OBESITY MEDICINE EDUCATION COLLABORATIVE Obesity Competencies
obesitymedicine.org/OMEC Table of Contents
Message from the OMEC Steering Committee 3
Executive Summary 4
Supporting Organizations 6
OMEC Competencies 7
Educator Instructional Guide 10
Instructions for Assessment of Learners within a Training Program 11
Instructions for Assessment of Existing or Planned Curricula 12
Instructions for Assessment of Non-training Educational Environments 13
Sample Assessment Form (Exhibit A) 14
Obesity Medicine Competency Assessment 15
These materials were developed by and are jointly owned by the Obesity Medicine Association, The Obesity Society, and the American Society for Metabolic and Bariatric Surgery, collectively, the Obesity Medicine Education Collaborative (“OMEC”). OMEC encourages the use of these materials by medical schools and institutions to assist in the development of a clinician workforce that is competent and knowledgeable in the prevention and treatment of obesity. OMEC grants medical schools and institutions permission to use this document for educational and noncommercial purposes as a tool to evaluate students in these various obesity medicine competencies. Attribution to OMEC must be provided in all use of these materials. These materials may not be commercialized or adapted into derivative works. Any use of these materials for any other purpose other than educational and noncommercial purposes or any purpose that is unlawful or otherwise violates the permissions granted herein is strictly prohibited.
2 I Obesity Medicine Education Collaborative Message from the OMEC Steering Committee
A major challenge facing medical educators today is adequately training current and future physicians, nurse practitioners, and physician assistants in the prevention and treatment of obesity. However, the educational response to this escalating problem during undergraduate medical education (UGME) and graduate medical education (GME) has been limited due to the shortage of qualified faculty members who are trained in the science and practice of obesity medicine; limited time in a crowded curriculum; and lack of recognition of obesity by a primary or specialty board.
Nonetheless, it is paramount to develop a competent and knowledgeable clinician workforce that can provide adequate care to the 38% of U.S. adults and 17% of U.S. children and adolescents who have obesity.
One path toward reaching this goal is the development of comprehensive obesity-focused competencies. The rationale for this approach is three-fold:
1 Medical training is competency-based.
2 It is acknowledged that assessment drives learning.
3 Having a comprehensive set of readily available curated competencies will facilitate widespread usage.
To this end, the Obesity Medicine Education Collaborative (OMEC) has developed the first set of obesity- related competencies based on the Six Core Domain Competencies of the Accreditation Council for Graduate Medical Education (ACGME) that can be used in UGME and GME training programs.
The competencies were deliberately developed for learners at multiple stages of training and among different disciplines, since all trainees must be sufficiently qualified to care for patients with obesity. Additionally, since most medical, nursing, and PA curricula are now competency-based, the competencies were designed to be seamlessly utilized within the training assessment framework. Depending on the particular competency, measurement benchmarks that assess knowledge, skills, behavior, and attitudes are included to facilitate evaluator ratings. Similar to competencies in other fields of practice, they can be used for both formative and summative assessments.
For more information, please visit obesitymedicine.org/OMEC or email [email protected].
On behalf of OMEC, it is our hope that routine and more robust assessment of learners will increase their competence to prevent and treat obesity.
In good health,
Robert Kushner, MD, MS, FACP, FTOS, The Obesity Society Deborah Bade Horn, DO, MPH, MFOMA, Obesity Medicine Association W. Scott Butsch, MD, MSc, FTOS, The Obesity Society
Obesity Medicine Education Collaborative I 3 Executive Summary
The Obesity Medicine Education Collaborative (OMEC) is an intersociety initiative that was formed in March 2016 and spearheaded by the Obesity Medicine Association (OMA), The Obesity Society (TOS), and the American Society for Metabolic and Bariatric Surgery (ASMBS). The mission of OMEC is to promote and disseminate comprehensive obesity medicine education across the continuum spanning undergraduate medical education (UGME), graduate medical education (GME), and fellowship training.
This executive summary reviews the methods and processes undertaken by the Collaborative to develop obesity medicine educational competencies1.
