dedicated to nutritional education, and obesity remains an issue in the United States among healthcare providers. OBJECTIVES To assess whether HP students differ in nutrition and exercise habits from non-health professional (NHP) students at a single university, and whether any gender-related differences existed in those habits. METHODS From September 25, 2018 to October 10, 2019, a 16-question multiple-choice survey was distributed via e-mail or in person to HP and NHP students enrolled at Nova Southeastern University (NSU) in Fort Lauderdale, Florida. Questions targeted participant dietary and exercise habits. Each question had five multiple-choice answer options, each of which was assigned a coded value to compare similarities and differences between the HP and NHP groups. RESULTS Of 732 responses (569 HP, 163 NHP), results showed no statistically significant difference between enrollment groups (p>0.05) in any response parameter including consumption of sweets, fast food, red meat, caffeine, water, fruit, and vegetables. Comparisons among sexes demonstrated significant differences. Women consumed less red meat, water, and protein, and women participated in less exercise compared to men. Women also consumed more sweets compared to men. CONCLUSIONS Results suggest that NSU students enrolled in HP and NHP programs have similar nutritional concepts and eating habits. This may indicate a need to strengthen nutritional education in dietary health and wellness for HP students.
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Affiliation(s)
- Michael A Downing
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Michael O Bazzi
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Mark E Vinicky
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Nicholas V Lampasona
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Oleg Tsvyetayev
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Harvey N Mayrovitz
- Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA
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Reilly JM, Plepys CM, Cousineau MR. Dual MD-MPH Degree Students in the United States: Moving the Medical Workforce Toward Population Health. Public Health Rep 2021; 136:640-647. [PMID: 33563071 DOI: 10.1177/0033354920978422] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE A growing need exists to train physicians in population health to meet the increasing need and demand for physicians with leadership, health data management/metrics, and epidemiology skills to better serve the health of the community. This study examines current trends in students pursuing a dual doctor of medicine (MD)-master of public health (MPH) degree (MD-MPH) in the United States. METHODS We conducted an extensive literature review of existing MD-MPH databases to determine characteristics (eg, sex, race/ethnicity, MPH area of study) of this student cohort in 2019. We examined a trend in the MD community to pursue an MPH career, adding additional public health and health care policy training to the MD workforce. We conducted targeted telephone interviews with 20 admissions personnel and faculty at schools offering MD-MPH degrees in the United States with the highest number of matriculants and graduates. Interviews focused on curricula trends in medical schools that offer an MD-MPH degree. RESULTS No literature describes the US MD-MPH cohort, and available MD-MPH databases are limited and incomplete. We found a 434% increase in the number of students pursuing an MD-MPH degree from 2010 to 2018. The rate of growth was greater than the increase in either the number of medical students (16%) or the number of MPH students (65%) alone. Moreover, MD-MPH students as a percentage of total MPH students more than tripled, from 1.1% in 2010 to 3.6% in 2018. CONCLUSIONS As more MD students pursue public health training, the impact of an MPH degree on medical school curricula, MD-MPH graduates, and MD-MPH career pursuits should be studied using accurate and comprehensive databases.
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Affiliation(s)
- Jo Marie Reilly
- 12223 Keck School of Medicine, Department of Family Medicine, University of Southern California, Los Angeles, CA, USA
| | - Christine M Plepys
- 398152 Association of Schools and Programs of Public Health, Washington, DC, USA
| | - Michael R Cousineau
- Gehr Family Center for Health System Science and Innovation, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Haque A, Mumtaz S, Khattak O, Mumtaz R, Ahmed A. Comparing the preventive behavior of medical students and physicians in the era of COVID-19: Novel medical problems demand novel curricular interventions. BIOCHEMISTRY AND MOLECULAR BIOLOGY EDUCATION : A BIMONTHLY PUBLICATION OF THE INTERNATIONAL UNION OF BIOCHEMISTRY AND MOLECULAR BIOLOGY 2020; 48:473-481. [PMID: 32682354 PMCID: PMC7404347 DOI: 10.1002/bmb.21406] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/15/2020] [Indexed: 05/22/2023]
Abstract
The global challenge presented by COVID-19 is unparalleled. Shortages in healthcare staff and manpower bring the practical skills of medical students under the spotlight. However, before they can be placed on hospital frontlines, it is crucial to assess their preparedness for patient interaction. This can be achieved by comparing their behavioral dynamics to those of physicians. An online questionnaire was administered between March 20, 2020 and March 27, 2020. The preventive strategies adopted by medical students and physicians at different ages and levels of education were compared by using chi-square test where a p value of <0.05 was considered statistically significant. We report that the demonstration of preventive behaviors increased with educational attainment and age. Older age groups avoided crowded areas, wore more masks, used disinfectants and did not touch their faces as compared to the younger participants (p < 0.001). Similarly, postgraduate doctors used more masks and disinfectants as compared to graduate doctors and medical students (p < 0.001). Based on our results, the lack of preventive behavior shown by medical students has implications for policy makers. We recommend short- and long-term changes to medical programs and admissions policies to equip medical students with the personal and professional skills to better contribute to the healthcare system in the present pandemic and beyond.
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Affiliation(s)
- Ayesha Haque
- Department of AnatomyDental college, HITEC‐Institute of Medical SciencesTaxilaPakistan
| | - Sadaf Mumtaz
- Department of PhysiologyDental College, HITEC‐Institute of Medical SciencesTaxilaPakistan
| | - Osama Khattak
- Principal, Dental collegeHITEC‐Institute of Medical SciencesTaxilaPakistan
| | - Rafia Mumtaz
- National University of Health Sciences and Technology (NUST)School of Electrical Engineering and Computer Science (SEECS), H‐12IslamabadPakistan
| | - Amal Ahmed
- School of MedicineImperial College LondonLondonUK
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Patnaik A, Tran J, McWhorter JW, Burks H, Ngo A, Nguyen TD, Mody A, Moore L, Hoelscher DM, Dyer A, Sarris L, Harlan T, Chassay CM, Monlezun D. Regional variations in medical trainee diet and nutrition counseling competencies: Machine learning-augmented propensity score analysis of a prospective multi-site cohort study. MEDICAL SCIENCE EDUCATOR 2020; 30:911-915. [PMID: 34457749 PMCID: PMC8368255 DOI: 10.1007/s40670-020-00973-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Medical professionals and students are inadequately trained to respond to rising global obesity and nutrition-related chronic disease epidemics, primarily focusing on cardiovascular disease. Yet, there are no multi-site studies testing evidence-based nutrition education for medical students in preventive cardiology, let alone establishing student dietary and competency patterns. METHODS Cooking for Health Optimization with Patients (CHOP; NIH NCT03443635) was the first multi-national cohort study using hands-on cooking and nutrition education as preventive cardiology, monitoring and improving student diets and competencies in patient nutrition education. Propensity-score adjusted multivariable regression was augmented by 43 supervised machine learning algorithms to assess students outcomes from UT Health versus the remaining study sites. RESULTS 3,248 medical trainees from 20 medical centers and colleges met study criteria from 1 August 2012 to 31 December 2017 with 60 (1.49%) being from UTHealth. Compared to the other study sites, trainees from UTHealth were more likely to consume vegetables daily (OR 1.82, 95%CI 1.04-3.17, p=0.035), strongly agree that nutrition assessment should be routine clinical practice (OR 2.43, 95%CI 1.45-4.05, p=0.001), and that providers can improve patients' health with nutrition education (OR 1.73, 95%CI 1.03-2.91, p=0.038). UTHealth trainees were more likely to have mastered 12 of the 25 competency topics, with the top three being moderate alcohol intake (OR 1.74, 95%CI 0.97-3.11, p=0.062), dietary fats (OR 1.26, 95%CI 0.57-2.80, p=0.568), and calories (OR 1.26, 95%CI 0.70-2.28, p=0.446). CONCLUSION This machine learning-augmented causal inference analysis provides the first results that compare medical students nationally in their diets and competencies in nutrition education, highlighting the results from UTHealth. Additional studies are required to determine which factors in the hands-on cooking and nutrition curriculum for UTHealth and other sites produce optimal student - and, eventually, preventive cardiology - outcomes when they educate patients in those classes.
