Medical student lifestyle counselling for non-communicable disease: impact on students’ competence and patients’ health behaviors

Promoting healthy lifestyle is key to tackling lifestyle-induced diseases, yet many doctors feel unskilled and medical schools lack its inclusion in their curricula. The impact of a novel elective lifestyle course is described, where students provided 3 months’ coaching to at-risk patients.

Students’ attitudes, competence and lifestyle were assessed pre- and post the 18-month course. Patients’ health measures and behaviors were measured. Student and patient views were ascertained.

Nineteen students, 13 controls, and 29 patients participated. Perception of physicians’ importance as lifestyle consultants increased in coaching students (mean ± SD 3.7 ± 0.4 vs. 3.2 ± 0.5; p = 0.05). Self-perceived competence remained high in coaching students (6.7 ± 1.8 vs. 6.7 ± 1.2; p = 0.66). Controls’ competence increased but did not attain coaching students’ levels (3.6 ± 2.1 vs. 5.5 ± 1.9; p = 0.009). Focus groups of students confirmed self-perceived acquisition of skills. More patients exercised (38% vs. 82.7%; p = 0.001); spent more time in physical activity (median mins/week + IQR) 25 + [0.180] vs. 120 + [45,300]; p = 0.039), and avoided less desirable foods, such as unhealthy snacks, sweets and drinks. LDL cholesterol showed declining trend. Patients highlighted students’ empathy and attentiveness; satisfaction was extremely high.

The course successfully enhanced students’ counselling skills, with beneficial effects for patients. This model for teaching experience-based lifestyle medicine has potential policy implications in terms of promoting effective lifestyle counselling by future physicians.