A steering committee comprised of OMA, TOS, and ASMBS members2 was joined by representatives from 12 additional professional societies and organizations3 to form working groups. Using the Six Core Domain Competencies4 of the Accreditation Council for Graduate Medical Education (ACGME) as a guiding framework, working group members collaborated by in-person meetings, email exchange, and conference calls between August 2016 and September 2017 to develop 32 obesity-related competencies with specific measurement and assessment benchmarks. The draft competencies, along with a vetting survey, were subsequently sent out for external review in October 2017 to 17 professional societies and organizations5. Results of the review were sent back to the working groups to revise the competencies based on comments.
A final document of 32 obesity-related competencies and associated benchmarks was completed in April 2018. The competencies are intended to be used by medical, nursing, and PA educators.
The 6 Core Domains and number of competencies are as follows:
Patient Care and Procedural Skills 5
Medical Knowledge 13
Practice-Based Learning and Improvement 5
Interpersonal and Communication Skills 3
Professionalism 2
System-Based Practice 4
1 Competency is an observational ability of a health professional, integrating multiple components such as knowledge, skill, values, and attitudes. Since competencies are observable, they can be measured and assessed to ensure acquisition. 2 Kushner RF, Horn D, Butsch S, Pennings N, Lazarus E, Morton J, Brethauer S, Matter S, Apovian C. 3 American Association of Clinical Endocrinologists (AACE), American Congress of Obstetricians and Gynecologists (ACOG), American Association of Nurse Practitioners (AANP), American Academy of PAs (AAPA), American College of Lifestyle Medicine (ACLM), American College of Preventive Medicine (ACPM), American Osteopathic Association (AOA), Association of Colleges of Osteopathic Medicine (AACOM), American Society of Nutrition (ASN), Endocrine Society (ES), Society of Behavioral Medicine (SBM), Society of General Internal Medicine (SGIM). 4 Six Domain Competency framework: Practice-based Learning & Improvement, Patient Care and Procedural Skills, Systems-Based Practice, Medical Knowledge, Interpersonal and Communication Skills, and Professionalism 5 American Society of Addiction Medicine (ASAM), American College of Preventative Medicine (ACPM), American Gastroenterological Association (AGA), Society of General Internal Medicine (SGIM), American Congress of Obstetricians and Gynecologists (ACOG), American Academy of Sleep Medicine (AASM), Academy of Nutrition and Dietetics (AND), American College of Physicians (ACP), American Medical Association (AMA), American Academy of Pediatrics (AAP), Endocrine Society (ES), American Academy of Family Physicians (AAFP), American Association of Clinical Endocrinologists (AACE), American Academy of PAs (AAPA), Association of American Medical Colleges (AAMC), American Heart Association (AHA), American Medical Women’s Association (AMWA).
4 I Obesity Medicine Education Collaborative Special thanks to the working group members, who dedicated their time and expertise to developing the 32 obesity medicine competencies:
• Robert Kushner, MD, MS, FACP, FTOS, The Obesity Society • Deborah Bade Horn, DO, MPH, MFOMA, Obesity Medicine Association • W. Scott Butsch, MD, MSc, FTOS, The Obesity Society • Caroline Apovian, MD, FACP, FACN, FTOS, The Obesity Society • Jamy Ard, MD, FTOS, The Obesity Society • Sarah Armstrong, MD, American Academy of Pediatrics • Daniel Bessesen, MD, FTOS, Endocrine Society • Stacy Brethauer, MD, FASMBS, American Society for Metabolic and Bariatric Surgery • Joshua Brown, PhD, FTOS, The Obesity Society • John Cleek, MD, The Obesity Society and Obesity Medicine Association • Mark DeFrancesco, MD, American Congress of Obstetricians and Gynecologists • Katherine Duncan, MD, Fellow Representative • Colony Fugate, DO, The Obesity Society and Obesity Medicine Association • Angela Golden, DNP, FNP-C, FAANP, American Association of Nurse Practitioners • Sherri Sheinfeld Gorin, PhD, Society of Behavioral Medicine • Carol Gorney, MPAS, PA-C, American Academy of PAs • Eduardo Grunvald, MD, FACP, The Obesity Society and Obesity Medicine Association • Adarsh K. Gupta, DO, MS, FACOFP, American Osteopathic