家庭医学实习中的肥胖教育：对实习主任的信念、障碍和课程内容的美加调查。
Obesity education in the family medicine clerkship: a US and Canadian survey of clerkship directors' beliefs, barriers, and curriculum content.
机构信息
Spectrum Health Family Medicine Department, 25 Michigan Ave, Suite 5100, Grand Rapids, MI, 49503, USA.
Spectrum Health, Office of Medical Education, 945 Ottawa Ave NW, Grand Rapids, MI, 49503, USA.
出版信息
BMC Med Educ. 2019 May 27;19(1):169. doi: 10.1186/s12909-019-1614-y.
BACKGROUND
Despite concerns regarding the increasing obesity epidemic, little is known regarding obesity curricula in medical education. Medical school family medicine clerkships address common primary care topics during clinical training. However, studies have shown that many family physicians feel unprepared at addressing obesity. The purpose of this study was to evaluate factors related to obesity education provided during family medicine clerkships as well as identify future plans regarding obesity education.
METHODS
Data were collected through the 2017 Educational Research Alliance (CERA) survey of Family Medicine Clerkship Directors (CDs) in the United States and Canada. Survey items included the level of importance of obesity education, teaching methods, barriers to teaching, and obesity related topics taught during the clerkship. Survey data were summarized and analyzed.
RESULTS
The survey response rate was 71.2%. The most frequent barrier to teaching obesity related topics was time constraints (89%). The most commonly taught topics were co-morbid conditions (82.1%), diet (76.9%), and exercise (76.9%). The least commonly taught topics were addressed less than 30% of the time, and included cultural aspects, obesity bias, medications than can cause weight gain, medications to treat obesity, and bariatric surgery. Over half of CDs (59%) are not planning to change existing curriculum, with 39% planning to add to the current curriculum. The CDs' perceptions of the importance of obesity education were significantly associated with the number of topics covered during clerkship (p < 0.001). No relationship was found between clerkship duration and the number of obesity topics taught.
CONCLUSION
The majority of clerkship directors are planning no changes to their existing curricula which consist of three common topics: obesity related co-morbid conditions, diet, and exercise. While time was the largest self-rated barrier in teaching obesity related topics, clerkship duration didn't impact the number of topics taught. However, the relative amount of importance placed by CDs upon obesity education was significantly associated with the number of topics covered during clerkship.
背景
尽管人们对肥胖症的流行日益关注，但对于医学教育中的肥胖症课程却知之甚少。医学院的家庭医学实习课程在临床培训期间涉及常见的初级保健主题。然而，研究表明，许多家庭医生觉得自己在处理肥胖问题时准备不足。本研究旨在评估家庭医学实习期间提供的肥胖教育相关因素，并确定未来肥胖教育计划。
方法
通过 2017 年美国和加拿大的家庭医学实习主任教育研究联盟（CERA）调查收集数据。调查项目包括肥胖教育的重要性水平、教学方法、教学障碍以及实习期间教授的与肥胖相关的主题。对调查数据进行总结和分析。
结果
调查回复率为 71.2%。教学肥胖相关主题的最常见障碍是时间限制（89%）。最常教授的主题是合并症（82.1%）、饮食（76.9%）和运动（76.9%）。教授最少的主题不到 30%的时间，包括文化方面、肥胖偏见、会导致体重增加的药物、治疗肥胖的药物和减重手术。超过一半的实习主任（59%）不打算改变现有课程，39%的人计划在现有课程中增加内容。实习主任对肥胖教育重要性的看法与实习期间涵盖的主题数量显著相关（p<0.001）。没有发现实习时间与教授的肥胖主题数量之间的关系。
结论
大多数实习主任不打算改变现有的课程，这些课程包括三个常见的主题：肥胖相关的合并症、饮食和运动。虽然时间是教授肥胖相关主题的最大自我评估障碍，但实习时间并没有影响教授的主题数量。然而，实习主任对肥胖教育的重视程度与实习期间涵盖的主题数量显著相关。
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