McKensey Bishop, Alayna Santarosa, Julia Pangalangan, Shagun Prabhu, Rebecca Zucconi, Mahima Gulati, Elizabeth Pegg Frates, Michelle Tollefson, Rahul Anand
6 min
Abstract
Chronic lifestyle-related diseases affect two-thirds of Americans, yet lifestyle medicine (LM) training in medical education remains limited.Shared Medical Appointments (SMAs) provide an innovative framework to teach and assess LM in undergraduate medical education (UME).Objective: To pilot a logic model-informed preclerkship elective using SMA simulations to teach and assess selfreported LM competencies in medical students.Methods: A 12week elective guided by ACLM competencies included weekly 150minute SMA simulations covering the six LM pillars.Students designed SMAs on lifestyle topics, received rubric-based feedback, and completed self-evaluations and reflections.This mixed-methods approach included quantitative analysis of retrospective pre-/postsurveys and qualitative thematic analysis.Results: Eleven participants completed the course, including six medical students and five health sciences students.Quantitative analysis (n = 6) revealed a significant improvement in medical student selfreported competencies in Patient Care (P = .01),Medical Knowledge (P < .01),Practice-Based Learning (P < .01),Interpersonal Skills (P < .01),and Professionalism (P = .03)with large effect sizes (1.13-2.71).Thematic analysis (n = 6) generated six themes highlighting increased confidence, real-world skill development, and strategies for sustaining group engagement.SMAbased pedagogy is feasible, effective, and scalable for developing and assessing LM competencies in early medical training.
Alex: With only six students, did the numbers hold up statistically?
Sam: All six showed gains across the domains, with tests confirming the changes weren't due to chance—patient care reached significance at the one percent level, for example. Effect sizes averaged around 1.3; that's a substantial improvement by standard measures.
Alex: The feedback loop from those mini-sessions drove a lot of it. What did their written reflections reveal?
Sam: The team read them closely to spot common patterns—like newfound ease in group talks or ideas for real clinics. They used thematic analysis to group similar insights, simply pulling out the big repeated ideas from personal stories. This showed the course built practical confidence beyond just ratings.
Alex: Faculty prep beforehand—did that play a role?
Sam: Faculty first trained in a program teaching how to blend health advice into group care. With five grad students joining as practice participants—but not in the data—it created a safe, realistic setup. The study used a planning chart to track if the course ran as intended.
Alex: After the mini-sessions, they checked their own leading skills too?
Sam: Yes, on a 15-item checklist covering things like delivering info, handling group talk, and wrapping up. Most students agreed or strongly agreed they did well, with combined rates from 83 to 100 percent on key behaviors—like giving evidence-based facts. They noted room to grow in spots like answering questions smoothly.
Alex: That flags specific skills to practice more. What came out in their written takeaways?
Sam: Researchers sorted reflections into six main patterns, like adjusting to how the group flowed or keeping folks hooked amid tough topics. Students saw value in the longer format for real feedback—one wrote how personal stories made ideas click alive. These insights point to how practice sharpened their feel for group care.
Alex: Makes sense why they'd feel more prepared. With just six students at one school, how solid is this overall?
Sam: The small group limits how widely it applies, and self-reports can include biases like wanting to look good. They used a look-back method to compare before and after fairly, and added reflections, but it can't prove actual skill jumps without outside measures. Still, the clear shifts point to promise for bigger tests.
Alex: What do they suggest doing next?
Sam: Try it at more schools with larger groups, mix in real patient work during later training years, and track if skills stick into residencies. Measure hard outcomes like patient changes over time. With simple guides and short teacher training, it's low-effort to repeat.
Alex: Scalable groundwork without overclaiming.
Sam: Precisely. This pilot shows a feasible path to better prep for group health care. The consistent gains across domains, backed by stats review from an expert, suggest a structured way to build these skills early. The multidisciplinary team brought balanced input, but as a single-site start with self-reports, it calls for larger, objective follow-ups.
Alex: A solid, cautious step forward. Thanks, Sam. And thanks for listening to ResearchPod.