An obesity educational intervention for medical students addressing weight bias and communication skills using standardized patients

BMC Medical Education

Marsha Yelen³  Joseph M Feinglass²  Dinah M Zeiss¹  Robert F Kushner¹ 

[1] Division of Endocrinology, Metabolism, and Molecular Medicine, Northwestern University Feinberg School of Medicine, 750 North Lake Shore Drive, Rubloff 9-976, Chicago, IL 60611, USA;Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, 750 North Lake Shore Drive, Rubloff 10th Floor, Chicago, IL 60611, USA;Office of Medical Education, Northwestern University Feinberg School of Medicine, 240 East Huron Street, Chicago, IL 60611, USA

关键词: Medical students;    Empathy;    Communication;    Stigma;    Standardized patient;    Obesity;   

Others  :  1118199
DOI  :  10.1186/1472-6920-14-53

 received in 2013-08-13, accepted in 2014-03-13,  发布年份 2014

【 摘 要 】

Background

In order to manage the increasing worldwide problem of obesity, medical students will need to acquire the knowledge and skills necessary to assess and counsel patients with obesity. Few educational intervention studies have been conducted with medical students addressing stigma and communication skills with patients who are overweight or obese. The purpose of this study was to evaluate changes in students' attitudes and beliefs about obesity, and their confidence in communication skills after a structured educational intervention that included a clinical encounter with an overweight standardized patient (SP).

Methods

First year medical students (n = 127, 47% female) enrolled in a communications unit were instructed to discuss the SPs' overweight status and probe about their perceptions of being overweight during an 8 minute encounter. Prior to the session, students were asked to read two articles on communication and stigma as background information. Reflections on the readings and their performance with the SP were conducted prior to and after the encounter when students met in small groups. A newly constructed 16 item questionnaire was completed before, immediately after and one year after the session. Scale analysis was performed based on a priori classification of item intent.

Results

Three scales emerged from the questionnaire: negative obesity stereotyping (7 items), empathy (3 items), and counseling confidence (3 items). There were small but significant immediate post-intervention improvements in stereotyping (p = .002) and empathy (p < .0001) and a very large mean improvement in confidence (p < .0001). Significant improvement between baseline and immediate follow-up responses were maintained for empathy and counseling at one year after the encounter but stereotyping reverted to the baseline mean. Percent of students with improved scale scores immediately and at one year follow up were as follows: stereotyping 53.1% and 57.8%; empathy 48.4% and 47.7%; and confidence 86.7% and 85.9%.

Conclusions

A structured encounter with an overweight SP was associated with a significant short-term decrease in negative stereotyping, and longer-term increase in empathy and raised confidence among first year medical students toward persons who are obese. The encounter was most effective for increasing confidence in counseling skills.

【 授权许可】

   
2014 Kushner et al.; licensee BioMed Central Ltd.

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