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Affiliation(s)
- Anish Patnaik
- McGovern Medical School, University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX USA
| | - Justin Tran
- McGovern Medical School, University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX USA
| | - John W. McWhorter
- School of Public Health, University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX USA
- Michael & Susan Dell Center for Healthy Living, Austin, TX USA
| | - Helen Burks
- McGovern Medical School, University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX USA
| | - Alexandra Ngo
- McGovern Medical School, University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX USA
| | - Tu Dan Nguyen
- McGovern Medical School, University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX USA
| | - Avni Mody
- McGovern Medical School, University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX USA
| | - Laura Moore
- School of Public Health, University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX USA
- Michael & Susan Dell Center for Healthy Living, Austin, TX USA
| | - Deanna M. Hoelscher
- School of Public Health, University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX USA
- Michael & Susan Dell Center for Healthy Living, Austin, TX USA
| | - Amber Dyer
- The Goldring Center for Culinary Medicine, Tulane University School of Medicine, New Orleans, LA USA
| | - Leah Sarris
- The Goldring Center for Culinary Medicine, Tulane University School of Medicine, New Orleans, LA USA
| | - Timothy Harlan
- The Goldring Center for Culinary Medicine, Tulane University School of Medicine, New Orleans, LA USA
| | - C Mark Chassay
- McGovern Medical School, University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX USA
| | - Dominique Monlezun
- McGovern Medical School, University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX USA
- The Goldring Center for Culinary Medicine, Tulane University School of Medicine, New Orleans, LA USA
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Van Horn L, Lenders CM, Pratt CA, Beech B, Carney PA, Dietz W, DiMaria-Ghalili R, Harlan T, Hash R, Kohlmeier M, Kolasa K, Krebs NF, Kushner RF, Lieh-Lai M, Lindsley J, Meacham S, Nicastro H, Nowson C, Palmer C, Paniagua M, Philips E, Ray S, Rose S, Salive M, Schofield M, Thompson K, Trilk JL, Twillman G, White JD, Zappalà G, Vargas A, Lynch C. Advancing Nutrition Education, Training, and Research for Medical Students, Residents, Fellows, Attending Physicians, and Other Clinicians: Building Competencies and Interdisciplinary Coordination. Adv Nutr 2019; 10:1181-1200. [PMID: 31728505 PMCID: PMC6855992 DOI: 10.1093/advances/nmz083] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/13/2019] [Accepted: 07/15/2019] [Indexed: 01/15/2023] Open
Abstract
Nutrition plays an important role in health promotion and disease prevention and treatment across the lifespan. Physicians and other healthcare professionals are expected to counsel patients about nutrition, but recent surveys report minimal to no improvements in medical nutrition education in US medical schools. A workshop sponsored by the National Heart, Lung, and Blood Institute addressed this gap in knowledge by convening experts in clinical and academic health professional schools. Representatives from the National Board of Medical Examiners, the Accreditation Council for Graduate Medical Education, the Liaison Committee on Medical Education, and the American Society for Nutrition provided relevant presentations. Reported is an overview of lessons learned from nutrition education efforts in medical schools and health professional schools including interprofessional domains and competency-based nutrition education. Proposed is a framework for coordinating activities of various entities using a public-private partnership platform. Recommendations for nutrition research and accreditation are provided.
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Affiliation(s)
- Linda Van Horn
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA,Address correspondence to LVH (e-mail: )
| | - Carine M Lenders
- Department of Pediatrics, Boston University School of Medicine, Boston, MA, USA
| | - Charlotte A Pratt
- Division of Cardiovascular Sciences, National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Bettina Beech
- Department of Population Health Science, University of Mississippi Medical Center, Jackson, MS, USA
| | - Patricia A Carney
- Department of Family Medicine; of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - William Dietz
- Redstone Global Center for Prevention and Wellness, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Rose DiMaria-Ghalili
- College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Timothy Harlan
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Robert Hash
- American Medical Association, Chicago, IL, USA
| | - Martin Kohlmeier
- Department of Nutrition, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Kathryn Kolasa
- Department of Family Medicine; of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC, USA
| | - Nancy F Krebs
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Robert F Kushner
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Mary Lieh-Lai
- Accreditation Council for Graduate Medical Education, Chicago, IL, USA
| | - Janet Lindsley
- Department of Biochemistry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Susan Meacham
- Division of Cardiovascular Sciences, National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Holly Nicastro
- Division of Cardiovascular Sciences, National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Caryl Nowson
- Department of Nutrition and Ageing, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Carole Palmer
- Division of Nutrition & Oral Health, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Miguel Paniagua
- Test Materials Development, National Board of Medical Examiners, Philadelphia, PA, USA
| | - Edward Philips
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
| | - Sumantra Ray
- Global Center for Nutrition and Health, University of Cambridge, Cambridge, United Kingdom
| | - Suzanne Rose
- Department of Medicine, School of Health, University of Connecticut, Farmington, CT, USA
| | - Marcel Salive
- Division of Geriatrics & Clinical Gerontology, National Institutes of Health, National Institute on Aging, Bethesda, MD, USA
| | - Marsha Schofield
- Nutrition Services Coverage, Academy of Nutrition and Dietetics, Chicago, IL, USA
| | - Kathryn Thompson
- Department of Biomedical Sciences, College of Osteopathic Medicine, University of New England, Biddeford, ME, USA
| | - Jennifer L Trilk
- Department of Biomedical Sciences, University of South Carolina School of Medicine, Greenville, SC, USA
| | - Gwen Twillman
- Department of Education & Development, American Society for Nutrition, Rockville, MD, USA
| | - Jeffrey D White
- Division of Cancer Treatment and Diagnosis, National Institutes of Health, National Cancer Institute, Bethesda, MD, USA
| | - Giovanna Zappalà
- Division of Geriatrics and Clinical Gerontology and Head of the Office of Nutrition, National Institutes of Health, National Institute on Aging, Bethesda, MD, USA
| | - Ashley Vargas
- Office of Disease Prevention, National Institutes of Health, Rockville, MD, USA
| | - Christopher Lynch
- Office of Nutrition Research, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
