Evaluation of a Whole Health-Lifestyle Medicine Curriculum for Physician Assistant Students: a Mixed Methods Analysis.

There is increased urgency to train healthcare professionals in lifestyle medicine (LM) to mitigate the impact of lifestyle factors on chronic disease (Trilk et al. in Am J Prevent Medic. 2019:e169-e75, 2019; Polak et al. in Am J Lifestyle Med. 2015;9:361-7, 2015). This training addresses physical activity, nutrition, stress management, sleep hygiene, relationships, tobacco cessation (Lifestyle medicine in ACLM Home, 2020), and self-care. Several studies have evaluated the impact of this training on physician assistant (PA) students (Keyes and Gardner in Clin Teach. 2020, 2020; Phillips et al. Med Sci Educ. 1-5). The current paper extends previous quantitative findings from Phillips et al., 2021, revealing positive qualitative changes in PA student language and approach to clinical vignettes after completion of a novel Whole Health/lifestyle medicine (WH-LM) curriculum.

Training Physician Assistant Students to Provide Evidence-Based, Holistic, Patient-Driven Care: a Novel Curriculum.

Lifestyle and behavior modifications are the primary preventative strategies to mitigate the growing morbidity, mortality, and cost of chronic disease in the USA (Trilk et al., American Journal of Preventive Medicine 56:e169-e175, 2019); hence, there have been multiple calls to train all healthcare professionals in lifestyle medicine (LM). This paper describes and evaluates the implementation of a novel Whole Health/lifestyle medicine (WH-LM) education initiative for physician assistant (PA) students embedded within a clinical rotation at the VA Boston Healthcare System (VABHS). Students demonstrated increased knowledge of WH-LM principles and increased self-efficacy in utilizing these principles following training.

Elevated rates of memory impairment in military service-members and veterans with posttraumatic stress disorder.

INTRODUCTION: Studies investigating the neurocognitive effects of posttraumatic stress disorder (PTSD) routinely find "deficits" in various cognitive domains. However, the rate of cognitive impairment in individuals with PTSD remains unclear, as studies have focused on null hypothesis testing (NHT) and inferring patterns of impairment rather than empirically determining the rate of cognitive impairment in this sample. METHOD: This study examined rates of cognitive impairment using a domain-specific approach in non-treatment-seeking Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn service members and veterans with (n = 92) and without (n = 79) PTSD and without substance abuse/dependence who passed a performance validity measure and were matched on age, education, estimated IQ, and ethnicity. Chi-square analyses were used to compare the rate of cognitive impairment across groups based on normative scores using three cutoffs (-1, -1.5, and -2 SDs). NHT was also used to compare performances across groups. RESULTS: Individuals with PTSD showed higher rates of impairment in memory (-1-SD cutoff) than controls, but equivalent rates of impairment in attention, processing speed, and executive functioning; no significant differences were found on NHT. Impairment in any domain was also more prevalent in PTSD (-1-, -1.5-, and -2-SD cutoffs). No differences were found on NHT or rates of impairment in individuals with PTSD with (n = 34) and without (n = 58) depression. CONCLUSIONS: Patients with PTSD were more likely to meet criteria for memory impairment and to show impairment in any domain than controls. Patients with PTSD and comorbid depression were no more likely to be impaired in any cognitive domain or to have lower scores on individual cognitive tasks than patients with PTSD alone. Clinicians noting cognitive impairment in individuals with PTSD should exercise caution before ascribing that impairment to another etiology if deficits are limited to memory.