Asif Irfan, Thornton Jane S, Carek Stephen, Miles Christopher, Nayak Melissa, Novak Melissa, Stovak Mark, Zaremski Jason L, Drezner Jonathan
Department of Family and Community Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
Public Health and Family Medicine, University of Western Ontario Schulich School of Medicine and Dentistry, London, Ontario, Canada.
Br J Sports Med. 2022 Apr;56(7):369-375. doi: 10.1136/bjsports-2021-104819. Epub 2022 Jan 10.
Regular physical activity provides a variety of health benefits and is proven to treat and prevent several non-communicable diseases. Specifically, physical activity enhances muscular and osseous strength, improves cardiorespiratory fitness, and reduces the risk of hypertension, coronary heart disease, stroke, type 2 diabetes, mental health disorders, cognitive decline and several cancers. Despite these well-known benefits, physical activity promotion in clinical practice is underused due to insufficient training during medical education. Medical trainees in the USA receive relatively few hours of instruction in sports and exercise medicine (SEM). One reason for this shortage of instruction is a lack of curricular resources at each level of medical education. To address this need, the American Medical Society for Sports Medicine (AMSSM) assembled a group of SEM experts to develop curricular guidance for exercise medicine and physical activity promotion at the medical school, residency and sports medicine fellowship levels of training. After an evidence review of existing curricular examples, we performed a modified Delphi process to create curricula for medical students, residents and sports medicine fellows. Three training level-specific curricula emerged, each containing Domains, General Learning Areas, and Specific Learning Areas; options for additional training and suggestions for assessment and evaluation were also provided. Review and comment on the initial curricula were conducted by three groups: a second set of experts in exercise medicine and physical activity promotion, sports medicine fellowship directors representing a variety of fellowship settings and the AMSSM Board of Directors. The final curricula for each training level were prepared based on input from the review groups. We believe enhanced medical education will enable clinicians to better integrate exercise medicine and physical activity promotion in their clinical practice and result in healthier, more physically active patients.
规律的体育活动对健康有诸多益处，且已被证明可治疗和预防多种非传染性疾病。具体而言，体育活动能增强肌肉和骨骼力量，改善心肺功能，并降低患高血压、冠心病、中风、2型糖尿病、心理健康障碍、认知衰退及多种癌症的风险。尽管有这些众所周知的益处，但由于医学教育期间培训不足，临床实践中体育活动的推广未得到充分利用。美国的医学实习生接受的运动与运动医学（SEM）教学时间相对较少。教学短缺的一个原因是医学教育各阶段缺乏课程资源。为满足这一需求，美国运动医学学会（AMSSM）召集了一组SEM专家，为医学院、住院医师培训及运动医学专科培训阶段的运动医学和体育活动推广制定课程指南。在对现有课程实例进行证据审查后，我们采用了改良的德尔菲法为医学生、住院医师和运动医学专科生创建课程。由此产生了三个针对不同培训阶段的课程，每个课程都包含领域、一般学习领域和特定学习领域；还提供了额外培训选项以及评估和评价建议。三组人员对初始课程进行了审查和评论：另一组运动医学和体育活动推广专家、代表各种专科培训环境的运动医学专科培训主任以及AMSSM董事会。每个培训阶段的最终课程是根据审查小组的意见编写的。我们相信，加强医学教育将使临床医生能够在临床实践中更好地整合运动医学和体育活动推广，从而使患者更健康、更积极地参与体育活动。
