Behavior Change Counseling Curricula for Medical Trainees

Abstract

Purpose Unhealthy behaviors contribute to half of U.S. deaths. However, physicians lack sufficient skill in counseling patients to change behaviors. Characterizing effective published curricular interventions for behavior-change counseling for medical trainees would inform educators toward improved training. Method The authors conducted a systematic literature search of studies published 1965–2011 evaluating curricula on behavior change counseling for medical trainees. Included studies described: (1) behavior change counseling, (2) teaching interventions for medical trainees, and (3) assessment of interventions. The authors extracted eligible articles, rated outcomes for learners and patients using Kirkpatrick’s hierarchy, and determined study quality. Results Of 2,788 identified citations, 109 met inclusion criteria. Most studies were performed in the United States (98), 93 at a single institution, and 81 in primary care settings. Curricular topics for counseling included smoking (67 studies), nutrition (30), alcohol/drug use (26), and exercise (22). Although most studies did not include theoretical frameworks, 39 used the Transtheoretical Model of Change. Sixty-two studies involved eight or fewer hours of curricular time, and 51 spanned four or fewer weeks. The studies with highest-level outcomes and quality employed multiple curricular techniques and included practice of counseling techniques in either simulated or actual clinical settings. Conclusions Existing literature suggests that trainees learn behavior change counseling through active, realistic practice and implementation of reminder and feedback systems within actual clinical practice settings. Multi-institutional medical education research on methods of teaching behavior-change counseling that influence patients’ health outcomes are needed to ensure trainees’ clinical competence and improve patient care.

Teaching Residents Screening, Brief Intervention, and Referral to Treatment (SBIRT) Skills for Alcohol Use: Using Chart-Stimulated Recall to Assess Curricular Impact

“…22 A recent systematic review of behavioral change counseling curricula for medical learners found that successful curricula included a focus on addressing gaps in knowledge and performance in the practice environment and reinforcing change over time until the new behavior is well-established. 23 An electronic clinical tool has the potential to provide trainees with ready access to knowledge regarding assessing alcohol use at the point of care and provide instructional scaffolding for the learner by giving them guidance on how to apply newly acquired SBIRT knowledge and skills in a given patient case. These tools could take the form of clinical alerts, guided data collection tools populated during medical visits, decision-support tools and/or self-administered questionnaires for patients.…”

Autoavaliação de egressos quanto à capacitação para práticas de controle do câncer

“…Podemos estar diante de uma formação que tenha um foco diferenciado na abordagem ao paciente, através de técnicas de anamnese e abordagem centrada na pessoa. [18][19] Pode haver também um foco excessivamente teórico e pouco prático, justificando a insegurança na execução dos exames, uma vez que é o treinamento prático, supervisionado, e a repetição que solidificam o conhecimento e trazem a segurança para a prática profissional. 18,[20][21] No Brasil, a formação do profissional médico tem objetivos bem definidos, estabelecidos pelas Diretrizes Curriculares para o Curso de Graduação em Medicina.…”

ABC das Teorias de Mudança de Comportamento: Resenha crítica

“…Esta TMC já foi proposta como um modelo para ser implementado a fim de integrar a formação profissional na educação médica 3 . Foi bastante encontrada, por exemplo, em uma revisão sistemática da literatura que buscou caracterizar a efetividade de intervenções curriculares para melhorar os comportamentos de estudantes de Medicina em relação ao aconselhamento de pacientes sobre comportamentos saudáveis 4 . Outro exemplo de sua utilização: na realização de ações educativas para promover práticas clínicas baseadas em evidência entre profissionais de saúde 5 .…”