Association • George Guthrie, MD, MPH, American College of Lifestyle Medicine • Leon I. Igel, MD, FACP, FTOS, Society of General Internal Medicine • Madeline Joseph, MD, FAAP, FACEP, Obesity Medicine Association • Scott Kahan, MD, MPH, FTOS, American College of Preventive Medicine and The Obesity Society • Rekha Kumar, MD, The Obesity Society • Ethan Lazarus, MD, FOMA, Obesity Medicine Association • Samer Mattar, MD, American Society for Metabolic and Bariatric Surgery • Janet McGill, MD, American Association of Clinical Endocrinologists • John Morton, MD, MPH, FTOS, American Society for Metabolic and Bariatric Surgery • Connie Newman, MD, FACP, FAHA, FAMWA, The Obesity Society and American Medical Women’s Association • Judith Ockene, PhD, MA, MEd, Society of Behavioral Medicine • Sherry Pagoto, PhD, Society of Behavioral Medicine • Magdalena Pasarica, MD, PhD, The Obesity Society • Nicholas Pennings, DO, FOMA, Obesity Medicine Association • Heidi Silver, PhD, American Society of Nutrition • Taraneh Soleymani, MD, FTOS, The Obesity Society • Chris Still, DO, FACP, FTOS, The Obesity Society • Virginia E. Uhley, PhD, RDN, The Obesity Society • Amanda Velazquez, MD, FTOS, Resident Representative • Pankaj Vij, MD, FACP, American College of Lifestyle Medicine • Megan Winters, Medical Student Representative • Adrienne Youdim, MD, FACP, The Obesity Society
Obesity Medicine Education Collaborative I 5 Supporting Organizations
The following organizations have lent their support through endorsement of the OMEC competencies.
The Obesity Society (TOS)
Obesity Medicine Association (OMA)
American Society of Metabolic and Bariatric Surgery (ASMBS)
Academy of Nutrition and Dietetics (AND)
American Academy of PAs (AAPA)
American Association of Clinical Endocrinologists (AACE)
American Association of Nurse Practitioners (AANP)
American Board of Obesity Medicine (ABOM)
American College of Osteopathic Pediatricians (ACOP)
American College of Surgeons (ACS)
American Medical Women’s Association (AMWA)
American Society for Gastrointestinal Endoscopy (ASGE)
Association for Bariatric Endoscopy (ABE)
Endocrine Society
Obesity Action Coalition (OAC)
Obesity Canada
Society of Behavioral Medicine (SBM)
Society of General Internal Medicine (SGIM)
Society of Teachers of Family Medicine (STFM)
World Obesity Federation (WOF)
6 I The Obesity Medicine Education Collaborative OMEC Competencies
Below is a list of the 32 OMEC competencies by domain group. PATIENT CARE AND PROCEDURAL SKILLS 5 COMPETENCIES
1 Elicits comprehensive obesity-focused medical history. 2 Performs and documents a comprehensive physical examination for the assessment of obesity. Effectively applies clinical reasoning skills when ordering and interpreting appropriate 3 laboratory and diagnostic tests during the evaluation of patients with obesity. Utilizes evidence-based models of health behavior change to assess patients’ readiness to change 4 in order to effectively counsel patients for weight management. Engages the patients and their support systems in shared decision- making by incorporating their values 5 and preferences in the development of a comprehensive personalized obesity management care plan.
MEDICAL KNOWLEDGE 13 COMPETENCIES
1 Demonstrates knowledge of obesity epidemiology. 2 Demonstrates knowledge of energy homeostasis and weight regulation. Demonstrates knowledge of anthropometric (body composition) measurements and 3 clinical assessments of energy expenditure. 4 Demonstrates knowledge of the etiologies, mechanisms, and biology of obesity. Demonstrates knowledge of obesity-related comorbidities and the corresponding benefits 5 of body mass index (BMI) reduction.
Applies knowledge of the principles of primary, secondary, and tertiary prevention of obesity 6 to the development of a comprehensive, personalized obesity management care plan.
Applies knowledge of obesity treatment guidelines to the development of a comprehensive, 7 personalized obesity management care plan.
Applies knowledge of using nutrition interventions to develop a comprehensive, 8 personalized obesity management care plan.
Applies knowledge of using physical activity interventions to develop a comprehensive, 9 personalized obesity management care plan.
Applies knowledge of using behavioral interventions to develop a comprehensive, 10 personalized obesity management care plan.
