Motivational Interviewing: Addressing Interest Among Health Professions Students.

Background and Objectives: Motivational interviewing (MI) is a patient-centered approach to behavior change counseling that is used among health professionals across multiple disciplines. However, MI training has yet to be broadly offered to health professional (HP) students. This study aimed to evaluate student interest in MI and the efficacy of an MI workshop to assess whether MI training should be incorporated into HP curricula. Methods: We conducted a needs assessment to evaluate HP student interest in learning MI. We then hosted a 6.5-hour MI workshop, followed by optional standardized patient encounters (SPEs). SPE performance was evaluated with a scored competency assessment. Results: Needs assessment respondents (N=93) were predominantly medical students (53%), of which 49% were interested in primary care-related fields. Most (58%) reported receiving 0 to 2 hours of MI training in their required curricula, yet 87% intended to use MI and were interested in receiving training. Nineteen students attended the MI workshop. Postworkshop knowledge assessment (N=11) improved by an average of 34% (premean [±SD], 41% [±12]; postmean [±SD], 75% [±10]; P<.001). The SPE mean competency score (5.09) surpassed the threshold for competence of 5. Conclusions: HP students reported receiving minimal MI training in their curricula despite being highly interested in MI. Interested students responded to our interdisciplinary MI workshop and SPEs with high satisfaction, suggesting that HP schools may benefit from incorporating MI into their curricula. Nevertheless, response rates were low, and selection bias may have skewed responses toward more favorable perceptions of MI.

Care of Cancer Survivors: Nutrition and Physical Activity.

A minority of cancer survivors meet guideline recommendations for nutrition and physical activity. There is a high prevalence of obesity in adult cancer survivors. It has been shown to increase cancer recurrence risk and be associated with poorer survival. There also is a high prevalence of malnutrition in patients with cancer. Those at highest risk include older patients, patients with advanced cancer, and patients with cancers that affect organs and body systems involved in eating and digestion. All patients with cancer should be screened regularly for the risk or presence of malnutrition. The Malnutrition Screening Tool (MST) has been validated for such screening. Individualized counseling by a dietitian can help patients achieve optimal intake. Patients should achieve adequate caloric (25-30 kcal/kg body weight) and protein (more than 1 g/kg) intake, have vitamin and/or mineral deficiencies corrected, and consider taking fish oil or long-chain N-3 fatty acid supplements. Enteral nutrition is recommended if food intake is inadequate, and parenteral nutrition can be considered if enteral nutrition is not possible or adequate. Physical activity is recommended. Standard recommendations are for at least 150 min/week of physical activity, with 300 minutes/week considered ideal. In general, supervised exercise programs have been shown to be more effective for cancer survivors than home-based exercise programs. Behavioral interventions that provide methods or materials to support behavior change (eg, fitness tracking devices, fitness classes) tend to be most effective.

Planting the Seeds of Change: Growing Lifestyle Medicine Interest Groups With the Donald A. Pegg Award.

The practice of Lifestyle medicine (LM) focuses on helping patients make healthy choices to prevent and treat disease. While such interventions are considered first-line treatment for many diseases, many medical schools have not yet been able to include lifestyle medicine classes in the core curriculum but most are able to offer a parallel curriculum that does not interfere with the schedule of core classes. Lifestyle Medicine Interest Groups (LMIGs) are being created around the country and around the globe. Many students and faculty members are interested in starting and sustaining a LMIG at their schools, but some do not have enough funding or they lack the framework that provides structure to their efforts. To address this situation, the American College of Lifestyle Medicine (ACLM) has encouraged the development of LMIGs, which are student-run organizations that provide a parallel curriculum in LM. To support and strengthen this effort, the ACLM initiated the Donald A. Pegg award to fund four allied health students in founding and augmenting their institution's LMIGs. The 2016 inaugural winners were James Gardner, P. Elainee Poling, Alyssa Abreu, and Jessie M. Hipple. Their LMIG activities have included events such as nutrition and cooking classes, exercise prescription seminars, group fitness sessions, and patient lifestyle counseling in various clinical settings. Pearls of wisdom for building successful LMIGs include cultivating strong faculty mentorship, marketing the personal benefits to students who attend activities, and collaborating with other student groups.