Keyes Sarah-Ann, Gardner Aimee
Baylor College of Medicine, Houston, Texas, USA.
Clin Teach. 2020 Dec;17(6):638-643. doi: 10.1111/tct.13152. Epub 2020 Apr 6.
The burden of chronic disease in the USA necessitates a shift in medicine and medical education from disease treatment to health and wellness promotion. At the forefront of this shift is the field of lifestyle medicine - the evidence-based use of lifestyle modification to prevent, treat and reverse disease. Health care providers, including physician assistants (PAs), can be the vehicle of behaviour change for patients, families and communities, and must receive adequate training to practice lifestyle medicine.
We describe a pilot lifestyle medicine curriculum implemented through a PA training programme run in the USA in the academic year 2016/2017. The curriculum included four taught modules on lifestyle medicine, two assessment activities and a survey of self-perceived competency, measured before and after the programme.
Forty students participated in the curriculum. Results showed a significant increase in self-perceived competencies in seven of nine lifestyle medicine areas (p < 0.001). After the curriculum, all students were successfully able to provide a written lifestyle medicine prescription for a mock patient, with the most common prescription topics including nutrition-related prescriptions (41%), followed by physical activity (26%), addressing substance use (10%), mental health or stresses (10%) and sleep (7%). Furthermore, on average students were able to correctly identify 70% of the desired recommendations for a mock patient.
Lifestyle medicine curricula can be successfully integrated into existing PA curricula, with demonstrated increases in self-assessments of competency and practical skills.
美国慢性病的负担使得医学和医学教育有必要从疾病治疗转向健康促进。生活方式医学领域处于这一转变的前沿——它是基于证据使用生活方式改变来预防、治疗和逆转疾病。包括医师助理(PA)在内的医疗保健提供者可以成为患者、家庭和社区行为改变的推动者,并且必须接受足够的培训以实践生活方式医学。
我们描述了一项通过2016/2017学年在美国开展的PA培训项目实施的生活方式医学试点课程。该课程包括四个关于生活方式医学的授课模块、两项评估活动以及一项对自我感知能力的调查,在项目前后进行测量。
40名学生参加了该课程。结果显示,在九个生活方式医学领域中的七个领域,自我感知能力有显著提高(p < 0.001)。课程结束后,所有学生都成功地为一名模拟患者提供了一份书面的生活方式医学处方,最常见的处方主题包括与营养相关的处方(41%),其次是体育活动(26%)、解决物质使用问题(10%)、心理健康或压力(10%)以及睡眠(7%)。此外,学生平均能够正确识别模拟患者所需建议的70%。
生活方式医学课程可以成功地整合到现有的PA课程中,自我评估的能力和实践技能有明显提高。