Do Internists, Pediatricians, and Psychiatrists Feel Competent in Obesity Care?
Physicians must effectively evaluate and treat obesity. To design a needs-driven curriculum intended to improve patient outcomes, physicians were surveyed about their self-perceived knowledge and skills.
The objective of this study was to determine the expressed needs of residents and faculty regarding obesity care training across three specialties.
The study used a survey given to faculty and residents in General Internal Medicine, Pediatrics, and Psychiatry.
Survey questions were generated from comprehensive nutrition curriculum and clinical recommendations, administered online, and then organized around a validated behavioral health framework—the 5As (assess, advise, agree, assist, arrange). Analyses were conducted to evaluate differences in perceived knowledge and skills between specialties and across training levels.
From an overall response rate of 65% (65 residents and 250 faculty members), nearly 20% reported inadequate competency in every item with 48% of respondents reporting an inability to adequately counsel patients about common treatment options. Internists reported the lowest competency in arranging referrals and follow-up. Psychiatrists reported the lowest competency in assessment skills.
This survey demonstrated a critical need for training in specific areas of obesity care. The proposed curriculum targets these areas taking into consideration observed differences across specialties.
Key wordsobesity care weight loss medical education (education, medical) obesity curriculum
- 1.U.S. Preventive Services Task Force. Screening for obesity in adults: Recommendations and rationale. See comment. Ann Intern Med. 2003;139(11):930–2. (Dec 2).Google Scholar
- 2.Klein S, Sheard NF, Pi-Sunyer X, et al. Weight management through lifestyle modification for the prevention and management of type 2 diabetes: Rationale and strategies. A statement of the American Diabetes Association the North American Association for the Study of Obesity and the American Society for Clinical Nutrition. Am J Clin Nutr. 2004;80(22):57–63. (Aug).PubMedGoogle Scholar
- 11.The Tobacco Use and Dependence Clinical Practice Guideline Panel, Staff, and Consortium Representatives. A clinical practice guideline for treating tobacco use and dependence: A US Public Health Service report.. The tobacco use and dependence clinical practice guideline panel, staff, and consortium representatives. JAMA. 2000;283(24):3244–54. (Jun 28).CrossRefGoogle Scholar
- 12.Ockene IS, Hebert J, Ockene JK, et al. Effect of physician-delivered nutrition counseling training and an office-support program on saturated fat intake, weight, and serum lipid measurements in a hyperlipidemic population: Worcester area trial for counseling in hyperlipidemia (WATCH). Arch Intern Med. 1999;159(7):725–31. (Apr 12).CrossRefPubMedGoogle Scholar
- 14.Group on Nutrition, Society of Teachers of Family Medicine, editor. Physician’s curriculum in primary care. 2001; Updated 2005.Google Scholar
- 15.Sadovsky R. Management of obesity: An official recommendation. Am Fam Phys. 2003;67(2):379.Google Scholar
- 16.National Heart, Lung, and Blood Institute Obesity Education Initiative, editor. Expert Panel on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: Evidence report. Bethesda, MD: NIH Publication No. 98-4083; 1998.Google Scholar