Bridging the gap - planning Lifestyle Medicine fellowship curricula: A cross sectional study

Rani Polak, Marie L Dacey, Hillary Keenan, Edward M Phillips

BackgroundThe emerging field, Lifestyle Medicine (LM), is the evidence-based practice of assisting individuals and families to adopt and sustain behaviors that can improve health. While competencies for LM educatio n have been defined and undergraduate curricula have been published, there are no published reports that address graduate level fellowship in LM. This paper describes the process of planning a LM fellowship curriculum at a major, academic teaching institution.MethodsIn September 2012 Harvard Medical School Department of Physical Medicine and Rehabilitation approved a ¿Research Fellowship in Lifestyle Medicine¿. A Likert scale questionnaire was created to measure LM stakeholders¿ perceived relative importance of six domains and eight educational experiences to possibly include in the syllabus of this one-year LM fellowship (1¿=¿not important; 5¿=¿very important). The survey was sent to forty relevant professionals worldwide. Equity in variance within each educational topic (LM domains; educational experiences) was calculated using the analysis of variance and comparison between them using Wilcoxon signed-rank test.ResultsThirty-five of the forty stakeholders (87.5%) completed the survey. All domains except smoking cessation were graded at 4 or 5 by at least 85% of the respondents. After excluding smoking cessation, the difference among the remaining five domains is non-significant (p¿=¿0.12). Thus, nutrition, physical activity, behavioral change techniques, stress resiliency, and personal health behaviors were judged equally as important components of a LM fellowship curriculum (average M¿=¿4.69, SD¿=¿0.15).All educational experiences, with the exception of completing certification programs, research experience and fund raising, were graded at 4 or 5 by at least 82% of the responders. After excluding these three, the difference among the remaining educational experiences did not reach statistical significance (p¿=¿0.07). Thus, clinical practice, teaching physicians and medical students, teaching other health care providers, developing lifestyle interventions and developing health promotion programs were supported and perceived as comparably important in a LM fellowship program (average M¿=¿4.23, SD¿=¿0.11).ConclusionsLifestyle fellowship curricula components were defined based on LM stakeholders¿ input. These five domains and five educational experiences represent the range of competencies previously noted as important in the practice of LM. As the foundation of an inaugural physician fellowship, they inform the educational objectives and future evaluation of this fellowship.