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Gorfinkel L, Klimas J, Reel B, Dong H, Ahamad K, Fairgrieve C, McLean M, Mead A, Nolan S, Small W, Cullen W, Wood E, Fairbairn N. In-hospital training in addiction medicine: A mixed-methods study of health care provider benefits and differences. Subst Abus 2019; 40:207-213. [PMID: 30689528 DOI: 10.1080/08897077.2018.1561596] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Background: Hospital-based clinical addiction medicine training can improve knowledge of clinical care for substance-using populations. However, application of structured, self-assessment tools to evaluate differences in knowledge gained by learners who participate in such training has not yet been addressed. Methods: Participants (n = 142) of an elective with the hospital-based Addiction Medicine Consult Team (AMCT) in Vancouver, Canada, responded to an online self-evaluation survey before and immediately after the structured elective. Areas covered included substance use screening, history taking, signs and symptoms examination, withdrawal treatment, relapse prevention, nicotine use disorders, opioid use disorders, safe prescribing, and the biology of substance use disorders. A purposefully selected sample of 18 trainees were invited to participate in qualitative interviews that elicited feedback on the rotation. Results: Of 168 invited trainees, 142 (84.5%) completed both pre- and post-rotation self-assessments between May 2015 and May 2017. Follow-up participants included medical students, residents, addiction medicine fellows, and family physicians in practice. Self-assessed knowledge of addiction medicine increased significantly post-rotation (mean difference in scores = 11.87 out of the maximum possible 63 points, standard deviation = 17.00; P < .0001). Medical students were found to have the most significant improvement in addiction knowledge (estimated mean difference = 4.43, 95% confidence interval = 0.76, 8.09; P = .018). Illustrative quotes describe the dynamics involved in the learning process among trainees. Conclusions: Completion of a hospital-based clinical elective was associated with improved knowledge of addiction medicine. Medical students appear to benefit more from the addiction elective with a hospital-based AMCT than other types of learners.
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Affiliation(s)
- Lauren Gorfinkel
- British Columbia Centre on Substance Use and Excellence in HIV/AIDS, St. Paul's Hospital , Vancouver , British Columbia , Canada.,Mailman School of Public Health, Columbia University , New York , New York , USA
| | - Jan Klimas
- British Columbia Centre on Substance Use and Excellence in HIV/AIDS, St. Paul's Hospital , Vancouver , British Columbia , Canada.,Department of Medicine, University of British Columbia , Vancouver , British Columbia , Canada.,School of Medicine, University College Dublin , Dublin , Ireland
| | - Breanne Reel
- Faculty of Health Sciences, Simon Fraser University , Burnaby , British Columbia , Canada
| | - Huiru Dong
- British Columbia Centre on Substance Use and Excellence in HIV/AIDS, St. Paul's Hospital , Vancouver , British Columbia , Canada.,School of Population and Public Health, University of British Columbia , Vancouver , British Columbia , Canada
| | - Keith Ahamad
- British Columbia Centre on Substance Use and Excellence in HIV/AIDS, St. Paul's Hospital , Vancouver , British Columbia , Canada.,Department of Family Practice, University of British Columbia , Vancouver , British Columbia , Canada
| | - Christopher Fairgrieve
- British Columbia Centre on Substance Use and Excellence in HIV/AIDS, St. Paul's Hospital , Vancouver , British Columbia , Canada
| | - Mark McLean
- British Columbia Centre on Substance Use and Excellence in HIV/AIDS, St. Paul's Hospital , Vancouver , British Columbia , Canada.,Department of Medicine, University of British Columbia , Vancouver , British Columbia , Canada
| | - Annabel Mead
- British Columbia Centre on Substance Use and Excellence in HIV/AIDS, St. Paul's Hospital , Vancouver , British Columbia , Canada.,Department of Family Practice, University of British Columbia , Vancouver , British Columbia , Canada
| | - Seonaid Nolan
- British Columbia Centre on Substance Use and Excellence in HIV/AIDS, St. Paul's Hospital , Vancouver , British Columbia , Canada.,Department of Family Practice, University of British Columbia , Vancouver , British Columbia , Canada
| | - Will Small
- British Columbia Centre on Substance Use and Excellence in HIV/AIDS, St. Paul's Hospital , Vancouver , British Columbia , Canada.,Faculty of Health Sciences, Simon Fraser University , Burnaby , British Columbia , Canada
| | - Walter Cullen
- School of Medicine, University College Dublin , Dublin , Ireland
| | - Evan Wood
- British Columbia Centre on Substance Use and Excellence in HIV/AIDS, St. Paul's Hospital , Vancouver , British Columbia , Canada.,Department of Medicine, University of British Columbia , Vancouver , British Columbia , Canada
| | - Nadia Fairbairn
- British Columbia Centre on Substance Use and Excellence in HIV/AIDS, St. Paul's Hospital , Vancouver , British Columbia , Canada.,Department of Medicine, University of British Columbia , Vancouver , British Columbia , Canada
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Machine Learning-Augmented Propensity Score-Adjusted Multilevel Mixed Effects Panel Analysis of Hands-On Cooking and Nutrition Education versus Traditional Curriculum for Medical Students as Preventive Cardiology: Multisite Cohort Study of 3,248 Trainees over 5 Years. BIOMED RESEARCH INTERNATIONAL 2018; 2018:5051289. [PMID: 29850526 PMCID: PMC5925138 DOI: 10.1155/2018/5051289] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 02/28/2018] [Indexed: 01/01/2023]
Abstract
Background Cardiovascular disease (CVD) annually claims more lives and costs more dollars than any other disease globally amid widening health disparities, despite the known significant reductions in this burden by low cost dietary changes. The world's first medical school-based teaching kitchen therefore launched CHOP-Medical Students as the largest known multisite cohort study of hands-on cooking and nutrition education versus traditional curriculum for medical students. Methods This analysis provides a novel integration of artificial intelligence-based machine learning (ML) with causal inference statistics. 43 ML automated algorithms were tested, with the top performer compared to triply robust propensity score-adjusted multilevel mixed effects regression panel analysis of longitudinal data. Inverse-variance weighted fixed effects meta-analysis pooled the individual estimates for competencies. Results 3,248 unique medical trainees met study criteria from 20 medical schools nationally from August 1, 2012, to June 26, 2017, generating 4,026 completed validated surveys. ML analysis produced similar results to the causal inference statistics based on root mean squared error and accuracy. Hands-on cooking and nutrition education compared to traditional medical school curriculum significantly improved student competencies (OR 2.14, 95% CI 2.00–2.28, p < 0.001) and MedDiet adherence (OR 1.40, 95% CI 1.07–1.84, p = 0.015), while reducing trainees' soft drink consumption (OR 0.56, 95% CI 0.37–0.85, p = 0.007). Overall improved competencies were demonstrated from the initial study site through the scale-up of the intervention to 10 sites nationally (p < 0.001). Discussion This study provides the first machine learning-augmented causal inference analysis of a multisite cohort showing hands-on cooking and nutrition education for medical trainees improves their competencies counseling patients on nutrition, while improving students' own diets. This study suggests that the public health and medical sectors can unite population health management and precision medicine for a sustainable model of next-generation health systems providing effective, equitable, accessible care beginning with reversing the CVD epidemic.
