Neuman Melissa, Kane Jamie, Kline Myriam, Shafer Rebecca, Lambert Douglas C
is a Fellow, Department of Hematology and Oncology, Donald and Barbara Zucker School of Medicine at Hofstra, Northwell Health, Uniondale, New York, USA.
is Obesity Medicine Chief and Associate Professor, Donald and Barbara Zucker School of Medicine at Hofstra, Northwell Health, Uniondale, New York, USA.
J Grad Med Educ. 2024 Dec;16(6):735-739. doi: 10.4300/JGME-D-24-00243.1. Epub 2024 Dec 13.
Treatment of obesity is a public health priority. However, little training in obesity medicine is currently integrated into residency programs. We integrated a 12-month obesity medicine training experience within a New York internal medicine residency program. We describe the structure, feasibility and acceptability, resident assessments, and patient weight loss outcomes of an optional longitudinal obesity medicine training experience for internal medicine residents. Between July 2016 and June 2021, 26 second-year residents participated in the 12-month program, which comprised 10 educational/clinical sessions overseen by obesity medicine attendings. Residents completed baseline and post-program 5-point surveys of knowledge, competence, and attitudes. Differences at 12 months were analyzed using paired tests. Resident patient weight loss was analyzed using the Wilcoxon signed rank test. The training experience was successfully integrated over the study period and remains ongoing at present, demonstrating feasibility and acceptability. Fourteen of 26 (54%) residents completed post-program surveys. Significant improvements in all measures of knowledge and competence were seen. The greatest improvements were in comfort discussing weight loss with patients (+1.1; 95% CI 0.8-1.5; <.001) and prescribing weight loss medications (+1.4; 95% CI 1.1-1.6; <.001). The 98 patients seen by residents lost an average of 4.5 kilograms (95% CI 3.0-6.0; <.001). The training experience was feasible and acceptable, and demonstrated improvements in resident outcomes and patient weight.
肥胖症治疗是公共卫生的重点。然而，目前住院医师培训项目中很少融入肥胖医学方面的培训。我们在纽约的一个内科住院医师培训项目中纳入了为期12个月的肥胖医学培训经历。我们描述了一项针对内科住院医师的可选纵向肥胖医学培训经历的结构、可行性和可接受性、住院医师评估以及患者体重减轻结果。在2016年7月至2021年6月期间，26名二年级住院医师参加了为期12个月的项目，该项目包括由肥胖医学主治医生监督的10次教育/临床课程。住院医师完成了关于知识、能力和态度的基线及项目后5分制调查。使用配对检验分析12个月时的差异。使用Wilcoxon符号秩检验分析住院医师患者的体重减轻情况。在研究期间，培训经历成功融入且目前仍在进行，证明了其可行性和可接受性。26名住院医师中有14名（54%）完成了项目后调查。在知识和能力的所有衡量指标上都有显著改善。最大的改善在于与患者讨论减肥的舒适度（提高1.1；95%置信区间0.8 - 1.5；<.001）和开具减肥药物的能力（提高1.4；95%置信区间1.1 - 1.6；<.001）。住院医师诊治的98名患者平均体重减轻了4.5千克（95%置信区间3.0 - 6.0；<.001）。该培训经历是可行且可接受的，并证明了住院医师的成果和患者体重有改善。
