Obesity education in the family medicine clerkship: a US and Canadian survey of clerkship directors’ beliefs, barriers, and curriculum content

Abstract

Background Despite concerns regarding the increasing obesity epidemic, little is known regarding obesity curricula in medical education. Medical school family medicine clerkships address common primary care topics during clinical training. However, studies have shown that many family physicians feel unprepared at addressing obesity. The purpose of this study was to evaluate factors related to obesity education provided during family medicine clerkships as well as identify future plans regarding obesity education. Methods Data were collected through the 2017 Educational Research Alliance (CERA) survey of Family Medicine Clerkship Directors (CDs) in the United States and Canada. Survey items included the level of importance of obesity education, teaching methods, barriers to teaching, and obesity related topics taught during the clerkship. Survey data were summarized and analyzed. Results The survey response rate was 71.2%. The most frequent barrier to teaching obesity related topics was time constraints (89%). The most commonly taught topics were co-morbid conditions (82.1%), diet (76.9%), and exercise (76.9%). The least commonly taught topics were addressed less than 30% of the time, and included cultural aspects, obesity bias, medications than can cause weight gain, medications to treat obesity, and bariatric surgery. Over half of CDs (59%) are not planning to change existing curriculum, with 39% planning to add to the current curriculum. The CDs’ perceptions of the importance of obesity education were significantly associated with the number of topics covered during clerkship ( p < 0.001). No relationship was found between clerkship duration and the number of obesity topics taught. Conclusion The majority of clerkship directors are planning no changes to their existing curricula which consist of three common topics: obesity related co-morbid conditions, diet, and exercise. While time was the largest self-rated barrier in teaching obesity related topics, clerkship duration didn’t impact the number of topics taught. However, the relative amount of importance placed by CDs upon obesity education was significantly associated with the number of topics covered during clerkship.

An analysis of weight loss efforts and expectations in a Canadian Cohort: A retrospective medical chart review

“…[37][38][39][40] Alternatively, this may reflect the lack of effective obesity management solutions available that could help patients attain their weight loss goals causing patients to turn to unproven therapies with large weight loss claims. Further, the low reported use of dietitians may indicate the lack of availability of dieticians or inadequate training for dieticians 41 and medical professionals 42,43 in Canada for treating obesity.…”

Study of bodyweight and eating attitude among female university members in the Kingdom of Saudi Arabia: A comparison between different methods of weight assessment

“…The study concluded that there is still a potential need for clerkship directors and others involved in family medicine education to assess their own biases regarding obesity and better preparing the doctors of the future. [ 50 ] In our study, we aimed to increase undergraduate medical students' abilities to assess BMI, body composition monitor, and anthropometric measurements together with increasing their ability to sort the obese persons who have eating disorders that need interventions and behavioral therapy by using EAT score. Overall, the results of this study can provide essential data for designing educational programs to prevent abnormal eating attitudes.…”

Implementing evidence-based obesity management guidelines requires development of medical competencies: A commentary outlining future directions in obesity education in Canada

“…With medical education in particular, North American undergraduate medical schools incorporate little training in evidence-based obesity management [ 20 , 23 ]. For example, previous studies exploring obesity-related medical education in US and Canadian family medicine clerkship programs noted that obesity was most commonly taught in curricula in the context of obesity-related complications (e.g., diabetes), or during discussion on lifestyle behavioural changes such as modifications in diet and exercise [ 23 ]. Current research and the Canadian Obesity Adult Management Guidelines put an emphasis on the biological and genetic aspects of obesity, and on mitigating bias and discrimination in obesity medicine [ 1 ].…”