Bridging the gap - planning Lifestyle Medicine fellowship curricula: A cross sectional study

Abstract

BackgroundThe emerging field, Lifestyle Medicine (LM), is the evidence-based practice of assisting individuals and families to adopt and sustain behaviors that can improve health. While competencies for LM education have been defined, and undergraduate curricula have been published, there are no published reports that address graduate level fellowship in LM. This paper describes the process of planning a LM fellowship curriculum at a major, academic teaching institution.MethodsIn September 2012 Harvard Medical School Department of Physical Medicine and Rehabilitation approved a “Research Fellowship in Lifestyle Medicine”. A Likert scale questionnaire was created and disseminated to forty LM stakeholders worldwide, which measured perceived relative importance of six domains and eight educational experiences to include in a one-year LM fellowship. Statistical procedures included analysis of variance and the Wilcoxon signed-rank test.ResultsThirty-five stakeholders (87.5%) completed the survey. All domains except smoking cessation were graded at 4 or 5 by at least 85% of the respondents. After excluding smoking cessation, nutrition, physical activity, behavioral change techniques, stress resiliency, and personal health behaviors were rated as equally important components of a LM fellowship curriculum (average M = 4.69, SD = 0.15, p = 0.12). All educational experiences, with the exception of completing certification programs, research experience and fund raising, were graded at 4 or 5 by at least 82% of the responders. The remaining educational experiences, i.e. clinical practice, teaching physicians and medical students, teaching other health care providers, developing lifestyle interventions and developing health promotion programs were ranked as equally important in a LM fellowship program (average M = 4.23, SD = 0.11, p = 0.07).ConclusionsLifestyle fellowship curricula components were defined based on LM stakeholders’ input. These domains and educational experiences represent the range of competencies previously noted as important in the practice of LM. As the foundation of an inaugural physician fellowship, they inform the educational objectives and future evaluation of this fellowship.

Family physicians prescribing lifestyle medicine: feasibility of a national training programme

“…Further, in 2012, during the study, the Israeli Society of Lifestyle Medicine (ISLM) was founded by three of its investigators (RP, AT-O, LM), and it was approved as a society within the IAFP by the Israeli Medical Association 29. As discussed in other manuscripts that describe LM as inclusive in a family medicine faculty's career path,30 most of this society's board consists of the programme's graduates.…”

Written Examinations in Swedish Medical Schools: Minds Molded to Medicate?

“…The majority of US medical schools do not include LM as a regular part of their undergraduate training 19 and initiatives offering lifestyle-medicine as optional courses are reported as novelties. 20 Yet, recently evolved LM curricula 21,22 and implementation initiatives 22-24 instill hope that a change may be underway.…”

Lifestyle Medicine Education

“…Previous research has indicated that live face-to-face CME formats, as compared with print and Web-based delivery systems, are often preferred 58 and have equal or greater impact on physician behaviors. 59 Although Web-based modules have become popular, live in-person lecture formats still constitute the majority of programs through all levels of UME, 11 GME, 37 and CME. 15 …”

“…36 However, when polled, LM stakeholders determined nutrition, physical activity, behavioral change techniques, stress resiliency, and personal behavior as equally important domains of a LM fellowship curriculum and more important than smoking cessation to be included in future LM fellowship curricula. 37 …”

“… 51 A research fellowship in LM, aimed to train an expert in LM, is being piloted as a GME path in the Institute of Lifestyle Medicine, Joslin Diabetes Center at Harvard Medical School. 37 …”