Obesity, Nutrition and Behavioral Change
Much of the second semester in the first year medical school curriculum is comprised of the core GTS courses known as TIME, Topics in Interdisciplinary Medicine. There are four courses, each concentrating on a specific topic. The first, Obesity, Nutrition and Behavioral Change (ONBC), begins right before the holiday break in December. TIME courses provide an introduction to clinical medicine during basic science learning.
Paul Watkins, Med ’78 and ’79, is the course director of TIME: Obesity, Nutrition and Behavioral Change as well as the “horizontal strand” leader of Nutrition (see Human Anatomy article, January 2014). Each horizontal strand has an anchor course in the GTS curriculum and ONBC provides that anchor for Nutrition. However, topics related to nutrition will be touched upon throughout the curriculum and the related content is tagged as being part of that horizontal strand. This ensures that essential criteria are covered throughout the students’ education.
ONBC strives to demonstrate how nutrition, physical activity and other lifestyle choices affect health risks, a patient’s lifespan and the quality of life. Approaches to the prevention and treatment of obesity in adults and children are a key component considering the relevance to current societal issues in the U.S. By the end of the course, students must be proficient in communications skills to allow them obtain a thorough nutritional history and to conduct a motivational interview to help the patient through significant diet changes.
The course structure consists of panel discussions, lectures, journal clubs, small group discussions and practical exercises. The lectures and panel discussions cover a majority of the course content and also provide an opportunity for students to interact with different faculty, real patients and dietitians. For example, one of the panel discussions titled, “Behavioral, pharmacological, and surgical management of obesity,” features a real patient coming to speak about his/her experience through some type of weight management treatment.
Simulation-type training is used to help students practice their clinical communications skills. They will role play with a clinical advisor to practice how they may facilitate a patient through a lifestyle change. Role playing is additionally used to assess the student’s ability to conduct nutritional and motivational interviews.
Towards the end of ONBC, students participate in a personal experience and learn what it’s like to become a patient with a significant lifestyle change. Students choose from four diet options which they then have to strictly follow for one week. At the end of the week, students have group discussions to reflect on their lifestyle change and how that may affect their interaction with patients in the future, who are going through a similar issue. Students can identify aspects of their own personal experiences that can be applied to a patient’s education and management.
ONBC covers the biological, ethical and public health aspects of obesity and nutrition. It delivers an introduction into the clinical side of medical school education with a topic that is making headlines on a national level.