Applies knowledge of using pharmacological treatments of obesity as part of a comprehensive, 11 personalized obesity management care plan.
Applies knowledge of the surgical treatments of obesity as part of a comprehensive, personalized 12 obesity management care plan.
Applies knowledge of emerging treatment modalities for obesity to the development of a 13 comprehensive, personalized obesity management care plan. Obesity Medicine Education Collaborative I 7 PRACTICE-BASED LEARNING AND IMPROVEMENT 5 COMPETENCIES
Evaluates strengths and deficiencies in knowledge of obesity medicine, 1 and sets and achieves goals for improvement.
Analyzes practice systems using quality improvement methods to monitor 2 and optimize obesity care.
Utilizes resources to locate, interpret, and apply evidence from scientific studies 3 regarding obesity treatment and its co-morbidities.
Uses information technology related to obesity treatment to optimize delivery of care 4 including electronic health records, software applications, and related devices (i.e., accelerometers, resting metabolic rate and body composition analysis technology).
Effectively educates patients, students, residents, and other health professionals on 5 the disease of obesity.
INTERPERSONAL AND COMMUNICATION SKILLS 3 COMPETENCIES
Uses appropriate language in verbal, nonverbal, and written communication that is non-biased, 1 non-judgmental, respectful, and empathetic when communicating with patients with obesity.
Uses appropriate language in verbal, nonverbal, and written communication that is non-biased, 2 non-judgmental, respectful, and empathetic when communicating about patients with obesity with colleagues within one’s profession and other members of the healthcare team.
Demonstrates awareness of different cultural views regarding perceptions of desired weight 3 and preferred body shape when communicating with the patient, family, and other members of the healthcare team.
8 I Obesity Medicine Education Collaborative PROFESSIONALISM 2 COMPETENCIES
Demonstrates ethical behavior and integrity when counseling patients and 1 their families who are living with overweight or obesity.
Displays compassion and respect toward all patients and families who are living 2 with overweight or obesity.
SYSTEMS-BASED PRACTICE 4 COMPETENCIES
Works collaboratively within an interdisciplinary team dedicated to obesity 1 prevention and treatment strategies.
2 Advocates for policies that are respectful and free of weight bias.
Utilizes chronic disease treatment and prevention models to advance obesity intervention 3 and prevention efforts within the clinical, community, and public policy domains.
Describes the costs of obesity intervention and prevention with regards to the individual,
4 health care system, and community.
Obesity Medicine Education Collaborative I 9 Educator Instructional Guide
EASY STEPS TO USING THE OMEC COMPETENCIES
The Obesity Medicine Education Collaborative (OMEC) was created to support training programs in the implementation of the obesity competencies, as well as to provide reliable assessment of performance of the competencies. The goal is to promote, disseminate, and improve comprehensive obesity medicine education across the continuum of medical education programs for physicians, nurse practitioners, and PAs.
The OMEC competencies were designed using the existing six ACGME domains. Within the six domains, there are 32 obesity-related competencies with specific measurement and assessment benchmarks to facilitate performance assessment.
The competencies can be applied to:
1 Formative or summative assessment of learners within a training program
2 Assessment of existing or planned curricula
3 Assessment of non-training educational environments
For questions regarding the implementation or use of the OMEC competencies at your program, institution, society, or company, please contact [email protected] to be connected with one of the steering committee members or an OMEC ambassador in your region.
10 I Obesity Medicine Education Collaborative Instructions for Assessment of Learners Within a Training Program
Choose the competencies to be evaluated.
Full or Partial Evaluation – Select from 6 Domains and 32 Competencies Appropriate for formative or summative evaluation during training at the start, midpoint, and completion of a rotation, training year, or full training program.
Selected Domain Evaluation Appropriate for shorter assignments, such as a journal club, M&M, or quality improvement project. These assignments may only cover a few competencies given limited time or limited focus.
Choose a Likert scale, either 1-5 or 1-9. Check with your institution or department to determine which scale has been chosen for consistency across learners.
Determine an acceptable benchmark score for your learner population. In the sample assessment form (Exhibit A), a blue bar has been placed below the Likert scales as an example. Consider your group of learners (medical students, nurse practitioner students, PA students, residents, or fellows). The “acceptable” benchmark goal will change for different levels of learners and is set by your program or rotation. See Exhibit A on page 14.
