Perceived preparedness to provide preventive counseling
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
OBJECTIVE: To assess the perceived preparedness of residents in adult primary care specialties to counsel patients about preventive care and psychosocial issues.
DESIGN: Cross-sectional national mail survey of residents (63% response rate).
MEASUREMENTS: Residents self-rated preparedness to counsel patients about smoking, diet and exercise, substance abuse, domestic violence, and depression.
RESULTS: Residents felt better prepared to counsel about smoking (62%) and diet and exercise (53%) than about depression (37%), substance abuse (36%), or domestic violence (21%). In most areas, females felt better prepared than males. Rates of counseling preparedness varied significantly by specialty after adjustment for gender, race, medical school location, and percent of training spent in ambulatory settings. FP residents felt better prepared than OB/GYN residents to counsel about smoking, diet and exercise, and depression, while OB/GYN residents felt better prepared to address domestic violence than IM or FP residents. IM residents’ perceptions of preparedness were between the other 2 specialties. Proportion of training spent in ambulatory settings was not associated with residents’ perceived preparedness.
CONCLUSIONS: Physicians completing residencies in adult primary care did not feel very well prepared to counsel patients about preventive and psychosocial issues. Significant differences exist among specialties, even after adjusting for differences in time spent in ambulatory settings. Increasing residency time in ambulatory settings may not alone be sufficient to ensure that residents emerge with adequate counseling skills.
- Healthy People 2010. Office of Disease Prevention and Health Promotion, Washington, DC
- Wechsler, H, Levine, S, Idelson, RK, Schor, EL, Coakley, E (1996) The physician’s role in health promotion revisited—a survey of primary care practitioners. N Engl J Med 34: pp. 996-8 CrossRef
- Goldstein, MG, DePue, JD, Monroe, AD (1998) A population-based survey of physician smoking cessation counseling practices. Prev Med 27: pp. 720-9 CrossRef
- Gottlieb, NH, Guo, J, Blozis, SA, Huang, PP (2001) Individual and contextual factors related to family practice residents’ assessment and counseling for tobacco cessation. J Am Board Fam Pract 14: pp. 343-51
- Park, ER, DePue, JD, Goldstein, MG (2003) Assessing the transtheoretical model of change constructs for physicians counseling smokers. Ann Behav Med 25: pp. 120-6 CrossRef
- Pollack, KI, Arredondo, EM, Yarnall, KSH (2001) How do residents prioritize smoking cessation for young “high-risk” women? Factors associated with addressing smoking cessation. Prev Med 33: pp. 292-9 CrossRef
- Moran, S, Thorndike, AN, Armstrong, K, Rigotti, NA (2003) Physicians’ missed opportunities to address tobacco use during prenatal care. Nicotine Tob Res 5: pp. 363-8 CrossRef
- Thorndike, AN, Rigotti, NA, Stafford, RS, Singer, DE (1998) National patterns in the treatment of smokers by physicians. JAMA 279: pp. 604-8 CrossRef
- Arndt, S, Schultz, SK, Turvey, C, Petersen, A (2002) Screening for alcoholism in the primary care setting: are we talking to the right people?. J Fam Pract 51: pp. 41-6
- Buchsbaum, DG, Buchanan, RG, Poses, RM, Schnoll, SH, Lawton, MJ (1992) Physician detection of drinking problems in patients attending a general medicine practice. J Gen Intern Med 7: pp. 517-21 CrossRef
- Fleming, MF (1997) Strategies to increase alcohol screening in health care settings. Alcohol Health Res World 21: pp. 340-7
- Friedmann, PD, McCullough, D, Chin, MH, Saitz, R (2000) Screening and intervention for alcohol problems. A national survey of primary care physicians and psychiatrists. J Gen Intern Med 15: pp. 84-91 CrossRef
- Spandorfer, JM, Yedy, I, Turner, BJ (1999) Primary care physicians’ views on screening and management of alcohol abuse: inconsistencies with national guidelines. J Fam Pract 48: pp. 899-902
- Galuska, DA, Will, JC, Serdula, MK, Ford, ES (1999) Are health care professionals advising obese patients to lose weight?. JAMA 282: pp. 1576-8 CrossRef
- Glasgow, RE, Eakin, EG, Fisher, EB, Bacak, SJ, Brownson, RC (2001) Physician advice and support for physical activity: results from a national survey. Am J Prev Med 21: pp. 189-96 CrossRef
- Kushner, RF (1995) Barriers to providing nutrition counseling by physicians: a survey of primary care practitioners. Prev Med 24: pp. 546-52 CrossRef
- Nawaz, H, Adams, ML, Katz, DL (1999) Weight loss counseling by health care providers. Am J Public Health 89: pp. 764-7 CrossRef
- Stafford, RS, Farhat, JK, Misra, B, Schoenfeld, DA (2000) National patterns of physician activities related to obesity management. Arch Fam Med 9: pp. 631-8 CrossRef
- Coyne, JC, Schwenk, TL, Fechner-Bates, S (1995) Nondetection of depression by primary care physicians reconsidered. Gen Hosp Psychiatry 17: pp. 3-12 CrossRef
- Docherty, JP (1997) Barriers to the diagnosis of depression in primary care. J Clin Psychiatry 58: pp. 5-10
- Penn, JV, Boland, R, McCartney, JR, Kohn, R, Mulvey, T (1997) Recognition and treatment of depressive disorders by Internal Medicine attendings and housestaff. Gen Hosp Psychiatry 19: pp. 179-84 CrossRef
- Simon, GE, Korff, M (1995) Recognition, treatment, management and outcomes of depression in primary care. Arch Fam Med 4: pp. 99-105 CrossRef
- Caralis, PV, Musialowski, R (1997) Women’s experiences with domestic violence and their attitudes and expectations regarding medical care of abuse victims. South Med J 90: pp. 1075-80 CrossRef
- Elliott, L, Nerney, M, Jones, T, Friedmann, PD (2002) Barriers to screening for domestic violence. J Gen Intern Med 17: pp. 112-6 CrossRef
- Hamberger, LK, Saunders, DG, Hovey, M (1992) Prevalence of domestic violence in community practice and rate of physician inquiry. Fam Med 24: pp. 283-7
- Rivo, ML, Saultz, JW, Wartman, SA, DeWitt, TG (2005) Defining the generalist physician’s training. JAMA 271: pp. 1499-504 CrossRef
- Seltzer, VL, Fishburne, JI, Jonas, HS (1998) Obstetrics and gynecology residencies: education in preventive and primary health care for women. Obstet Gynecol 91: pp. 305-10 CrossRef
- Accreditation Council on Graduate Medical Education. Residency review committee. Program requirements for residency education in family practice. Available at: http://www.acgme.org. Accessed July 2001.
