Medical student lifestyle counselling for non-communicable disease: impact on students’ competence and patients’ health behaviors

Abstract

BACKGROUND: Promoting healthy lifestyle is key to tackling lifestyle-induced diseases, yet many doctors feel unskilled and medical schools lack its inclusion in their curricula. The impact of a novel elective lifestyle course is described, where students provided 3 months' coaching to at-risk patients. METHODS: Students' attitudes, competence and lifestyle were assessed pre- and post the 18-month course. Patients' health measures and behaviors were measured. Student and patient views were ascertained. RESULTS: Nineteen students, 13 controls, and 29 patients participated. Perception of physicians' importance as lifestyle consultants increased in coaching students (mean ± SD 3.7 ± 0.4 vs. 3.2 ± 0.5; p = 0.05). Self-perceived competence remained high in coaching students (6.7 ± 1.8 vs. 6.7 ± 1.2; p = 0.66). Controls' competence increased but did not attain coaching students' levels (3.6 ± 2.1 vs. 5.5 ± 1.9; p = 0.009). Focus groups of students confirmed self-perceived acquisition of skills. More patients exercised (38% vs. 82.7%; p = 0.001); spent more time in physical activity (median mins/week + IQR) 25 + [0.180] vs. 120 + [45,300]; p = 0.039), and avoided less desirable foods, such as unhealthy snacks, sweets and drinks. LDL cholesterol showed declining trend. Patients highlighted students' empathy and attentiveness; satisfaction was extremely high. CONCLUSIONS: The course successfully enhanced students' counselling skills, with beneficial effects for patients. This model for teaching experience-based lifestyle medicine has potential policy implications in terms of promoting effective lifestyle counselling by future physicians.