Score the learner by scanning the five benchmark descriptions for the competency being evaluated and selecting an appropriate score.
Identify the method of assessment. This could be direct observation, journal club presentations, chart review, or another method of assessment.
Provide supporting details. Positive observations: Give the learner specific examples in which he or she excelled. Suggestions for improvement: Provide learners with areas to refocus.
Note: Some competencies have suggested metrics or examples in the “Notes” box to help the evaluator be more objective in the score.
Consider a self-assessment by the learner at the start of the evaluation period and repeat the self-assessment at the end of evaluation period.
Obesity Medicine Education Collaborative I 11 Instructions for Assessment of Existing or Planned Curricula
Choose the educational content to be evaluated. This could be a curriculum or CME offerings by the institution or entity.
Evaluation:
Evaluate using all 6 domains and 32 competencies.
Use OMEC as a framework to map the current content.
Identify the domains and competencies successfully addressed.
Identify gaps for improvement based on competencies or entire domains that are minimal or absent in the current content.
Improvement:
Identify topics or opportunities that can be added or adjusted to address competency gaps noted above.
Use the OMEC map of your program to plan for improvement in future educational choices.
12 I The Obesity Medicine Education Collaborative Instructions for Assessment of Non-Training Educational Environments
The OMEC competencies can provide a road map for education of individuals, companies, institutions, and societies that work or operate closely with medical prescribers in the field of obesity medicine. Not all six domains apply in these scenarios; for example, many patient care competencies would not apply to non-medical providers.
However, many of the competencies around professionalism, medical knowledge, interpersonal and communication skills, system-based practice, and practice improvement can be applied in a variety of environments that relate to obesity.
Example #1: A hospital system can identify competencies to focus and drive staff training around the care of patients with obesity.
Example #2: An industry partner that provides an obesity-related product or service – such as a medication or surgical device for the treatment of obesity – can choose competencies to incorporate into employee training in an effort to better understand the field and the healthcare providers with whom they interact.
SAMPLE ASSESSMENT FORM (EXHIBIT A) See page 14 for the sample assessment form.
Consider your group of learners (medical students, nurse practitioner students, PA students, residents, fellows, or other learners) and determine an acceptable benchmark score for your learner population. The “acceptable” benchmark goal will change for different learner levels and is set by you and your program or rotation.
In the sample assessment form on the next page, a blue bar has been placed above the middle benchmark as an example of a benchmark or goal that a medical student, nurse practitioner student, or PA student might achieve as acceptable for their training level. The blue bar might be moved above the fourth benchmark for residents and above the fifth benchmark for a learner in a fellowship program.
Obesity Medicine Education Collaborative I 13 OBESITY MEDICINE COMPETENCY ASSESSMENT SAMPLE FORM
Level of Education Competency (UGME, GME, Domain Fellowship)
INSTRUCTIONS: This evaluation should be based on observations of the . Typical are expected to achieve the benchmark level of competency (highlighted in blue) at this stage of their health professional careers. Occasionally, may be above or below the benchmark. Please also provide specific positive observations and suggestions for improvement.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Method of Assessment (e.g., MCQ Exam, OSCE Exam, Patient Observation, Chart Review, Oral Exam, Reflections, Checklist, Global Rating, Simulation)
Positive Observations:
Suggestions for Improvement:
NAME OF EVALUATOR POSITION
14 I The Obesity Medicine Education Collaborative OBESITY MEDICINE Competency Assessment COMPETENCY DOMAIN: PATIENT CARE AND PROCEDURAL SKILLS (5 COMPETENCIES)
1 Competency: Elicits comprehensive obesity-focused medical history.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Complete Complete Complete history Complete Complete history taking history taking taking is patient and history taking history taking is insensitive, is reasonably family-centered, is patient and is patient and disorganized, and/ sensitive and uses people-first family-centered, family-centered, or misses important uses people-first language, is uses people- uses people- details for patients language, is fairly organized and first language, first language, with simple weight organized and complete, is is organized and is organized and management complete, missing appropriate for complete, is complete, is challenges. few important gathering obesity- appropriate appropriate details for patients related information, for gathering for gathering with simple weight and is efficient for obesity-related obesity-related management patients with information, and information, challenges. simple weight is efficient for and is efficient management patients with for patients challenges. moderate weight with complex management clinical and challenges. psychological weight manage- ment challenges.