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13
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Hays R. Including health promotion and illness prevention in medical education: a progress report. MEDICAL EDUCATION 2018; 52:68-77. [PMID: 28905431 DOI: 10.1111/medu.13389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 04/18/2017] [Accepted: 06/05/2017] [Indexed: 06/07/2023]
Abstract
CONTEXT In 1988, the World Federation of Medical Education called for reform in medical education, publishing 12 recommendations. The sixth recommendation of this Edinburgh Declaration was to 'complement instruction about the management of patients with increased emphasis on promotion of health and prevention of disease'. Thirty years on, this paper reports an exploration of what has changed since then. METHODS Several search strategies were used, including websites of medical standards organisations, and formal searches of PubMed and Google Scholar using key words such as 'medical education standards', 'health promotion', 'illness prevention', 'effectiveness' and 'assessment'. As these searches produced more descriptive than evidence-based papers, the exploration widened to follow evolving discussions about changing emphases in medical education relevant to public health. RESULTS Health promotion and illness prevention are in the undergraduate medical education standards of the more influential regulators. There is little evidence of the impact of this inclusion on graduate outcomes and later medical practice, although 'differently educated' doctors may have contributed to the success of broader public health strategies achieved through reorganisation of health care, media campaigns and legislation changes. There is greater success in postgraduate specialty training of general practitioners and public health doctors. The discussion about public health interventions and the roles of doctors has moved on to topics such as patient safety, the health of doctors, global health and planetary health. CONCLUSIONS The inclusion of health promotion and illness prevention strategies in undergraduate curricula varied considerably, but was strongest in programmes claiming social accountability and responding to medical education standards of the more influential regulators. However, the contribution of medical education to improvements in health care and the health of populations is difficult to measure. It may be timely to revisit the purpose and practicality of broadening the scope of undergraduate medical curricula in public health medicine.
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Affiliation(s)
- Richard Hays
- Division of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia
- Rural Clinical School, University of Tasmania, Hobart, Tasmania, Australia
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Kershaw G, Grivna M, Elbarazi I, AliHassan S, Aziz F, Al Dhaheri AI. Integrating Public Health and Health Promotion Practice in the Medical Curriculum: A Self-Directed Team-Based Project Approach. Front Public Health 2017; 5:193. [PMID: 28879173 PMCID: PMC5573437 DOI: 10.3389/fpubh.2017.00193] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 07/18/2017] [Indexed: 11/13/2022] Open
Abstract
Preparing health professionals in health promotion (HP) and disease prevention is essential for improvement of population health, community HP, and better health care for individuals. The aim of this article is to describe an HP project in the form of a major self-directed project-based learning task integrated within the curriculum in the second year of the medical degree program at United Arab Emirates University. The project introduces students to public health and HP practice and develops students’ literature searching, writing, presentation skills, and team work. Students learn the principles underlying behavioral change, and the design of HP programs and materials, through a lecture format. Small groups of students each choose a specific health topic for their project. Over 11 weeks, students obtain information about their topic from appropriate sources (library, PubMed, Google Scholar, credible health sources such as World Health Organization). Using the principles learned in the lectures, they develop appropriate materials for their target audience: for example, posters, a pamphlet, social media content, or a video or radio message. Students seek advice from specialist faculty as needed. In week 12, each team presents their project background, rationale, and materials to their colleagues in a seminar format open to all faculty. They then submit the materials they developed for assessment. Group marks are assigned for presentations and materials. Key concepts are assessed by multiple choice questions in comprehensive course examinations. By participation in the HP project, many students develop a solid background in prevention. The information retrieval, writing, and presentation skills, as well as experience of team work, are valuable both for the remaining years of their training and their future careers.
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Affiliation(s)
- Geraldine Kershaw
- Medical Education Department, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Michal Grivna
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Souheila AliHassan
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Faisal Aziz
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Aysha Ibrahim Al Dhaheri
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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15
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Klimas J, Ahamad K, Fairgrieve C, McLean M, Mead A, Nolan S, Wood E. Impact of a brief addiction medicine training experience on knowledge self-assessment among medical learners. Subst Abus 2017; 38:141-144. [PMID: 28394732 PMCID: PMC5783636 DOI: 10.1080/08897077.2017.1296055] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Implementation of evidence-based approaches to the treatment of various substance use disorders is needed to tackle the existing epidemic of substance use and related harms. Most clinicians, however, lack knowledge and practical experience with these approaches. Given this deficit, the authors examined the impact of an inpatient elective in addiction medicine amongst medical trainees on addiction-related knowledge and medical management. METHODS Trainees who completed an elective with a hospital-based Addiction Medicine Consult Team (AMCT) in Vancouver, Canada, from May 2015 to May 2016, completed a 9-item self-evaluation scale before and immediately after the elective. RESULTS A total of 48 participants completed both pre and post AMCT elective surveys. On average, participants were 28 years old (interquartile range [IQR] = 27-29) and contributed 20 days (IQR = 13-27) of clinical service. Knowledge of addiction medicine increased significantly post elective (mean difference [MD] = 8.63, standard deviation [SD] = 18.44; P = .002). The most and the least improved areas of knowledge were relapse prevention and substance use screening, respectively. CONCLUSIONS Completion of a clinical elective with a hospital-based AMCT appears to improve medical trainees' addiction-related knowledge. Further evaluation and expansion of addiction medicine education is warranted to develop the next generation of skilled addiction care providers.
