Lifestyle medicine curriculum for a preventive medicine residency program: implementation and outcomes.

Haq Nawaz, Paul V Petraro, Christina Via, Saif Ullah, Lionel Lim, Dorothea Wild, Mary Kennedy, Edward M Phillips
Author Information
  1. Haq Nawaz: Department of Preventive Medicine, Griffin Hospital, Derby, CT, USA.
  2. Paul V Petraro: Department of Preventive Medicine, Griffin Hospital, Derby, CT, USA.
  3. Christina Via: Department of Preventive Medicine, Griffin Hospital, Derby, CT, USA.
  4. Saif Ullah: Department of Preventive Medicine, Griffin Hospital, Derby, CT, USA.
  5. Lionel Lim: Department of Preventive Medicine, Griffin Hospital, Derby, CT, USA.
  6. Dorothea Wild: Department of Preventive Medicine, Griffin Hospital, Derby, CT, USA.
  7. Mary Kennedy: Institute of Lifestyle Medicine, Physical Medicine & Rehabilitation Service, VA Boston Healthcare System, Brockton, MA, USA.
  8. Edward M Phillips: Institute of Lifestyle Medicine, Physical Medicine & Rehabilitation Service, VA Boston Healthcare System, Brockton, MA, USA.

Abstract

BACKGROUND: The vast majority of the healthcare problems burdening our society today are caused by disease-promoting lifestyles (e.g., physical inactivity and unhealthy eating). Physicians report poor training and lack of confidence in counseling patients on lifestyle changes.
OBJECTIVE: To evaluate a new curriculum and rotation in lifestyle medicine for preventive medicine residents.
METHODS: Training included didactics (six sessions/year), distance learning, educational conferences, and newly developed lifestyle medicine rotations at the Institute of Lifestyle Medicine, the Yale-Griffin Prevention Research Center, and the Integrative Medicine Center. We used a number of tools to assess residents' progress including Objective Structured Clinical Examinations (OSCEs), self-assessments, and logs of personal health habits.
RESULTS: A total of 20 residents participated in the lifestyle medicine training between 2010 and 2013. There was a 15% increase in residents' discussions of lifestyle issues with their patients based on their baseline and follow-up surveys. The performance of preventive medicine residents on OSCEs increased each year they were in the program (average OSCE score: PGY1 73%, PGY2 83%, PGY3 87%, and PGY4 91%, p=0.01). Our internal medicine and preliminary residents served as a control, since they did participate in didactics but not in lifestyle medicine rotations. Internal medicine and preliminary residents who completed the same OSCEs had a slightly lower average score (76%) compared with plural for resident, preventive medicine residents (80%). However, this difference did not reach statistical significance (p=0.11).
CONCLUSION: Incorporating the lifestyle medicine curriculum is feasible for preventive medicine training allowing residents to improve their health behavior change discussions with patients as well as their own personal health habits.

Keywords

References

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MeSH Term

Adult
Clinical Competence
Curriculum
Diet, Healthy
Education, Distance
Female
Habits
Humans
Internship and Residency
Life Style
Male
Patient-Centered Care
Physical Fitness
Physician's Role
Preventive Medicine
Smoking Cessation
Stress, Psychological

Word Cloud

Created with Highcharts 10.0.0medicinelifestyleresidentspreventivetrainingpatientscurriculumOSCEshealthdidacticsrotationsLifestyleMedicineCenterresidents'personalhabitsdiscussionsaveragep=0preliminaryBACKGROUND:vastmajorityhealthcareproblemsburdeningsocietytodaycauseddisease-promotinglifestylesegphysicalinactivityunhealthyeatingPhysiciansreportpoorlackconfidencecounselingchangesOBJECTIVE:evaluatenewrotationMETHODS:Trainingincludedsixsessions/yeardistancelearningeducationalconferencesnewlydevelopedInstituteYale-GriffinPreventionResearchIntegrativeusednumbertoolsassessprogressincludingObjectiveStructuredClinicalExaminationsself-assessmentslogsRESULTS:total20participated2010201315%increaseissuesbasedbaselinefollow-upsurveysperformanceincreasedyearprogramOSCEscore:PGY173%PGY283%PGY387%PGY491%01internalservedcontrolsinceparticipateInternalcompletedslightlylowerscore76%comparedpluralresident80%Howeverdifferencereachstatisticalsignificance11CONCLUSION:Incorporatingfeasibleallowingimprovebehaviorchangewellresidencyprogram:implementationoutcomesmedicaleducation

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