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我们是否在充分培养下一代医生,使其能够将运动作为预防和治疗手段进行开方?住院医师表示希望接受更多运动处方方面的培训。

Are we adequately preparing the next generation of physicians to prescribe exercise as prevention and treatment? Residents express the desire for more training in exercise prescription.

作者信息

Solmundson Kara, Koehle Michael, McKenzie Donald

机构信息

Department of Family Practice, University of British Columbia (UBC) School of Medicine.

Division of Sports Medicine, Department of Family Practice, University of British Columbia (UBC) School of Medicine.

出版信息

Can Med Educ J. 2016 Oct 18;7(2):e79-e96. eCollection 2016 Oct.

Abstract

BACKGROUND

Physical activity (PA) is a key intervention for chronic disease, yet few physicians provide exercise prescription (EP). EP is an important component in larger strategies of reducing non-communicable disease (NCD). Our objective was to assess Family Medicine Residents (FMR) knowledge, competence, and perspectives of EP to help inform future curriculum development.

METHODS

A 49-item cross-sectional survey was administered to 396 University of British Columbia FMR. Residents' EP knowledge, competence, attitudes/beliefs, current practices, personal physical activity levels, and perspectives of training were assessed using, primarily, a 7-point Likert scale.

RESULTS

The response rate was 80.6% (319/396). After eliminating 25 that failed to meet the inclusion criteria, 294 were included in the final analysis. The majority 95.6% of FMR reported EP as important in their future practice, despite having low knowledge of the Canadian PA Guidelines (mean score 1.77/4), low self-reported competence prescribing exercise as prevention (mean score 13.35/21), and rating themselves "somewhat incompetent" prescribing exercise to patients with chronic disease (mean score 11.26/21). FMR believe PA is integral to their patients' health (98.0%), sedentary behaviour is harmful (97.9%), and feel a responsibility to discuss PA with patients (99.7%). Few FMR (14.9%) perceived their training in EP as adequate and 91.0% desire more.

CONCLUSIONS

FMR report EP is important, yet do not perceive they are sufficiently prepared to provide EP. In future curricular development, medical educators should consider residents' low knowledge, competence, perceived program support, and their expressed desire for more training in exercise prescription.

摘要

背景

体育活动(PA)是慢性病的关键干预措施,但很少有医生提供运动处方(EP)。运动处方是减少非传染性疾病(NCD)更大战略的重要组成部分。我们的目标是评估家庭医学住院医师(FMR)对运动处方的知识、能力和看法,以帮助为未来的课程开发提供信息。

方法

对396名英属哥伦比亚大学的家庭医学住院医师进行了一项包含49个项目的横断面调查。主要使用7点李克特量表评估住院医师的运动处方知识、能力、态度/信念、当前实践、个人体育活动水平以及对培训的看法。

结果

回复率为80.6%(319/396)。在剔除25名不符合纳入标准的人员后,最终分析纳入了294人。尽管对加拿大体育活动指南的了解程度较低(平均得分1.77/4),自我报告的将运动作为预防措施的处方能力较低(平均得分13.35/21),并且给自己在为慢性病患者开运动处方方面的评分是“有点不称职”(平均得分11.26/21),但大多数(95.6%)家庭医学住院医师报告运动处方在他们未来的实践中很重要。家庭医学住院医师认为体育活动对患者健康至关重要(98.0%),久坐行为有害(97.9%),并感到有责任与患者讨论体育活动(99.7%)。很少有家庭医学住院医师(14.9%)认为他们在运动处方方面的培训足够,91.0%的人希望获得更多培训。

结论

家庭医学住院医师报告运动处方很重要,但不认为自己有足够的准备来提供运动处方。在未来的课程开发中,医学教育工作者应考虑住院医师知识和能力较低、对项目支持的认知以及他们对更多运动处方培训的明确需求。

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