We know that health care is an important sector in promoting physical activity (PA). However, few health professional training programs include PA, nor does standardized guidance exist on implementing it in the curriculum. A new study, conducted by several members of the EIM Education Committee, aimed to fill this gap by gathering expert opinion on key PA categories and topics that should be included in the curriculum of health professional training programs. The study brought together 73 clinical experts and educational leaders across seven health professions — registered dietitians, physicians, nurses, occupational therapists, physical therapists, physician assistants and exercise physiologists — to form a consensus on what should actually be taught to aspiring health care professionals across all disciplines.
The experts were led through an iterative three-round e-Delphi Survey in order to determine what key categories and topics should be included in the curriculum of all health care professionals. The researchers defined a category as a large class of topics with particular shared characteristics, while each topic was considered a specific point within a category. Pedagogically, categories could be considered headings, while topics would be specific objectives. Researchers asked the experts to rank categories drawn from EIM curriculum and included: Cellular and Systemic Implications of Exercise, Clinical Exercise Physiology, PA and Public Health, The Administrative Aspects of Integrating PA into Health Systems, and Health Behavior Change. After ranking, experts were then asked to name specific topics among each category they believed were important to be included in health care professional curriculum.
While the researchers were sure the panelists would find that each of the PA categories were important, they were surprised to see one emerge with overwhelming support. Expert panelists ranked Health Behavior Change the highest (98.7%) followed by Cellular and Systemic Implications of Exercise, Clinical Exercise Physiology, and PA and Public Health. The Administrative Aspects of Integrating PA into Health Systems ranked least important (48.0%). Moreover, panelists identified five to eight specific PA topics within each PA category that could be included.
This is important and timely work, as health professional training programs re-imagine their curricula for a changing health care system. We are entering a new generation of education reform designed to improve the performance of health systems by adapting core professional competencies to specific contexts. With these changes, we are witnessing a transformation of national health systems to include more integrated, comprehensive, population health efforts that focus on the behavioral determinants of health and emphasize health promotion and disease prevention. In line with these reforms, this work provides an outline of curricula for a multitude of health professions. While additional work is needed to translate the study’s recommendations to individual health professions, these results can be used as a starting point for health professional programs.
The goal of these recommendations is not to replace the role of qualified exercise professionals, but to increase the knowledge, skills, and self-efficacy of health professionals so that patients receive consistent, integrated recommendations regarding PA. Rather, the results from this study can serve as a template for the inclusion of PA into all programs. The researchers state that they “envision leaders, knowledgeable and passionate for PA promotion, coming together to refine our findings based on a job task analysis for their field. For example, physicians may be best suited to providing exercise prescriptions, while nurses may be better positioned to provide referrals and connect patients to community PA resources. Not only should these leaders look to refine the content for their specific health field, but to develop appropriate learning objectives for the material, explore innovative modalities for the delivery of this content, and include experts from other fields (i.e., health psychologists) to provide their unique perspectives.
The EIM National Center would like to thank Mark Stoutenberg, Ph.D., MSPH, FACSM, Byron Powell, Ph.D., LCSW, Paolo Busignani, Allison Bowersock, Ph.D. and Rachele Pojednic, Ph.D., Ed.M. for their work on this paper. To read the study, click here.