Teaching Preclinical Medical Students Lifestyle Counseling Skills for Patients' Health Behavior Change

Physicians face barriers to counseling patients regarding lifestyle, specifically, low perceived importance of and confidence in counseling, leading to underuse. There is a dearth in the literature evaluating educational interventions for counseling skills among preclinical medical students. Closing this gap is crucial to taking advantage of critical opportunities early in training.

We taught a session on evidence-based counseling for lifestyle changes to 124 preclinical medical students using case scenarios and role-plays. Our evaluation included (1) measures of perceived importance of and confidence in counseling and (2) measures of perceived gains related to learning objectives. We also undertook qualitative analysis of the session evaluation and thematic analysis of written assignments.

There were statistically significant increases in perceived importance of and confidence in lifestyle counseling. Postintervention student responses demonstrated the highest gain for listing and addressing obstacles to physician counseling, followed by applying physician counseling interventions. Students applied models correctly; however, our thematic analysis of written assignments demonstrated room for continued improvement in application of motivational interviewing techniques.

It is significant that our session impacted students' attitudes on the importance of lifestyle counseling. Based on the session evaluation, we are refining assignment instructions for clarity, providing more time for each role-play, and starting with a faculty role-play demonstration. Aggregate data over time will be more robust than our single cohort. Our evaluation was limited to self-reported attitudes and role-play transcript review, but future interventions could use thematic analysis of recorded role-plays or direct observation of patient simulations.