Are we adequately preparing the next generation of physicians to prescribe exercise as prevention and treatment? Residents express the desire for more training in exercise prescription

Solmundson, Kara; Koehle, Michael S.; McKenzie, Donald C.

doi:10.36834/cmej.36702

Cited by 39 publications

(45 citation statements)

References 62 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Insufficient PA knowledge was a challenge for family medicine residents [ 36 ]. Structured PA curricula were effective at improving knowledge among primary care residents [ 23 , 24 , 26 ], and health professionals [ 30 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Physical activity counseling in primary care and family medicine residency training: a systematic review

2018

View full text Add to dashboard Cite

BackgroundPhysical inactivity is a global public health challenge. Physical activity (PA) promotion in healthcare delivery systems is effective to reduce physical inactivity. A primary care setting provides an appropriate environment for PA counseling since it is a primary contact with primary care or family physicians encounter the majority of the population. Lack of knowledge and inadequate training in PA counseling is one of the most important barriers to PA promotion. The purpose of this systematic review was to evaluate PA counseling training in primary care residency programs.MethodsThe authors systematically searched PubMed, Web of Science, Scopus and The Cochrane Library for articles published in English from 2000 to 2017. Articles regarding PA counseling in primary care residency training were extracted and outcomes assessed for this systematic review.ResultsBased on the initial review, 378 articles were excluded (362 articles excluded based on titles and abstracts and 16 articles excluded based on full texts). Four articles were included in this review, addressed PA counseling curricula in primary care residency training. All studies included PA counseling training as part of obesity and healthy lifestyle training. The training improved knowledge among primary care residents, but may not necessarily result in better attitudes or self-efficacy, which could be improved by elective rotations that focus on improved attitudes, self-efficacy, and professional norms for PA counseling. Brief training in counseling did not improve quality nor increase the rate of counseling.ConclusionsThis systematic review demonstrates a lack of evidence due to a small number of included studies. The heterogeneous outcomes from the minimal programs are needed to carefully interpret. However, this review sheds light on the importance of training in PA counseling in primary care residency programs. The development of training in PA counseling should focus on an approach that improves attitudes and the self-efficacy of primary care residents. Elective rotations, where residents voluntarily choose their subject, may provide the appropriate training period for PA counseling. Policymakers and academics should play an active role in the implementation of PA counseling as an essential competency for primary care physicians.Electronic supplementary materialThe online version of this article (10.1186/s12909-018-1268-1) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionmentioning

confidence: 99%

Physical activity counseling in primary care and family medicine residency training: a systematic review

2018

View full text Add to dashboard Cite

show abstract

“…These findings are in agreement with previous literature reporting that 85% of medical students perceived their physical activity counselling and exercise prescription as insufficient, which may be at least in part, responsible for the infrequent rates of PA counselling and exercise prescription in patient-provider sessions among Canadian physicians. 9 , 12 This research demonstrates a need for a more intensive and standardized PA counselling and exercise prescription training across the medical spectrum as it can lead to increased PA by patients and improved body composition, fitness and clinical outcomes. 6 , 25 In our sample, only 23% reported any previous training on PAE, and of those, many reported single large group sessions.…”

Section: Discussionmentioning

confidence: 91%

“… 11 This message is consistent among family medicine residents from British Columbia who perceived their exercise prescription training as inadequate (85% of residents) and desired further education as part of their medical training (92% of residents). 12 …”

Section: Introductionmentioning

confidence: 99%

The effects of previous educational training on physical activity counselling and exercise prescription practices among physicians across Nova Scotia: a cross-sectional study

et al. 2018

View full text Add to dashboard Cite

Background: Physicians (MDs) report difficulty including physical activity (PA) and exercise (PAE) as part of routine care. MDs who report previous educational training in PAE may prescribe exercise more frequently. We evaluated the effects of previous training on perceptions and practices of PA counselling and exercise prescriptions among MDs in Nova Scotia.Methods: MDs (n=174) across Nova Scotia completed an online self-reflection survey regarding their current PAE practices. MDs who reported previous training (n=41) were compared to those who reported no training (n=133). Results: Trained-MDs were 22% more confident performing PA counselling than untrained-MDs (p<0.005). In patient appointments, trained-MDs included PAE more often (51% vs 39%; p=0.03) but trained-MDs and untrained-MDs had similar rates of exercise prescriptions (12%; p>0.05). The most impactful barriers (on a scale of 1 to 4) were lack of time (2.5) and perceived patient interest (2.4), which were unaffected by previous training (p>0.05).Conclusion: Previous training was associated with a higher confidence to include PAE discussions with patients by MDs in Nova Scotia, but had minimal influence on their many barriers that prevent exercise prescription. Although some training supports MDs inclusion of PAE into their practice, there is a need for greater, more intensive educational training to assist MDs in prescribing exercise.

show abstract

“…These results are consistent with previous literature observing that Canadian medical residents (or trainees) perceive their current PAE training as inadequate. 24 Despite being very effective, we acknowledge that interactive workshop-based training may be limited in reach with challenging logistics of reaching practicing physicians in the community en masse . However, this study does show efficacy with a simple educational workshop intervention.…”

Section: Discussionmentioning

confidence: 99%

Exercise is medicine Canada workshop training improves physical activity practices of physicians across Canada, independent of initial confidence level

O’Brien¹,

Shields²,

Solmundson³

et al. 2020

Can. Med. Ed. J

Self Cite

View full text Add to dashboard Cite

Background: Educational workshops help physicians (MDs) include physical activity and exercise (PAE) content in more patient appointments. It is unclear if MDs with varying degrees of self-confidence discussing PAE with their patients equally benefit from such training. We evaluated whether MDs’ initial self-confidence affects the impact of an educational PAE workshop. Methods: MDs (n = 63) across Canada completed self-reflection questionnaires initially and 3-months following a PAE workshop. MDs were divided into low-confidence [self-efficacy score (out of 100%): <40%; n = 21], medium-confidence (40-60%; n = 19) and high-confidence (>60%; n = 23). Results: PAE counselling self-efficacy increased in all groups (relative increase: Low=~40%, Medium=~20%, High=~10%). Training increased the low-confidence group’s knowledge, awareness of guidance/resources and perception of their patients’ interest in lifestyle management (~30% change; all p < 0.001). Compared to baseline, a greater proportion (all p < 0.001) of MDs reported prescribing exercise at 3-month follow-up in each of the low-confidence (10% to 62%) medium-confidence (16% to 89%) and high-confidence (57% to 87%) groups. Conclusion: PAE training favorably improved MDs’ self-confidence, perceived impact of many barriers and the proportion of MDs prescribing exercise, at each level of confidence. An educational workshop particularly assisted MDs with low-confidence (i.e., those who needed it the most) integrate PAE into their practice.

show abstract

Are we adequately preparing the next generation of physicians to prescribe exercise as prevention and treatment? Residents express the desire for more training in exercise prescription

Cited by 39 publications

References 62 publications

Physical activity counseling in primary care and family medicine residency training: a systematic review

Physical activity counseling in primary care and family medicine residency training: a systematic review

The effects of previous educational training on physical activity counselling and exercise prescription practices among physicians across Nova Scotia: a cross-sectional study

Exercise is medicine Canada workshop training improves physical activity practices of physicians across Canada, independent of initial confidence level

Contact Info

Product

Resources

About