title: Improving residents' clinical approach to obesity: impact of a multidisciplinary didactic curriculum.
abstract: OBJECTIVE
  Obesity has been declared a 21st century pandemic by WHO. Yet surveys reveal physicians-in-training are uncomfortable managing obesity. One major barrier is the lack of residency education on obesity management. This study incorporates an obesity-specific didactic curriculum into an internal medicine (IM) residency programme and assesses its impact on residents' knowledge, attitudes, practice behaviours, and clinical outcomes in patients with obesity.
  
  
  METHODS
  The intervention consisted of four, 1 h, obesity-specific lectures in the University of Florida Resident Noon Conference. Lectures were taught by multidisciplinary experts and offered to 75 IM residents every 2 weeks from 5 November 2010 to 17 December 2010. Impact on IM residents' knowledge and attitudes was assessed by a pre- and post-intervention Obesity Awareness Questionnaire (OAQ). IM residents' clinical performance was assessed by chart reviews of 238 patients with body mass index >25 kg/m(2) in residents' clinics 4 months pre- and 6 months post-intervention for three clinical outcomes and seven practice behaviours on obesity management. Pre- and post-intervention outcomes were compared via paired t tests (quantitative data) or McNemar's test (binary data).
  
  
  RESULTS
  Mean lecture attendance was 25/75 residents (33%) per lecture. Survey response was 67/75 residents (89%) pre-OAQ and 63/75 residents (84%) post-OAQ. While most attitudes remained unchanged, IM residents gained significant confidence in exercise counselling, safety of bariatric surgery, and patients' weight loss potential; they were more likely to address obesity in the plan and referrals to bariatric surgery. Clinical outcomes and IM residents' knowledge demonstrated no improvement.
  
  
  CONCLUSIONS
  Our brief lecture-based curriculum has the potential to improve IM residents' attitudes and practice behaviours towards obesity. The lack of improvement in clinical outcomes and resident knowledge prompts the need for multimodal, longitudinal curricula with experiential application of obesity medicine.
authors.affiliation: Division of Internal Medicine, Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA.
authors.forename: Andres
authors.initials: A
authors.lastname: Acosta
authors.affiliation: Division of Internal Medicine, Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA.
authors.forename: Alice
authors.initials: A
authors.lastname: Azzalin
authors.affiliation: Division of Internal Medicine, Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA.
authors.forename: Claudia J
authors.initials: CJ
authors.lastname: Emmons
authors.affiliation: Department of Health Outcomes and Policy, University of Florida College of Medicine, Gainesville, Florida, USA.
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: Shuster
authors.affiliation: Departments of Medicine and Population Health, New York Harbor Veteran Affairs Administration, New York University School of Medicine, New York, New York, USA.
authors.forename: Melanie
authors.initials: M
authors.lastname: Jay
authors.affiliation: Division of Internal Medicine, Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA.
authors.forename: Margaret C
authors.initials: MC
authors.lastname: Lo
mesh_terms: D002908:Chronic Disease / Q000534:rehabilitation; D003479:Curriculum; D004503:Education, Medical, Graduate; D004521:Educational Measurement; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D009765:Obesity / Q000523:psychology* / Q000628:therapy
keywords: MEDICAL EDUCATION & TRAINING; PRIMARY CARE; PUBLIC HEALTH