Mapping lifestyle medicine in undergraduate medical education: a lever for enhancing the curriculum

Background: In 2017, the Bipartisan Policy Center called for inclusion of lifestyle medicine (LM) in undergraduate medical education. Recognizing the requirement that lifestyle medicine should be an integral and integrated part of the curriculum, we undertook an in-depth mapping process to determine the extent of LM teaching at our Faculty, staff perceptions and the impact on medical students. Methods: The study utilized mixed methodology. In Phase 1 (Mapping) structured analysis of course syllabi were conducted followed by observation of teaching sessions throughout the pre-clinical and clinical years, recording content, the degree of coverage, and time allocated to LM Medicine. In Phase 2 (Impact and perceptions), students ' attitudes and confidence in LM counselling were ascertained by questionnaire (scale 1-4) on completion of second and fourth year of studies. Interviews were conducted with course coordinators. Results: Phase 1: Students received 58 hours of LM teaching, 49 hours pre-clinical and 9 clinical; 42 hours were dedicated to theoretical knowledge and 16 hours to teaching practical skills related to lifestyle behavior change. Nutrition received the most attention (18 hours), alcohol, sleep, smoking and sexuality the least. On completion of the internal medicine rotation, students (n = 48) agreed that LM guidance should be part of the physician's role and that patients expected their physicians to be role models (mean +/- sd; 3.4 +/- 0.7). Students were fairly confident about providing general LM counselling (3.3 +/- 1.1); but less so for exercise (3.0 +/- 1.2), nutrition (2.7 +/- 1.1), stress (2.5 +/- 1.0), sleep (2.2 +/- 1.2), and sexuality (2.1 +/- 1.2). Staff recognized the importance of LM but reported time limitations and the need to bring in external experts to teach LM as challenges. Conclusions: Real-time mapping of teaching is a valuable way to ascertain teaching in practice. Based on our mapping process, redesign of curricula is needed to integrate more competency-based, experiential teaching, particularly in the clinical years.

Automated summary

This study utilized a mixed methodology to explore the extent of lifestyle medicine teaching in medical education and its impact on medical students. Based on the mapping process, it was found that there is a need for the integration of competency-based, experiential teaching in the curriculum, particularly in the clinical years. Students showed confidence in providing general lifestyle medicine counseling but had lower confidence in specific areas such as exercise, nutrition, stress, sleep, and sexuality. Staff recognized the importance of lifestyle medicine but faced challenges such as time limitations and the need for external experts.