Wetherill Marianna S, Davis Gracen C, Kezbers Krista, Carter Valarie, Wells Elizabeth, Williams Mary B, Ijams Shannon D, Monlezun Dominique, Harlan Timothy, Whelan Lori J
Hudson College of Public Health, University of Oklahoma - Tulsa Schusterman Center, 4502 E. 41st Street, Tulsa, OK 74135 USA.
University of Oklahoma School of Community Medicine, Tulsa, OK 74135 USA.
Med Sci Educ. 2018 Dec 6;29(1):163-172. doi: 10.1007/s40670-018-00655-4. eCollection 2019 Mar.
US medical schools are increasingly integrating lifestyle medicine competencies into their academic programs. Yet, physician assistant (PA) academic programs have been slower to respond.
We developed, implemented, and evaluated a nutrition-centered lifestyle medicine curriculum for 2nd-year PA students ( = 24). The 4-week hybrid, 2-credit hour course activities aligned with the American College of Lifestyle Medicine competencies for primary care providers and reinforced four of the Accreditation Standards for PA Education. We combined didactic lectures with weekly hands-on cooking modules from the "Health meets Food" courseware for medical students. We employed a pre-post evaluation design including a comparison group of 2nd-year PA students in a separate program. We assessed changes in personal nutrition behaviors and knowledge and confidence for counseling in nutrition, exercise/physical activity, weight, smoking, and alcohol, using the modified 5A's framework (assess, advise, agree, assist, and arrange) for lifestyle counseling.
Students receiving the intervention demonstrated significantly higher gains in both knowledge and confidence for the 5A's of nutrition counseling compared to the control group. Self-reported knowledge and confidence for the 5A's of counseling for the other lifestyle behaviors similarly improved among the intervention group compared to the control group, but to a lesser extent.
A nutrition-centered lifestyle medicine course can demonstrate PA academic program adherence to accreditation standards, while also introducing students to nutrition and lifestyle medicine competencies. Hands-on experiences that reinforce didactic instruction may maximize student knowledge and self-efficacy for implementing lifestyle medicine into their practice.
美国医学院校越来越多地将生活方式医学能力纳入其学术课程。然而,医师助理(PA)学术项目的响应速度较慢。
我们为二年级PA学生(n = 24)开发、实施并评估了一门以营养为中心的生活方式医学课程。为期4周的混合式、2学分课程活动符合美国生活方式医学学院针对初级保健提供者的能力要求,并强化了PA教育认证标准中的四项。我们将理论讲座与来自医学生“健康与食物”课件的每周实践烹饪模块相结合。我们采用了前后评估设计,包括另一个项目中的二年级PA学生对照组。我们使用改良的5A框架(评估、建议、商定、协助和安排)进行生活方式咨询,评估个人营养行为以及营养、运动/身体活动、体重、吸烟和饮酒咨询方面的知识和信心的变化。
与对照组相比,接受干预的学生在营养咨询5A方面的知识和信心方面有显著更高的提升。与对照组相比,干预组在其他生活方式行为咨询5A方面的自我报告知识和信心同样有所改善,但程度较小。
以营养为中心的生活方式医学课程可以证明PA学术项目符合认证标准,同时还能让学生了解营养和生活方式医学能力。强化理论教学的实践经验可能会最大限度地提高学生在实践中应用生活方式医学的知识和自我效能。