Exercise is Medicine Canada workshop training improves physical activity practices of physicians across Canada, independent of initial confidence level.

BACKGROUND: Educational workshops help physicians (MDs) include physical activity and exercise (PAE) content in more patient appointments. It is unclear if MDs with varying degrees of confidence discussing PAE with their patients equally benefit from such training. We evaluated whether MDs' initial confidence affects the impact of an educational PAE workshop. METHODS: MDs (n = 63) across Canada completed self-reflection questionnaires initially and 3-months following a PAE workshop. MDs were divided into low-confidence [confidence score (out of 100%): <40%; n = 21], medium-confidence (40-60%; n = 19) and high-confidence (>60%; n = 23). RESULTS: PAE counselling confidence increased in all groups (relative increase: Low=~40%, Medium=~20%, High=~10%). Training increased the low-confidence group's knowledge, awareness of guidance/resources and perception of their patients' interest in lifestyle management (~30% change; all p < 0.001). Compared to baseline, a greater proportion (all p < 0.001) of MDs reported prescribing exercise at 3-month follow-up in each of the low-confidence (10% to 62%) medium-confidence (16% to 89%) and high-confidence (57% to 87%) groups. CONCLUSION: PAE training favorably improved MDs' confidence, perceived impact of many barriers and the proportion of MDs prescribing exercise, at each level of confidence. An educational workshop particularly assisted MDs with low-confidence (i.e., those who needed it the most) integrate PAE into their practice.

CONTEXTE: Les ateliers éducatifs aident les médecins (MD) à inclure un contenu sur l'activité physique et l'exercice (PAE) dans un plus grand nombre de consultations auprès de leurs patients. On ne peut établir clairement si les médecins, avec divers degrés de confiance en soi pour discuter de l'activité physique et de l'exercice avec leurs patients, bénéficient tous également d'une telle formation. Nous avons évalué si la confiance en soi initiale du médecin influence les effets d'un atelier éducatif sur l'activité physique et l'exercice. MÉTHODES: Des médecins (n = 63) de partout au Canada ont rempli des questionnaires d'introspection au départ et trois mois après un atelier sur l'activité physique et l'exercice. Les médecins ont été divisés selon un niveau de confiance faible [score d'auto-efficacité (sur 100 %) : < 40 %; n = 21], moyen (40 - 60 %; n = 19) et élevé (> 60 %; n = 23). RÉSULTATS: L'auto-efficacité de services de consultation en matière d'activité physique et d'exercice a augmenté dans tous les groupes (augmentation relative : faible = ~40 %, moye n = ~20 %, élevé = ~10 %). La formation a augmenté les connaissances, la sensibilisation aux conseils/ressources et la perception de l'intérêt de leurs patients dans la gestion du style de vie dans le groupe à faible niveau de confiance (changement d'environ 30 %; tous p < 0,001). Par rapport à la valeur initiale, une plus grande proportion (tous p < 0,001) des médecins ont indiqué prescrire de l'exercice au suivi de trois mois dans chacun des groupes avec un degré de confiance faible (10 % à 62 %), moyen (16 % à 89 %) et élevé (57 % à 87 %). CONCLUSION: La formation sur l'activité physique et l'exercice a amélioré la confiance en soi des médecins, les effets perçus de nombreux obstacles et la proportion de médecins prescrivant de l'exercice, à chaque degré de confiance. Un atelier éducatif a aidé plus particulièrement les médecins avec un faible degré de confiance (c.-à-d., ceux qui en avaient le plus besoin) à intégrer l'activité physique et l'exercice dans leur pratique.

Exercise is Medicine Canada physical activity counselling and exercise prescription training improves counselling, prescription, and referral practices among physicians across Canada.

Exercise is Medicine Canada (EIMC) is an initiative that promotes physical activity (PA) counselling and exercise prescription within health care. The purpose of this study was to compare physicians' perceptions and practices around PA counselling and exercise prescription following EIMC training. Physicians (n = 46) from 7 different provinces completed questionnaires initially and 3 months following an EIMC workshop. Three months after intervention, physicians reported greater confidence compared with baseline for providing physical activity and exercise (PAE) information to patients (79% vs 55%; p < 0.001), assessing patients' PAE (69% vs 44%, p = 0.005), answering patients' PAE questions (78% vs 54%, p < 0.001), providing PAE advice (71% vs 43%, p < 0.001), and identifying which patients would benefit from referral to qualified exercise professionals (77% vs 52%, p = 0.002). At follow-up, physicians reported PA prescription barriers as less impactful (out of 4; all p < 0.05), including perceived patients' lack of interest (2.75 to 2.25), lack of available resources (2.59 to 2.00), and lack of time (2.41 to 2.14). The proportion of physicians providing written exercise prescriptions increased from 20% to 74%. This study suggests that the completion of a 1-day EIMC workshop increases physicians' confidence, knowledge, and counselling behaviours of physicians in prescribing PAE.

Are we adequately preparing the next generation of physicians to prescribe exercise as prevention and treatment? Residents express the desire for more training in exercise prescription.

BACKGROUND: Physical activity (PA) is a key intervention for chronic disease, yet few physicians provide exercise prescription (EP). EP is an important component in larger strategies of reducing non-communicable disease (NCD). Our objective was to assess Family Medicine Residents (FMR) knowledge, competence, and perspectives of EP to help inform future curriculum development. METHODS: A 49-item cross-sectional survey was administered to 396 University of British Columbia FMR. Residents' EP knowledge, competence, attitudes/beliefs, current practices, personal physical activity levels, and perspectives of training were assessed using, primarily, a 7-point Likert scale. RESULTS: The response rate was 80.6% (319/396). After eliminating 25 that failed to meet the inclusion criteria, 294 were included in the final analysis. The majority 95.6% of FMR reported EP as important in their future practice, despite having low knowledge of the Canadian PA Guidelines (mean score 1.77/4), low self-reported competence prescribing exercise as prevention (mean score 13.35/21), and rating themselves "somewhat incompetent" prescribing exercise to patients with chronic disease (mean score 11.26/21). FMR believe PA is integral to their patients' health (98.0%), sedentary behaviour is harmful (97.9%), and feel a responsibility to discuss PA with patients (99.7%). Few FMR (14.9%) perceived their training in EP as adequate and 91.0% desire more. CONCLUSIONS: FMR report EP is important, yet do not perceive they are sufficiently prepared to provide EP. In future curricular development, medical educators should consider residents' low knowledge, competence, perceived program support, and their expressed desire for more training in exercise prescription.