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Affiliation(s)
- Jan Klimas
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC, CANADA, V6Z 1Y6
- Department of Medicine, University of British Columbia, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC, CANADA, V6Z 1Y6
- School of Medicine, University College Dublin, Coombe Healthcare Centre, Dolphins barn, Dublin 8, Ireland
| | - Keith Ahamad
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC, CANADA, V6Z 1Y6
- Department of Family Medicine, University of British Columbia, Vancouver, BC, CANADA, V6Z 1Y6
| | - Christopher Fairgrieve
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC, CANADA, V6Z 1Y6
- Department of Family Medicine, University of British Columbia, Vancouver, BC, CANADA, V6Z 1Y6
| | - Mark McLean
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC, CANADA, V6Z 1Y6
- Department of Family Medicine, University of British Columbia, Vancouver, BC, CANADA, V6Z 1Y6
| | - Annabel Mead
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC, CANADA, V6Z 1Y6
- Department of Family Medicine, University of British Columbia, Vancouver, BC, CANADA, V6Z 1Y6
| | - Seonaid Nolan
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC, CANADA, V6Z 1Y6
- Department of Family Medicine, University of British Columbia, Vancouver, BC, CANADA, V6Z 1Y6
| | - Evan Wood
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC, CANADA, V6Z 1Y6
- Department of Medicine, University of British Columbia, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC, CANADA, V6Z 1Y6
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Dang TM, Maggio LA. Supporting the Call to Action: A Review of Nutrition Educational Interventions in the Health Professions Literature and MedEdPORTAL. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2017; 92:403-416. [PMID: 28225733 DOI: 10.1097/acm.0000000000001532] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
PURPOSE Despite calls to improve nutrition education, training for medical students is inadequate. This systematic review provides an overview of published educational interventions for undergraduate-level health professionals and makes recommendations for improving nutrition training. METHOD The authors conducted a systematic review of articles (through July 16, 2015) and examined resources in MedEdPORTAL (through September 28, 2015) focused on materials published since January 2004 that describe nutrition educational interventions for undergraduate-level health professionals. The authors extracted data on pedagogical characteristics, content areas covered, study design, and study outcomes. RESULTS Of 1,616 article citations, 32 met inclusion criteria. Most were designed at a single institution (n = 29) for medical students (n = 24). Of 51 MedEdPORTAL resources, 15 met inclusion criteria. Most were designed at a single institution (n = 12) for medical students (n = 15). Interventions spread across several countries, learner levels, and settings. Content areas covered included basic science nutrition, population health, counseling, and training framed by specific patient populations and organ systems. No clear trends were observed for intended learning outcomes, type of instructor, method of instruction, or duration. CONCLUSIONS The heterogeneity of interventions and the content areas covered highlight the lack of adopted curricular standards for teaching clinical nutrition. Recommendations that educators should consider include interprofessional education approaches, online learning, placing an emphasis on learners' personal health behaviors, and standardized and real patient interactions. Educators should continue to publish curricular materials and prioritize the evaluation and sharing of resources.
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Affiliation(s)
- Timothy M Dang
- T.M. Dang is a medical student, Stanford University School of Medicine, Stanford, California.L.A. Maggio is associate professor of medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Clarke CA, Frates J, Pegg Frates E. Optimizing Lifestyle Medicine Health Care Delivery Through Enhanced Interdisciplinary Education. Am J Lifestyle Med 2016; 10:401-405. [PMID: 30202301 PMCID: PMC6124981 DOI: 10.1177/1559827616661694] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
While few may argue about the importance of healthy lifestyle choices on the effects of chronic health conditions, many would highlight the challenge that its practical integration poses in daily clinical practice. The field of lifestyle medicine aims to assist individuals and communities to adopt and sustain healthy behaviors. It is a powerful yet often underutilized tool. This article illustrates the importance of joint multidisciplinary efforts in the effective practice of lifestyle medicine. Furthermore it stresses the importance of equipping healthcare providers with the tools and education necessary to deliver consistent, and high quality holistic care.
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Affiliation(s)
- Camille A. Clarke
- Camille A. Clarke, MD, Seventh Day Adventist Guam Clinic, 388 Ypao Road, Tamuning, Guam 96913; e-mail:
| | - John Frates
- Seventh Day Adventist Guam Clinic, Tamuning, Guam (CAC)
- Department of Medicine, Loma Linda University, Loma Linda, California (CAC)
- Roxbury Latin School, West Roxbury, Massachusetts (JF)
- Harvard Medical School, Boston, Massachusetts (EPF)
- Stroke Research and Recovery Institute, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts (EPF)
- Wellness Synergy, LLC, Wellesley, Massachusetts (EPF)
| | - Elizabeth Pegg Frates
- Seventh Day Adventist Guam Clinic, Tamuning, Guam (CAC)
- Department of Medicine, Loma Linda University, Loma Linda, California (CAC)
- Roxbury Latin School, West Roxbury, Massachusetts (JF)
- Harvard Medical School, Boston, Massachusetts (EPF)
- Stroke Research and Recovery Institute, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts (EPF)
- Wellness Synergy, LLC, Wellesley, Massachusetts (EPF)
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18
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Mabry R, Koohsari MJ, Bull F, Owen N. A systematic review of physical activity and sedentary behaviour research in the oil-producing countries of the Arabian Peninsula. BMC Public Health 2016; 16:1003. [PMID: 27655373 PMCID: PMC5031342 DOI: 10.1186/s12889-016-3642-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 09/06/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The dramatic rise in Noncommunicable Diseases (NCD) in the oil-producing countries of the Arabian Peninsula is driven in part by insufficient physical activity, one of the five main contributors to health risk in the region. The aim of this paper is to review the available evidence on physical activity and sedentary behaviour for this region. Based on the findings, we prioritize an agenda for research that could inform policy initiatives with regional relevance. METHODS We reviewed regional evidence on physical activity and sedentary behaviour to identify the needs for prevention and policy-related research. A literature search of peer-reviewed publications in the English language was conducted in May 2016 using PubMed, Web of Science and Google Scholar. 100 studies were identified and classified using the Behavioural Epidemiology Framework. RESULTS Review findings demonstrate that research relevant to NCD prevention is underdeveloped in the region. A majority of the studies were epidemiological in approach with few being large-scale population-based studies using standardised measures. Correlates demonstrated expected associations with health outcomes, low levels of physical activity (particularly among young people), high levels of sedentary behaviour (particularly among men and young people) and expected associations of known correlates (e.g. gender, age, education, time, self-motivation, social support, and access). Very few studies offered recommendations for translating research findings into practice. CONCLUSIONS Further research on the determinants of physical activity and sedentary behaviour in the Arabian Peninsula using standard assessment tools is urgently needed. Priority research includes examining these behaviours across the four domains (household, work, transport and leisure). Intervention research focusing on the sectors of education, health and sports sectors is recommended. Furthermore, adapting and testing international examples to the local context would help identify culturally relevant policy and programmatic interventions for the region.
