Doctor obesity bias can be measured effectively with new test

Acad Med. 2012 Dec 23. [Epub ahead of print]

Measuring Medical Student Attitudes and Beliefs Regarding Patients Who Are Obese.

Ip EH, Marshall S, Vitolins M, Crandall SJ, Davis S, Miller D, Kronner D, Vaden K, Spangler J.

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Dr. Ip is professor of biostatistical sciences, Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina. Ms. Marshall is a fourth-year medical student, University of California, San Francisco School of Medicine, San Francisco, California. Dr. Vitolins is professor of epidemiology and prevention medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina. Dr. Crandall is professor of family and community medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina. Mr. Davis is assistant professor of family and community medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina. Dr. Miller is associate professor of internal medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina. Ms. Kronner is project manager, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina. Ms. Vaden is education coordinator, Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina. Dr. Spangler is professor of family and community medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.

Abstract

PURPOSE:

Research shows obesity bias to undermine the patient-doctor relationship and lead to substandard care. The authors developed and tested an instrument to measure medical students’ attitudes and beliefs about obese patients.

METHOD:

The authors conducted a literature search to identify validated measures of obesity bias. Because they identified no appropriate scale, they decided to design a novel survey instrument: the Nutrition, Exercise and Weight Management (NEW) Attitudes Scale. An expert panel generated items which focus groups of third-year medical students then discussed. Next, experienced medical educators judged and weighted the remaining revised items. Then, second- and fourth-year medical students completed the scale alongside two previously validated measures of obesity bias, the Anti-Fat Attitudes Questionnaire (AFA) and Beliefs About Obese Persons Scale (BAOP). Third-year students completed the NEW Attitudes Scale before and after a simulated encounter with an obese standardized patient instructor. The authors tested the validity and reliability.

RESULTS:

The final instrument comprised 31 items. A sample of 201 judges rated the items. A sample of 111 second- and fourth-year medical students completed the survey (mean score 24.4, range -37 to 76 out of a possible -118 to 118; higher scores indicate more positive attitudes). Pearson correlations between the NEW Attitudes Scale and AFA and BAOP were, respectively, -0.47 and 0.23. Test-retest reliability was 0.89. Students scored 27% higher after completing the standardized patient-instructor encounter (P < .001).

CONCLUSION:

The NEW Attitudes Scale has good validity and reliability and may be used in future studies.

PMID:
23269296
[PubMed – as supplied by publisher]

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