Obesity Curriculum in PBL for Tutors
Date
Authors
Contributor
Advisor
Department
Instructor
Depositor
Speaker
Researcher
Consultant
Interviewer
Narrator
Transcriber
Annotator
Journal Title
Journal ISSN
Volume Title
Publisher
Volume
Number/Issue
Starting Page
Ending Page
Alternative Title
Abstract
Introduction: Data from the Center of Disease Control from 2021-2023 showed that 40.3% of adults in the US have obesity. By 2030, nearly 50% of adults in the US will have obesity. Despite these predictive statistics, a survey done in 2018 noted that there are currently no dedicated Obesity Curriculums at many medical schools, including the John A. Burns School of Medicine (JABSOM), with an average of 10 hours of obesity curriculum and <40% of schools stating that an obesity-related topic was covered well. In 2023, a FORWARD QI Initiative chose 10 schools to integrate an Obesity Curriculum at their schools to teach students about obesity as a chronic disease, rather than just a risk factor for other health conditions. JABSOM is one of those schools. Looking at gaps within JABSOM’s curriculum, natural places to add preclinical obesity-related curriculum were in the cardiovascular/pulmonary (MD2) and endocrinology (MD4) problem-based learning (PBL) cases.
Objectives: Determine the efficacy of newly integrated Obesity Curriculum material into PBL cases and accompanying Tutor Notes on increasing tutors' abilities to facilitate discussions with students about obesity as a chronic disease at JABSOM.
Methods: To our knowledge, this is the first study to assess these outcomes; thus, no existing assessment was found in the literature. MD2 co-course directors were approached to see if specific prompts and resources could be added to two PBL cases. Tutors of the 2024-2025 PBL tutorials were given a pre-survey, asking about their understanding of obesity as a chronic disease, pathophysiology and treatment options for obesity, and comfort level around teaching these topics to medical students. At the end of the unit, PBL tutors received a post-survey with similar questions. The results were compared for analysis.
Results: A total of 17/21 MD2 tutors responded to the pre-survey and 13/21 to the post-survey. The pre-survey showed that 64.7% tutors have had little or no training regarding the care of patients who are obese or overweight, and 35.3% felt slightly or not at all comfortable teaching medical students about the approach to care of obesity. The post-survey revealed that 69.2% felt that the revised PBL cases spurred conversation about obesity as a chronic disease during their tutorials, and 76.9% felt that the additional tutor notes helped them facilitate these discussions. More tutors felt quite or extremely comfortable teaching students about the prevalence (61.0% vs 41.2%), diagnostic criteria (38.5% vs 23.5%), complications (61.5% vs 53.0%), treatment (53.8% vs 23.5%), and approach to care of obesity (38.5% vs 23.5%) in the post-survey vs the pre-survey, respectively.
Discussion: Future practicing physicians need to be aware of obesity as a chronic disease. To address this need, we created learning opportunities for students through tutors’ incorporation of this discussion into PBL cases. This survey suggests that 1) There is always much to learn to be up-to-date in teaching others, 2) If courses have multiple teachers, everyone must be given the same updated information to utilize in their teaching, and 3) Although suggestions may be made by tutors, it is up to students to decide if they really want to learn about a topic. This study was limited by the use of self-reported data, small sample size, and disproportionate number of respondents between the pre- and post-surveys. Of note, a separate longitudinal assessment of students’ knowledge about obesity is currently being done by the FORWARD QI initiative in all 4 years of medical students.
Target Audience: Medical Educators
References:
Emmerich SD, Fryar CD, Stierman B, Ogden CL. Obesity and severe obesity prevalence in adults: United States, August 2021–August 2023. NCHS Data Brief, no 508. Hyattsville, MD: National Center for Health Statistics. 2024. DOI: https://dx.doi.org/10.15620/cdc/159281
Ward ZJ, Bleich SN, Cradock AL, et al. Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity. New England Journal of Medicine. 2019;381(25):2440-2450. doi:https://doi.org/10.1056/nejmsa1909301
Butsch, W.S., Kushner, R.F., Alford, S. et al. Low priority of obesity education leads to lack of medical students’ preparedness to effectively treat patients with obesity: results from the U.S. medical school obesity education curriculum benchmark study. BMC Med Educ20, 23 (2020). https://doi.org/10.1186/s12909-020-1925-z