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Affiliation(s)
- Ruth Mabry
- Office of the World Health Organization Representative, PO Box 476, Al Atheiba, Postal Code 130 Oman
| | - Mohammad Javad Koohsari
- Behavioural Epidemiology Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
- Institute for Health and Ageing, Australian Catholic University, Melbourne, Australia
- Melbourne School of Population and Global Health, the University of Melbourne, Melbourne, Australia
| | - Fiona Bull
- Centre for Built Environment and Health, School of Population Health, the University of Western Australia, Perth, Australia
| | - Neville Owen
- Baker IDI & Heart Diabetes Institute, Swinburne University, Melbourne, Australia
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Novel Longitudinal and Propensity Score Matched Analysis of Hands-On Cooking and Nutrition Education versus Traditional Clinical Education among 627 Medical Students. Adv Prev Med 2015; 2015:656780. [PMID: 26435851 PMCID: PMC4578831 DOI: 10.1155/2015/656780] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 08/23/2015] [Indexed: 11/18/2022] Open
Abstract
Background. Physicians are inadequately equipped to respond to the global obesity and nutrition-associated chronic disease epidemics. We investigated superiority of simulation-based medical education with deliberate practice (SBME-DP) hands-on cooking and nutrition elective in a medical school-based teaching kitchen versus traditional clinical education for medical students. Materials and Methods. A 59-question panel survey was distributed to an entire medical school twice annually from September 2012 to May 2014. Student diet and attitudes and competencies (DACs) counseling patients on nutrition were compared using conditional multivariate logistic regression, propensity score-weighted, and longitudinal panel analyses. Inverse-variance weighted meta-analysis (IVWM) was used for planned subgroup analysis by year and treatment estimates across the three methods. Results. Of the available 954 students, 65.72% (n = 627) unique students were followed to produce 963 responses. 11.32% (n = 109) of responses were from 84 subjects who participated in the elective. SBME-DP versus traditional education significantly improved fruit and vegetable diet (OR = 1.38, 95% CI: 1.07-1.79, p = 0.013) and attitudes (OR = 1.81, 95% CI: 1.40-2.35, p < 0.001) and competencies (OR = 1.72, 95% CI: 1.54-1.92, p < 0.001). Conclusions. This study reports for the first time superiority longitudinally for SBME-DP style nutrition education for medical students which has since expanded to 13 schools.
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20
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Attitude toward preventive counseling and healthy practices among medical students at a Colombian university. Front Med 2015; 9:251-9. [DOI: 10.1007/s11684-015-0393-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 03/04/2015] [Indexed: 01/24/2023]
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Abstract
The actual causes of premature adult deaths, the preponderance of noncommunicable chronic diseases, and their associated costs are related to unhealthy behaviors, such as poor nutrition, physical inactivity, and tobacco use. Although recommended as the first line of prevention and management, providers often do not provide behavioral change counseling in their care. Medical education in lifestyle medicine is, therefore, proposed as a necessary intervention to allow all health providers to learn how to effectively and efficiently counsel their patients toward adopting and sustaining healthier behaviors. Lifestyle medicine curricula, including exercise, nutrition, behavioral change, and self-care, have recently evolved in all levels of medical education, together with implementation initiatives like Exercise is Medicine and the Lifestyle Medicine Education (LMEd) Collaborative. The goal of this review is to summarize the existing literature and to provide knowledge and tools to deans, administrators, faculty members, and students interested in pursuing lifestyle medicine training or establishing and improving an LMEd program within their institution.
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Affiliation(s)
- Rani Polak
- Institute of Lifestyle Medicine, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Joslin Diabetes Center, Boston, Massachusetts (RP, RMP, EMP)
| | - Rachele M Pojednic
- Institute of Lifestyle Medicine, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Joslin Diabetes Center, Boston, Massachusetts (RP, RMP, EMP)
| | - Edward M Phillips
- Institute of Lifestyle Medicine, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Joslin Diabetes Center, Boston, Massachusetts (RP, RMP, EMP)
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22
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Polak R, Dacey ML, Keenan H, Phillips EM. Bridging the gap--planning Lifestyle Medicine fellowship curricula: A cross sectional study. BMC MEDICAL EDUCATION 2014; 14:1045. [PMID: 25551283 PMCID: PMC4318224 DOI: 10.1186/s12909-014-0271-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 12/11/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND The emerging field, Lifestyle Medicine (LM), is the evidence-based practice of assisting individuals and families to adopt and sustain behaviors that can improve health. While competencies for LM education have been defined, and undergraduate curricula have been published, there are no published reports that address graduate level fellowship in LM. This paper describes the process of planning a LM fellowship curriculum at a major, academic teaching institution. METHODS In September 2012 Harvard Medical School Department of Physical Medicine and Rehabilitation approved a "Research Fellowship in Lifestyle Medicine". A Likert scale questionnaire was created and disseminated to forty LM stakeholders worldwide, which measured perceived relative importance of six domains and eight educational experiences to include in a one-year LM fellowship. Statistical procedures included analysis of variance and the Wilcoxon signed-rank test. RESULTS Thirty-five stakeholders (87.5%) completed the survey. All domains except smoking cessation were graded at 4 or 5 by at least 85% of the respondents. After excluding smoking cessation, nutrition, physical activity, behavioral change techniques, stress resiliency, and personal health behaviors were rated as equally important components of a LM fellowship curriculum (average M = 4.69, SD = 0.15, p = 0.12). All educational experiences, with the exception of completing certification programs, research experience and fund raising, were graded at 4 or 5 by at least 82% of the responders. The remaining educational experiences, i.e. clinical practice, teaching physicians and medical students, teaching other health care providers, developing lifestyle interventions and developing health promotion programs were ranked as equally important in a LM fellowship program (average M = 4.23, SD = 0.11, p = 0.07). CONCLUSIONS Lifestyle fellowship curricula components were defined based on LM stakeholders' input. These domains and educational experiences represent the range of competencies previously noted as important in the practice of LM. As the foundation of an inaugural physician fellowship, they inform the educational objectives and future evaluation of this fellowship.
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Affiliation(s)
- Rani Polak
- Institute of Lifestyle Medicine, Physical Medicine and Rehabilitation, Harvard Medical School, Joslin Diabetes Center, One Joslin Place, Boston, MA, USA.
| | - Marie L Dacey
- School of Arts & Sciences, MCPHS University, 179 Longwood Ave, Boston, MA, USA.
| | - Hillary Keenan
- Joslin Diabetes Center, Harvard Medical School, One Joslin Place, Boston, MA, USA.
| | - Edward M Phillips
- Institute of Lifestyle Medicine, Physical Medicine and Rehabilitation, Harvard Medical School, Joslin Diabetes Center, One Joslin Place, Boston, MA, USA.
