Development and Evaluation of a Nutrition and Physical Activity Counseling Module for First-Year Medical Students

Few Americans follow recommendations regarding nutrition or physical activity, and few physicians provide nutritional counseling (NC) or physical activity counseling (PAC) to patients. Clinical, systems-based, and institutional barriers to teaching and providing NC and PAC exist, but theoretical models of behavior change and principles of adult learning theory (ALT) can enable medical educators to overcome these barriers.

We developed an educational intervention consisting of interactive lectures and two standardized patient experiences to provide first-year medical students with practical experience in PAC and NC. Students completed pre and post educational assessments of attitudes, knowledge, and self-efficacy with the counseling techniques.

Knowledge scores increased from 6.1 to 8.5 (p<.001) on a 13-item test. Self-confidence scores for NC increased from 45 to 78 (p<.001), and self-confidence scores for PAC increased from 51 to 82 (p<.001). While overall attitudes regarding the necessity and utility of counseling with specific disease states were not different pre/ post test (necessity pre/post 6.3 to 6.2 p= .71; utility pre/post 5.8 to 5.7 p=.88), necessity and utility scores for disease states treated primarily with counseling were different compared to disease states students perceive to be primarily pharmacologically treated (counseling vs. pharmacological necessity 5.9 vs. 6.6 p<.001; utility 5.4 vs. 6.1 p<.001).

An educational intervention based on theoretical models of behavior change and ALT can increase knowledge and self confidence scores regarding counseling for NC and PAC.