An obesity care curriculum improves residents’ self-efficacy and clinical practice habits

Abstract

Background

Most residency programs lack formal curricula on obesity care leaving physicians unprepared to treat obesity. After conducting a targeted needs assessment, we refined a previously developed online obesity care curriculum and determined its effect on resident physicians’ outcomes.

Methods

This study employed a prospective, non-randomized, pre-post design to evaluate the impact of an online obesity care curriculum on resident physicians' obesity care self-efficacy and frequency of self-reported clinical practice habits. Participants included internal medicine, family medicine, preventive medicine, and internal medicine-pediatrics residents. The curriculum was offered as a standalone experience (‘curriculum only’) or part of a 10-day obesity medicine elective (‘curriculum + elective’). We recruited 45 residents – 33 selected the ‘curriculum only’ and 12 selected the ‘curriculum + elective’ option. We evaluated changes pre/post across 10 obesity care self-efficacy domains (1-not at all confident; 4-very confident) and self-reported frequency of 10 clinical practice habits (1-never; 5-always) among all residents. We used paired t-tests to calculate mean pre/post changes and compared outcomes between the ‘curriculum only’ and ‘curriculum + elective’ groups using unpaired t-tests. Given the multiple comparisons, we considered a statistically significant result if p-value <0.005 (Bonferroni correction).

Results

Overall, residents completed a mean of 9.5 (SD 2.7) of 11 core e-modules. Residents significantly increased self-efficacy and frequency across obesity care domains (p < 0.005); largest increases in frequency were in discussing metabolic-bariatric surgery (mean change 0.8, SD 1.0), behavioral counseling (0.8, SD 1.2), referring to weight management programs (0.7, SD 0.7), and discussing obesity medications (0.6, SD 0.9). No significant differences in pre/post changes were found comparing ‘curriculum only’ to ‘curriculum + elective.’

Conclusion

This curriculum's positive impact on clinical practice habits is an important precursor that may lead to changes in treatment outcomes for patients with obesity.