Résumés
Abstract
Background: Medical students must demonstrate competency in health promotion and illness prevention; however, movement behaviour promotion content is lacking in medical curricula. Canada’s 24-Hour Movement Guidelines (24HMG) present an opportunity to transform medical curricula to promote movement behaviours within a 24-hour paradigm. We previously co-produced a 24HMG curriculum map and 14 curriculum objectives at one Canadian medical school. The aim of this study was to gain consensus on the curriculum map and objectives among faculty and medical students and explore implementation determinants.
Methods: This study followed a concurrent nested mixed methods design using a modified Delphi method to assess the level of (dis)agreement with map components followed by interviews to explore the implementability of the map. A preliminary survey was distributed to collect demographic and movement behaviour data, followed by three online modified Delphi surveys. Suggested improvements to the map were solicited through open-text boxes. Interviews were semi-structured and conducted online. Interview data were analyzed using content analysis guided by the Consolidated Framework for Implementation Research (CFIR) 2.0.
Results: Consensus was reached on 156/180 items (86.7%) in Survey 1 (faculty, n = 6; students, n = 8), 49/51 items (96.1%) in Survey 2 (faculty, n = 4; students, n = 7), and 8/8 items (100%) in Survey 3 (faculty, n = 3; students, n = 7). Implementation determinants encompassed all five CFIR 2.0 domains, mostly the inner setting (e.g., culture, structural barriers).
Conclusions: Reciprocity and open communication between medical schools and external change agents should be prioritized when co-producing curriculum change in the present landscape of inflation and medical professional burnout.
Résumé
Contexte : Les étudiants en médecine doivent démontrer leur compétence en matière de promotion de la santé et de prévention des maladies. Cependant, le contenu relatif à la promotion du mouvement fait défaut dans les programmes d'études médicales. Les directives canadiennes en matière de mouvement sur 24 heures offrent l'occasion de transformer les programmes d'études médicales afin de promouvoir le fait de bouger sur 24 heures. Nous avons précédemment coproduit une cartographie ainsi que 14 objectifs d’un curriculum favorisant le mouvement sur 24 heures au sein d’une faculté de médecine au Canada. Le but de cette étude était d'obtenir un consensus sur cette cartographie et sur les objectifs du curriculum proposé parmi les professeurs et étudiants en médecine et d'explorer les déterminants de sa mise en oeuvre.
Méthodes : Cette étude a suivi un devis méthodologique mixte utilisant une méthode Delphi modifiée afin d’évaluer le niveau d’accord et de désaccord avec les composants de la cartographie, suivi d'entretiens pour explorer l’opérationnalisation de celle-ci. Un sondage préliminaire a été distribué pour recueillir des données démographiques et sur les comportements de mouvement, suivi de trois sondages Delphi modifiés en ligne. Les suggestions d'amélioration de la cartographie ont été collectées par le biais de questions à réponses courtes ouvertes. Les entrevues étaient semi-structurées et réalisées en ligne. Les données des entretiens ont été analysées à l'aide d'une analyse de contenu guidée par le Consolidated Framework for Implementation Research (CFIR) 2.0.
Résultats : Un consensus a été atteint pour 156 des 180 points (86,7 %) dans l'enquête 1 (professeurs, n = 6 ; étudiants, n = 8), 49/51 points (96,1 %) dans l'enquête 2 (professeurs, n = 4 ; étudiants, n = 7), et 8/8 points (100 %) dans l'enquête 3 (professeurs, n = 3 ; étudiants, n = 7). Les déterminants de la mise en oeuvre englobaient les cinq domaines du CFIR 2.0, concernant principalement l'environnement interne (par exemple, la culture, les obstacles structurels).
Conclusions : La réciprocité et la communication ouverte entre les facultés de médecine et les agents de changement externes devraient être prioritaires lors de la coproduction d’un changement de curriculum dans le paysage actuel d’inflation et d‘épuisement professionnel des médecins.
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