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      Developing a training programme in physical activity counselling for undergraduate medical curricula: a nationwide Delphi study

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          Abstract

          Objectives

          To identify the essential content and approaches for developing a training programme in physical activity (PA) counselling for undergraduate medical curricula.

          Design

          A three-round Delphi survey was conducted to investigate four key topics: (1) contents of PA counselling in medical education; (2) teaching and learning methods; (3) medical school collaboration and (4) educational policy implementation. Round 1 collected opinions from the participants. Round 2 focused on scoring the opinions. Round 3 summarised the expert opinions. A mean score of 4 or above identified as an important item.

          Setting

          All 23 medical schools in Thailand.

          Participants

          Academic staff who were experts or in charge of medical schools in the fields of PA, health promotion or medical education.

          Results

          A total of 20 representatives from 18 of the 23 Thai medical schools participated in the study (for a response rate of 78.2%). The top three most important indicators of knowledge were (1) the definition and types of PA (4.75±0.55), (2) the FITT principle (frequency, intensity, time and type) (4.75±0.55) and (3) the benefits of PA (4.65±0.67). The most important component of the training involved general communication skills (4.55±0.60). An extracurricular module (4.05±0.76) was preferable to an intracurricular module (3.95±0.94). Collaborations with medical education centres and teaching hospitals (4.45±0.78) and supporting policies to increase medical students’ PA (4.40±0.73) were considered to be important.

          Conclusion

          Knowledge and counselling skills are important for PA counselling. Building collaborations between medical education and health institutions, as well as implementing effective educational policies, are key approaches to the integration of PA counselling into medical education. Future research should focus on investigating the effects of training in PA counselling on the learning outcomes of medical students and the clinical outcomes of patients.

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          Most cited references27

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          Physical activity habits of doctors and medical students influence their counselling practices.

          Doctors are well positioned to provide physical activity (PA) counselling to patients. They are a respected source of health-related information and can provide continuing preventive counselling feedback and follow-up; they may have ethical obligations to prescribe PA. Several barriers to PA counselling exist, including insufficient training and motivation of doctors and improvable, personal PA habits. Rates of exercise counselling by doctors remain low; only 34% of US adults report exercise counselling at their last medical visit. In view of this gap, one of the US health objectives for 2010 is increasing the proportion of patients appropriately counselled about health behaviours, including exercise/PA. Research shows that clinical providers who themselves act on the advice they give provide better counselling and motivation of their patients to adopt such health advice. In summary, there is compelling evidence that the health of doctors matters and that doctors' own PA practices influence their clinical attitudes towards PA. Medical schools need to increase the proportion of students adopting and maintaining regular PA habits to increase the rates and quality of future PA counselling delivered by doctors.
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            The Delphi technique

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              Physical activity education in the undergraduate curricula of all UK medical schools. Are tomorrow's doctors equipped to follow clinical guidelines?

              Physical activity (PA) is a cornerstone of disease prevention and treatment. There is, however, a considerable disparity between public health policy, clinical guidelines and the delivery of physical activity promotion within the National Health Service in the UK. If this is to be addressed in the battle against non-communicable diseases, it is vital that tomorrow's doctors understand the basic science and health benefits of physical activity. The aim of this study was to assess the provision of physical activity teaching content in the curricula of all medical schools in the UK. Our results, with responses from all UK medical schools, uncovered some alarming findings, showing that there is widespread omission of basic teaching elements, such as the Chief Medical Officer recommendations and guidance on physical activity. There is an urgent need for physical activity teaching to have dedicated time at medical schools, to equip tomorrow's doctors with the basic knowledge, confidence and skills to promote physical activity and follow numerous clinical guidelines that support physical activity promotion.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2019
                3 September 2019
                : 9
                : 8
                : e030425
                Affiliations
                [1 ] departmentDepartment of Clinical Medicine , Walailak University School of Medicine , Thasala, Nakhon Si Thammarat, Thailand
                [2 ] departmentFamily Medicine Clinic , Walailak University Hospital , Thasala, Nakhon Si Thammarat, Thailand
                [3 ] departmentFamily Medicine Unit , Thasala Hospital , Thasala, Nakhon Si Thammarat, Thailand
                [4 ] departmentInternational Health Policy Program, Thailand , Ministry of Public Health , Muang, Nonthaburi, Thailand
                Author notes
                [Correspondence to ] Dr Apichai Wattanapisit; apichai.wa@ 123456wu.ac.th
                Author information
                http://orcid.org/0000-0002-9537-8510
                Article
                bmjopen-2019-030425
                10.1136/bmjopen-2019-030425
                6731937
                31481372
                dd025964-be12-4736-8691-1f3db4d1a03b
                © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 13 March 2019
                : 05 August 2019
                : 12 August 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100010034, Walailak University;
                Funded by: Physical Activities Research Center;
                Award ID: 60-00-05
                Categories
                Sports and Exercise Medicine
                Research
                1506
                1736
                Custom metadata
                unlocked

                Medicine
                curricula,medical education,physical activity counselling
                Medicine
                curricula, medical education, physical activity counselling

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