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Taylor GW, Stumpos ML, Kerschbaum W, Inglehart MR. Educating Dental Students About Diet-Related Behavior Change: Does Experiential Learning Work? J Dent Educ 2014. [DOI: 10.1002/j.0022-0337.2014.78.1.tb05658.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- George W. Taylor
- Department of Preventive and Restorative Dental Sciences; University of California, San Francisco School of Dentistry
| | | | - Wendy Kerschbaum
- Dental Hygiene Program; University of Michigan School of Dentistry
| | - Marita Rohr Inglehart
- Department of Periodontology and Oral Medicine; University of Michigan School of Dentistry; Department of Psychology; College of Literature, Science of Arts, University of Michigan
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24
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Frank E, Schlair S, Elon L, Saraiya M. Do US medical students report more training on evidence-based prevention topics? HEALTH EDUCATION RESEARCH 2013; 28:265-275. [PMID: 22730492 DOI: 10.1093/her/cys073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Little is known about the extent to which evidence-based prevention topics are taught in medical school. All class of 2003 medical students (n = 2316) at 16 US schools were eligible to complete three questionnaires: at the beginning of first and third years and in their senior year, with 80.3% responding. We queried these students about 21 preventive medicine topics, concerning the extent of their training and their patient counseling frequency at some of these time points. At the beginning of the third year, self-reported extensive training was low for all preventive medicine topics (range 7-26%). USPSTF-recommended topics received more curricular time (median for topics: 36% if recommended versus 24.5% if not, P = 0.025), as did topics addressed through testing rather than through discussion (median for topics: 37% for testing and 25% for discussion, P = 0.005). Extensive training was always associated with higher counseling frequency, and intention to go into primary care, female gender, a positive attitude toward prevention and positive personal health habits were associated with higher counseling frequency. Although some bemoan the overall low levels of US medical students' prevention-related training and practice, we demonstrate that at least they are preferentially evidence-based, a novel and encouraging finding for preventionists.
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Affiliation(s)
- Erica Frank
- School of Population and Public Health-Faculty of Medicine, University of British Columbia, Vancouver, BC, V6T 1Z3
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25
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Kavukcu E, Burgazli KM, Akdeniz M, Bilgili P, Öner M, Koparan S, Yörümez A. Family medicine and sports medicine students' perceptions of their educational environment at a primary health care center in Germany: using the DREEM questionnaire. Postgrad Med 2013; 124:143-50. [PMID: 23095434 DOI: 10.3810/pgm.2012.09.2585] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The medical learning environment is changing progressively due to its crucial importance in clinical learning and educational performance. The purpose of this study was to investigate student perceptions of the medical learning environment at a primary health care center outside of a university hospital using the Dundee Ready Educational Environment Measure (DREEM) questionnaire. Various aspects of the environment were compared between family medicine (FM) and sports medicine (SM) students to assess the role of these different rotations and their effect on student perceptions. The DREEM questionnaire, a validated tool for measuring perceptions of educational environments in medical educational environments, was completed by 110 students who were enrolled in FM and SM rotations at Wuppertal Primary Health Care and Research Center in Wuppertal, Germany. Other than 9 of the 50 items, there were no statistically significant differences in DREEM questionnaire scores between these 2 groups, indicating that students' perceptions of the educational environment were not remarkably affected by their rotations. Scores across the sample were fairly high (FM students, 139.45/200; SM students, 140.05/200; overall total score, 139.85/200). These high scores suggest that students enrolled in FM and SM health science programs generally hold positive perceptions of their course environment outside of the university hospital. The positive perception of the educational environment at this primary health care center is hopefully indicative of similar rotations' perceptions internationally. While future studies are needed to confirm this, the current findings offer a chance to identify and explore the areas that received low scores in greater detail.
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Affiliation(s)
- Ethem Kavukcu
- Department of Family Medicine, Akdeniz University, Antalya, Turkey; Wuppertal Primary Health Care and Research Center, Wuppertal, Germany.
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Schlair S, Hanley K, Gillespie C, Disney L, Kalet A, Darby PC, Frank E, Spencer E, Harris J, Jay M. How medical students' behaviors and attitudes affect the impact of a brief curriculum on nutrition counseling. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2012; 44:653-7. [PMID: 22421794 DOI: 10.1016/j.jneb.2011.08.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2011] [Revised: 07/29/2011] [Accepted: 08/18/2011] [Indexed: 05/16/2023]
Abstract
OBJECTIVE To evaluate a nutrition curriculum and explore the influence of medical students' own nutrition practices on its impact. METHODS An anonymous survey was given to first-year medical students attending a required course immediately prior to and 2 weeks after a 2-hour interactive nutrition curriculum intervention in a large private urban medical school in New York, New York. Main outcomes included self-reported nutrition counseling confidence, ability to assess diet, and nutrition knowledge measured using 4-point Likert scales. RESULTS One hundred eleven students completed surveys pre-curriculum (69%) and 121 completed them post-curriculum (75%). The authors found overall pre-post differences in dietary assessment ability (2.65 vs 3.05, P < .001) and counseling confidence (1.86 vs 2.22, P < .001). In addition to the curricular impact, students' nutrition-related behaviors and attitudes were positively associated with outcomes. CONCLUSIONS AND IMPLICATIONS A nutrition curriculum for medical students improves students' nutrition counseling-related confidence, knowledge, and skills even when controlling for personal nutrition-related behaviors.
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Affiliation(s)
- Sheira Schlair
- Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
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Chisholm A, Hart J, Mann KV, Harkness E, Peters S. Preparing medical students to facilitate lifestyle changes with obese patients: a systematic review of the literature. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2012; 87:912-23. [PMID: 22622210 DOI: 10.1097/acm.0b013e3182580648] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
PURPOSE Doctors will increasingly encounter opportunities to support obese patients in lifestyle change efforts, but the extent to which medical schools prepare their students for this challenge is unknown. Further, despite evidence indicating theory-based techniques are effective in facilitating patients' behavioral changes, the methods taught to medical students and the means of content delivery are unclear. The authors reviewed the literature to investigate how effective educational interventions are in preparing medical students to facilitate lifestyle changes with obese patients. METHOD The authors systematically searched Excerpta Medica (EMBASE), PsycINFO, MEDLINE, and Scopus for educational interventions on obesity management for medical students published in English between January 1990 and November 2010 and matching PICOS (Population, Interventions, Comparators, Outcomes, Study design) inclusion criteria. RESULTS Results of a narrative synthesis are presented. Of 1,680 studies initially identified, 36 (2%) full-text articles were reviewed, and 12 (1%) were included in the final dataset. Eleven (92%) of these studies had quantitative designs; of these, 7 (64%) did not include control groups. Nine (75%) of the 12 studies were atheoretical, and 4 (33%) described behavior management strategies. Despite positive reported outcomes regarding intervention evaluations, procedures to control for bias were infrequently reported, and conclusions were often unsupported by evidence. CONCLUSIONS Evidence from this systematic review revealed data highly susceptible to bias; thus, intervention efficacy could not be determined. Additionally, evidence-based strategies to support patients' obesity-related behavior changes were not applied to these studies, and thus it remains unknown how best to equip medical students for this task.