- Accreditation Council on Graduate Medical Education. Residency review committee. Program requirements for residency education in internal medicine. Available at: http://www.acgme.org. Accessed July 2001.
- Accreditation Council on Graduate Medical Education. Residency review committee. Program requirements for residency education in obstetrics/gynecology. Available at: http://www.acgme.org. Accessed July 2001.
- Blumenthal, D, Gokhale, M, Campbell, EG, Weissman, JS (2001) Preparedness for clinical practice: reports of graduating residents at academic health centers. JAMA 286: pp. 1027-34 CrossRef
- Bertakis, KD, Helms, LJ, Callahan, EJ, Azari, R, Robbins, JA (1995) The influence of gender on physician practice style. Med Care 33: pp. 407-16 CrossRef
- Frank, E, Kunovich-Frieze, T (1995) Physician’s prevention counseling behaviors: current status and future directions. Prev Med 24: pp. 543-5 CrossRef
- Henderson, JT, Weiss, CS (2001) Physician gender effects on preventive screening and counseling: an analysis of male and female patients’ health care experiences. Med Care 39: pp. 1281-92 CrossRef
- Laube, DW, Ling, FW (1999) Primary care in obstetrics and gynecology resident education: a baseline survey of residents’ perceptions and experiences. Obstet Gynecol 94: pp. 632-6 CrossRef
- Graduate Medical Education Database 1996–1997. Chicago, IL: American Medical Association; 1996.
- Rodriguez, MA, Bauer, H, McLoughlin, E, Grumbach, K (1999) Screening and intervention for intimate partner abuse: practices and attitudes of primary care physicians. JAMA 282: pp. 468-74 CrossRef
- Biernat, K, Simpson, D, Duthie, E, Bragg, D, London, R (2003) Primary care residents self assessment skills in dementia. Adv Health Sci Educ 8: pp. 105-10 CrossRef
- Accreditation Council on Graduate Medical Education. ACGME Outcome Project. Available at: http://www.acgme.org/outcome. 2000.
- Goroll, AH, Sirio, C, Duffy, FD (2004) A new model for accreditation of residency programs in internal medicine. Ann Intern Med 140: pp. 902-9
- Parsons, LH, Zaccaro, D, Wells, B, Stovall, TG (1995) Methods of and attitudes toward screening obstetrics and gynecology patients for domestic violence. Am J Obstet Gynecol 173: pp. 381-6 CrossRef
- Schmidt, L, Greenberg, BD, Holzman, GB, Schulkin, J (1997) Treatment of depression by obstetrician-gynecologists: a survey study. Obstet Gynecol 90: pp. 296-300 CrossRef
- Goldstein, MG, Niaura, R, Willey-Lessne, C (1997) Physicians counseling smokers. A population-based survey of patients’ perceptions of health care provider-delivered smoking cessation interventions. Arch Intern Med 157: pp. 1313-9 CrossRef
- Frank, E, Wright, EH, Serdula, MK, Elon, LK, Baldwin, G (2002) Personal and professional nutrition-related practices of U.S. female physicians. Am J Clin Nutr 75: pp. 326-32
- Nichols, GA, Brown, JB (2000) Following depression in primary care: do family practice physicians ask about depression at different rates than internal medicine physicians?. Arch Fam Med 9: pp. 478-82 CrossRef
- Sciamanna, CN, DePue, JD, Goldstein, MG (2002) Nutrition counseling in the promoting cancer prevention in primary care study. Prev Med 35: pp. 437-46 CrossRef
- Williams, JW, Rost, K, Dietrich, AJ, Ciotti, MC, Zyzanski, SJ, Cornell, J (1999) Primary care physicians’ approach to depressive disorders. Arch Fam Med 8: pp. 58-67 CrossRef
- Perceived preparedness to provide preventive counseling
Journal of General Internal Medicine
Volume 20, Issue 5 , pp 386-391
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- primary care
- medical education
- patientdoctor communication
- Industry Sectors