Format

Send to

Choose Destination
See comment in PubMed Commons below
Med Educ Online. 2014 Jul 24;19:24325. doi: 10.3402/meo.v19.24325. eCollection 2014.

Physical activity counseling in medical school education: a systematic review.

Author information

1
Department of Psychology, School of Arts & Sciences, MCPHS University, Boston, MA, USA; Institute of Lifestyle Medicine, Joslin Diabetes Center, Boston, MA, USA; Marie.dacey@mcphs.edu.
2
Institute of Lifestyle Medicine, Joslin Diabetes Center, Boston, MA, USA.
3
Institute of Lifestyle Medicine, Joslin Diabetes Center, Boston, MA, USA; Department of Family Medicine, Maccabi Health Service, Jerusalem, Israel; Department of Family Medicine, Hebrew University, Jerusalem, Israel.
4
Institute of Lifestyle Medicine, Joslin Diabetes Center, Boston, MA, USA; Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA.

Abstract

BACKGROUND:

Despite a large evidence base to demonstrate the health benefits of regular physical activity (PA), few physicians incorporate PA counseling into office visits. Inadequate medical training has been cited as a cause for this. This review describes curricular components and assesses the effectiveness of programs that have reported outcomes of PA counseling education in medical schools.

METHODS:

The authors systematically searched MEDLINE, EMBASE, PsychINFO, and ERIC databases for articles published in English from 2000 through 2012 that met PICOS inclusion criteria of medical school programs with PA counseling skill development and evaluation of outcomes. An initial search yielded 1944 citations, and 11 studies representing 10 unique programs met criteria for this review. These studies were described and analyzed for study quality. Strength of evidence for six measured outcomes shared by multiple studies was also evaluated, that is, students' awareness of benefits of PA, change in students' attitudes toward PA, change in personal PA behaviors, improvements in PA counseling knowledge and skills, self-efficacy to conduct PA counseling, and change in attitude toward PA counseling.

RESULTS:

Considerable heterogeneity of teaching methods, duration, and placement within the curriculum was noted. Weak research designs limited an optimal evaluation of effectiveness, that is, few provided pre-/post-intervention assessments, and/or included control comparisons, or met criteria for intervention transparency and control for risk of bias. The programs with the most evidence of improvement indicated positive changes in students' attitudes toward PA, their PA counseling knowledge and skills, and their self-efficacy to conduct PA counseling. These programs were most likely to follow previous recommendations to include experiential learning, theoretically based frameworks, and students' personal PA behaviors.

CONCLUSIONS:

Current results provide some support for previous recommendations, and current initiatives are underway that build upon these. However, evidence of improvements in physician practices and patient outcomes is lacking. Recommendations include future directions for curriculum development and more rigorous research designs.

KEYWORDS:

counseling; exercise; medical school education; physical activity; systematic review

PMID:
25062944
PMCID:
PMC4111877
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for PubMed Central
    Loading ...
    Support Center