Adventures in piloting an interprofessional obesity curriculum

Abstract

NEEDS AND OBJECTIVES: Treating obesity is a complex task and barriers to effective counseling include lack of adequate time during clinical encounters and insufficient provider training. Further, providers become frustrated when they perceive that obese patients are not motivated to change their lifestyles. Implementation of obesity curricula within graduate health professions education programs to address these barriers is important. Use of a curriculum that incorporates an interprofessional approach may foster and facilitate collaborative efforts among health professionals; a multi-disciplinary approach to the treatment of obesity is considered to be especially effective.We sought to design an interprofessional curriculum in obesity counseling that could be individualized based on learner needs and would be appropriate for use across the lifespan and which focused on acquisition of skills related to two domains: 1) motivational interviewing (MI) and 2) health literacy. SETTING AND PARTICIPANTS: The curriculum was piloted in the Department of Pediatrics in an urban academic hospital with three residents and two nurse practitioner students. It is scheduled to be piloted with Ob/GYN and internal medicine residents. DESCRIPTION: The curriculum included 3 one-hour interactive sessions followed by an evaluative OSCE. Materials for the sessions were compiled by adapting existing curricula that had been developed separately for pediatrics and internal medicine residents. To this curriculum we included additional items based on a needs assessment obtained from the program director and trainees. The first session included discussion about perceived barriers to obesity treatment and a review of health literacy principles and obesity counseling as well as a brief introduction to MI. The second session focused on challenges in the assessment of the literacy levels of patients and an introduction to specific MI skills, such as change talk and goal setting. The third session was reserved for role playing using the skills learned in the first two sessions. Each session concluded with plans for skills practice within the clinical setting. EVALUATION: We evaluated the curriculum with a 10-minute OSCE station counseling a resistant adolescent on weight reduction. Participants were assessed on use of counseling techniques, including MI skills. Following the OSCE, qualitative feedback was obtained from the trainees via a written survey and audio-taped debriefing session. DISCUSSION/REFLECTION/LESSONS LEARNED: Learners had strong feelings of frustration and resignation about their experiences with obesity counseling and were initially resistant to using MI. To address this, we strove to create an environment where learners could be honest about their perceptions and attitudes. Feedback from participants indicated that there was increasing acceptance of MI over the sessions. Learners highly valued the opportunity to learn in an interprofessional setting, identifying areas of similarity and difference in approach to obesity counseling.