February 10, 2015 by Nicholas Spence
An overwhelming amount of clinician time is spent on management of chronic diseases of patients, with an increasing emphasis on changing unhealthy lifestyle behaviors. Optimizing patient care and health outcomes requires clinicians to possess the confidence, knowledge and skills to affect behavior change in a practical manner. This is the impetus for MedCHEF, a new program in the School of Medicine, West Virginia University Eastern Division. MedCHEF aims to teach skills that will provide new physicians with the self-assurance required to address difficult topics, including diet and exercise as well as evaluate a patient’s readiness for lifestyle change through motivational interviewing.
At times, the clinical setting and well-intentioned recommendations of clinicians may seem far removed from the “real world” of feasibility or practicality, in the eyes of patients. This is where the rubber meets the road for MedCHEF: medical students work with chefs possessing vast experience preparing delicious, nutrient dense meals for people with chronic diseases. Students learn and practice cooking skills as well as healthy food preparation. They also engage in grocery shopping excursions with a dietitian to master the process in a manner consistent with the needs of patients.
This hands-on experience enables students to become resources, facilitating behavior change by translating clinical advice into concrete and practical actions. It also provides students with an opportunity to bridge with patients by engaging in conversation on related topics, such as food preparation, flavors, tastes, and preferences, based on their own authentic experiences in the kitchen.
Motivational interviewing is also a major component of the curriculum. In short, motivational interviewing is the ability to affect behavior change to improve health outcomes using a patient-centered approach, by increasing intrinsic motivation through the process of exploring and settling ambivalence. Curriculum creator, Dr. Rosemarie Cannarella Lorenzetti contrasts the traditional approach and motivational interviewing method quite simply: “What’s the difference between telling a patient to exercise more and asking them what they can do for 15 minutes three days a week to get more exercise? There’s a big difference between those two questions.”
At this point, you are probably wondering, “how good is this recipe?” So far, the results have been positive, with notable increases in students’ perceived importance of talking about nutrition and exercise along with more confidence in communicating with patients about these lifestyle behaviors.
Beyond medicine, it seems as though this unique blend of ingredients is suitable for existing and future health care practitioners across the board!