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Preparing Medical Students to Facilitate Lifestyle Changes With Obese Patients: A Systematic Review of the Literature

Chisholm, Anna MRes; Hart, Jo PhD; Mann, Karen V. PhD; Harkness, Elaine PhD; Peters, Sarah PhD

Academic Medicine:
doi: 10.1097/ACM.0b013e3182580648
Preventive Medicine

Purpose: Doctors will increasingly encounter opportunities to support obese patients in lifestyle change efforts, but the extent to which medical schools prepare their students for this challenge is unknown. Further, despite evidence indicating theory-based techniques are effective in facilitating patients’ behavioral changes, the methods taught to medical students and the means of content delivery are unclear. The authors reviewed the literature to investigate how effective educational interventions are in preparing medical students to facilitate lifestyle changes with obese patients.

Method: The authors systematically searched Excerpta Medica (EMBASE), PsycINFO, MEDLINE, and Scopus for educational interventions on obesity management for medical students published in English between January 1990 and November 2010 and matching PICOS (Population, Interventions, Comparators, Outcomes, Study design) inclusion criteria.

Results: Results of a narrative synthesis are presented. Of 1,680 studies initially identified, 36 (2%) full-text articles were reviewed, and 12 (1%) were included in the final dataset. Eleven (92%) of these studies had quantitative designs; of these, 7 (64%) did not include control groups. Nine (75%) of the 12 studies were atheoretical, and 4 (33%) described behavior management strategies. Despite positive reported outcomes regarding intervention evaluations, procedures to control for bias were infrequently reported, and conclusions were often unsupported by evidence.

Conclusions: Evidence from this systematic review revealed data highly susceptible to bias; thus, intervention efficacy could not be determined. Additionally, evidence-based strategies to support patients’ obesity-related behavior changes were not applied to these studies, and thus it remains unknown how best to equip medical students for this task.

Author Information

Ms. Chisholm is a doctoral student, School of Psychological Sciences, University of Manchester, Manchester, United Kingdom.

Dr. Hart is lecturer, Manchester Medical School, University of Manchester, Manchester, United Kingdom.

Dr. Mann is professor emeritus, Division of Medical Education, Dalhousie University, Halifax, Nova Scotia, Canada.

Dr. Harkness is research fellow, School of Translational Medicine, University of Manchester, Manchester, United Kingdom.

Dr. Peters is senior lecturer, School of Psychological Sciences, University of Manchester, Manchester, United Kingdom.

Correspondence should be addressed to Ms. Chisholm, Coupland Building 1, School of Psychological Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom; telephone: 0161-3061751; e-mail:

© 2012 Association of American Medical Colleges