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Affiliation(s)
- Anna Chisholm
- School of Psychological Sciences, University of Manchester, Manchester, United Kingdom.
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Ladhani Z, Scherpbier AJJA, Stevens FCJ. Competencies for undergraduate community-based education for the health professions--a systematic review. MEDICAL TEACHER 2012; 34:733-43. [PMID: 22905658 DOI: 10.3109/0142159x.2012.700742] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
BACKGROUND Community-based education (CBE) along with competency approach is increasingly becoming popular. However, there appears to be lack of evidence on CBE competencies for undergraduate curriculum, therefore this systematic review attempted to identify and categorize CBE competencies to determine the ones used frequently. AIMS The systematic review aimed at identifying and categorizing CBE competencies implemented in nursing and medical schools to inform all stakeholders of health professional's education. METHOD A systematic review of electronic databases including MEDLINE, CINAHL, and ERIC and manual search of four medical education journals was carried out. Search was restricted to original research, published in English language between January 2000 and December 2009. RESULTS Nineteen studies fulfilled the search criteria. The competencies identified were categorized under six themes: Public Health; Cultural Competence; Leadership and Management; Community Development; Research; and Generic Competencies. Moreover, a number of clinical competencies were also found to be overlapping with CBE. CONCLUSIONS The literature on CBE competencies is limited in number and in its geographical span as most of the studies found was from developed countries; to expand the efforts to other institutions and countries, core competencies for CBE must be recognized and disseminated widely for its integration in health professionals' curriculum.
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Van der Veer T, Frings-Dresen MHW, Sluiter JK. Health behaviors, care needs and attitudes towards self-prescription: a cross-sectional survey among Dutch medical students. PLoS One 2011; 6:e28038. [PMID: 22132202 PMCID: PMC3221693 DOI: 10.1371/journal.pone.0028038] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 10/31/2011] [Indexed: 12/17/2022] Open
Abstract
Purpose There is a growing awareness of the potent ways in which the wellbeing of physicians impacts the health of their patients. The purpose of this study was to investigate the health behaviors, care needs and attitudes towards self-prescription of Dutch medical students, and any differences between junior preclinical and senior clinically active students. Methods All students (n = 2695) of a major Dutch medical school were invited for an online survey. Physical activity, eating habits, alcohol consumption, smoking, Body Mass Index, substance use and amount of sleep per night were inquired, as well as their need for different forms of care and their attitude towards self-prescription. Results Data of 902 students were used. Physical activity levels (90% sufficient) and smoking prevalence (94% non-smokers) were satisfying. Healthy eating habits (51% insufficient) and alcohol consumption (46% excessive) were worrying. Body Mass Indexes were acceptable (20% unhealthy). We found no significant differences in health behaviors between preclinical and clinically active students. Care needs were significantly lower among clinically active students. (p<0.05) Student acceptance of self-prescription was significantly higher among clinically active students. (p<0.001) Conclusions Unhealthy behaviors are prevalent among medical students, but are no more prevalent during the clinical study phase. The need for specific forms of care appears lower with study progression. This could be worrying as the acceptance of self-care and self-prescription is higher among senior clinical students. Medical faculties need to address students' unhealthy behaviors and meet their care needs for the benefit of both the future physicians as well as their patients.
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Affiliation(s)
- Tjeerd Van der Veer
- Coronel Institute of Occupational Health, Academic Medical Center (AMC), Amsterdam, The Netherlands
| | | | - Judith K. Sluiter
- Coronel Institute of Occupational Health, Academic Medical Center (AMC), Amsterdam, The Netherlands
- * E-mail:
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Liang En W, Koh GCH, Lim VKG. Caring for underserved patients through neighborhood health screening: outcomes of a longitudinal, interprofessional, student-run home visit program in Singapore. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2011; 86:829-39. [PMID: 21617510 DOI: 10.1097/acm.0b013e31821d841d] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
PURPOSE Service learning, an effective vehicle for teaching undergraduate public health while providing underserved communities with medical care, is not well established in Asia. The authors evaluated a service learning program, Neighborhood Health Screening (NHS), in Singapore. METHOD Medical and nursing undergraduate students provided in-home medical services to patients in a low-income neighborhood (January-June 2010). The authors assessed student-reported pedagogical effectiveness in nine domains, asked students for qualitative feedback on their experiences, assessed patients' satisfaction with NHS, and tracked clinical outcomes. RESULTS Of the 240 medical and 34 nursing students who participated, 222 (93%) and 34 (100%), respectively, completed the questionnaire; 136 of the medical students (57%) also provided qualitative feedback. Most students felt NHS was beneficial across all domains. Male medical students were less likely to report increased understanding of deficiencies in the health care system and long-term management of chronic disease; preclinical students were more likely to report improvements in comprehending ethical issues, critical thinking and action skills, and gaining and applying knowledge. Qualitative feedback supported quantitative findings. Patients were satisfied with NHS: 266 (75%) agreed that NHS improved their health, and 301 (85%) felt NHS provided sufficient time to address their issues. After a single year, amongst patients with known hypertension, treatment increased from 63% to 93% (P < .001), and blood pressure control amongst those who were on treatment improved from 42% to 79% (P < .001). CONCLUSIONS Service learning can make an important contribution to medical teaching and patient care in Asia.
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Affiliation(s)
- Wee Liang En
- Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
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Garwood CL, Bishja M, Smythe MA. An innovative elective course in anticoagulation management. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2010; 74:187. [PMID: 21436928 PMCID: PMC3058466 DOI: 10.5688/aj7410187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Accepted: 08/09/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To develop and implement an elective pharmacy course in anticoagulation management and assess student learning. DESIGN Students participated in active-learning activities including evaluating a patient receiving outpatient or inpatient anticoagulation therapy, participating in a team project and presentation, and completing a "living with anticoagulation" assignment that included modeling both the health care provider's and the patient's role. ASSESSMENT A precourse and postcourse standardized examination on anticoagulation along with a short answer midterm and final examination were administered. Performance between precourse and postcourse examination improved by approximately 25%, and 90% of students scored ≥ 90% on the final examination. Reflective narratives provided support that students found the "living with anticoagulation" assignment a valuable learning experience which developed empathy towards patients. CONCLUSION An elective course in anticoagulation management that included multiple active-learning assignments was successful in increasing both students' knowledge and empathy.
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Affiliation(s)
- Candice L Garwood
- Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, USA
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