Cooke Natalie K, Ash Sarah L, Goodell L Suzanne
Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, Raleigh, NC 27695, USA.
Educ Health (Abingdon). 2017 May-Aug;30(2):156-162. doi: 10.4103/efh.EfH_57_16.
Medical schools are challenged to incorporate more prevention-based education into curricula, offering an opportunity to revisit approaches to nutrition education. The objective of this study was to explore United States (US) medical students' understanding of childhood obesity, specifically barriers to childhood obesity prevention and treatment and students' perceived educational deficits.
The research team conducted phone interviews with 78 3rd- and 4th-year medical students, representing 25 different medical schools across the US. Using a semi-structured interview guide, researchers asked students to describe the etiology of childhood obesity and reflect on where they acquired knowledge of the etiology and what additional resources they would need to treat obese children. Using a phenomenological approach to analysis, researchers identified five dominant emergent themes.
Student-perceived barriers to childhood obesity prevention and treatment in clinical care included student-centered (e.g., lack of knowledge), patient-centered (e.g., lack of access), and healthcare system-centered barriers (e.g., limited time). Students requested more applicable nutrition information and counseling skills relevant to preventing and treating childhood obesity; however, they tended to identify others (e.g., parents, schools), rather than themselves, when asked to describe how childhood obesity should be prevented or treated.
To provide students with an understanding of their role in preventing and treating childhood obesity, US medical schools need to provide students with childhood obesity-specific and general nutrition education. To build their self-efficacy in nutrition counseling, schools can use a combination of observation and practice led by skilled physicians and other healthcare providers. Increasing students' self-efficacy through training may help them overcome perceived barriers to childhood obesity prevention and treatment.
医学院校面临着将更多基于预防的教育纳入课程的挑战，这为重新审视营养教育方法提供了契机。本研究的目的是探讨美国医学生对儿童肥胖的理解，特别是儿童肥胖预防和治疗的障碍以及学生们意识到的教育缺陷。
研究团队对78名三、四年级医学生进行了电话访谈，这些学生代表了美国25所不同的医学院校。研究人员使用半结构化访谈指南，要求学生描述儿童肥胖的病因，并反思他们从何处获得病因知识以及治疗肥胖儿童还需要哪些额外资源。研究人员采用现象学分析方法，确定了五个主要的突出主题。
学生们认为临床护理中儿童肥胖预防和治疗的障碍包括以学生为中心的障碍（如知识不足）、以患者为中心的障碍（如难以获得医疗服务）和以医疗系统为中心的障碍（如时间有限）。学生们要求获得更多与儿童肥胖预防和治疗相关的适用营养信息和咨询技能；然而，当被要求描述应如何预防或治疗儿童肥胖时，他们往往认为是其他人（如家长、学校），而不是他们自己。
为了让学生了解他们在预防和治疗儿童肥胖中的作用，美国医学院校需要为学生提供针对儿童肥胖的和一般的营养教育。为了增强他们在营养咨询方面的自我效能感，学校可以采用由经验丰富的医生和其他医疗服务提供者主导的观察和实践相结合的方法。通过培训提高学生的自我效能感可能有助于他们克服所认为的儿童肥胖预防和治疗障碍。
