Educating physician‐assistant students as agents of lifestyle medicine

Abstract

SUMMARY Background 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. Methods 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. Results 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. Conclusion Lifestyle medicine curricula can be successfully integrated into existing PA curricula, with demonstrated increases in self‐assessments of competency and practical skills.

Results of a controlled study in lifestyle medicine in a cohort of preclinical medical students

“…Educators in other professions are developing resiliency intervention programs. [25][26] Drawing on their findings may strengthen programs designed for medical students. Varying the number of intervention hours in future studies would help to determine the optimal length of the program.…”

Physician Nutrition Advice and Referrals to Registered Dietitians

“…14 While providers recognize the importance of nutrition in disease progression, [15][16][17] nutrition education has been historically underrepresented in health professional curricula, 18 with noted absences at medical schools and residency programs, 15 nursing schools, 5 and physician assistant programs. 2,13 Due to a lack of targeted nutrition education in these educational models and ongoing integration of care between specialties, one behavioral counseling strategy being widely recommended in clinical guidelines 3,6,7,19 is to refer patients to registered dietitian nutritionists (RDN), who are specifically trained to deliver both medical and individual nutrition therapy in acute and chronic care. 8,20 Perhaps due to inadequate education, healthcare providers' attitudes and confidence in their ability to give nutrition advice are consistently reported to be low, 12,13,17,21,22 and there are limited data examining the actual nutrition advice currently being given to patients.…”

“…Healthcare providers are increasingly being called upon to deliver nutrition advice to their patients, [1][2][3][4][5] and many clinical guidelines [6][7][8][9][10] specifically outline nutrition therapy for the treatment of non-communicable chronic diseases such as cardiovascular disease, hypertension, obesity, and diabetes. Medical doctors, particularly primary care physicians (PCPs), have traditionally tended to be a patient's first point of contact, making them suitable gatekeepers for a patient's treatment plan, which can include nutrition counseling.…”

Medical students as agents of lifestyle medicine

“…Gardner for their article demonstrating the successful implementation of lifestyle medicine into the curriculum of physician associates. 1 The article indicates that four 50-minute teaching sessions, followed by coursework and a critical thinking task, were sufficient to significantly increase competency in lifestyle medicine, which employs the use of lifestyle factors such as nutrition, physical activity, and sleep and stress management to combat disease. 2 The potential of extending this teaching to qualified doctors is highlighted by the authors, but we suggest implementation at medical school.…”