16 I Obesity Medicine Education Collaborative COMPETENCY DOMAIN: PATIENT CARE AND PROCEDURAL SKILLS (5 COMPETENCIES)
2 Competency: Performs and documents a comprehensive physical examination for the assessment of obesity.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Physical Physical Physical Physical Physical examination examination examination is examination examination is incomplete, contains key usually complete is consistently is consistently techniques are components; and focused, complete, complete, inaccurate and techniques are technique is systematic, systematic, insensitive to pa- fairly appropriate mostly accurate, and focused and focused tient’s modesty and and fairly sensitive usually ensures appropriately appropriately comfort to patient’s patient’s modesty using accurate using accurate during physical modesty and and comfort techniques techniques that examination; comfort during during physical that ensure ensure patient’s incomplete physical examination; patient’s modesty modesty and documentation examination; documentation and comfort; comfort; docu- of findings. fairly complete of findings are documentation mentation of documentation mostly complete of findings is findings is of findings. and organized for complete and complete and patients with well organized well organized simple weight for patients with for patients with management moderate weight complex weight challenges. management management challenges. challenges.
Obesity Medicine Education Collaborative I 17 COMPETENCY DOMAIN: PATIENT CARE AND PROCEDURAL SKILLS (5 COMPETENCIES)
3 Competency: Effectively applies clinical reasoning skills when ordering and interpreting appropriate laboratory and diagnostic tests during the evaluation of patients with obesity.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Use of evidence- Use of laboratory Use of laboratory Use of laboratory Use of laboratory based laboratory and diagnostic and diagnostic and diagnostic and diagnostic tests and diagnostics tests is organized, tests is organized, tests is organized is organized and tests is incomplete clinical reasoning clinical reasoning and efficient efficient without or disorganized, and interpretation and interpretation without extraneous orders unnecessary are missing a few of data support extraneous diagnostics in or non-evidence- key components differential diagnostics for complex cases of based tests, but differential diagnosis and moderately obesity, clinical clinical reasoning diagnosis is include the challenging cases reasoning and and interpretation supported. diagnosis for of obesity, clinical interpretation of data is limited, simple cases reasoning and of data are and differential of obesity. interpretation accurate and diagnosis is limited of data are support the or not supported. accurate and correct diagnosis. support the correct diagnosis.
18 I Obesity Medicine Education Collaborative COMPETENCY DOMAIN: PATIENT CARE AND PROCEDURAL SKILLS (5 COMPETENCIES)
4 Competency: Utilizes evidence-based models of health behavior change to assess patients’ readiness to change in order to effectively counsel patients for weight management.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Counseling for Counseling for Counseling for Counseling for Counseling for weight management weight manage- weight manage- weight manage- weight manage- is performed, but ment is sometimes ment is usually ment is consistently ment is consistently evidence-based performed using performed using performed using performed using models of health evidence-based evidence-based evidence-based evidence-based behavior change models of health models of health models of health models of health are not used. behavior change. behavior change. behavior change. behavior change. The goals are Goals provided are Goals provided are Goals provided are Goals provided are incomplete and sometimes clear, clear, thorough, clear, thorough, clear, thorough, provider-centered. thorough, and and patient- and patient- and patient- patient-centered centered. centered. centered. for patients with Counseling is Counseling is Counseling is simple weight usually efficient consistently consistently management for patients with efficient for efficient for challenges. simple weight patients with patients with management moderate weight complex weight challenges. management management challenges. challenges.
Obesity Medicine Education Collaborative I 19 COMPETENCY DOMAIN: PATIENT CARE AND PROCEDURAL SKILLS (5 COMPETENCIES)
5 Competency: Engages the patients and their support systems in shared decision-making by incorporating their values and preferences in the de- velopment of a comprehensive personalized obesity management care plan.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Patients and their Patients and their Patients and Patients and their Patients and their support systems support systems their support support systems support systems are rarely engaged are sometimes systems are are consistently are consistently in shared decision- engaged in shared usually engaged in engaged in shared engaged in shared making, and the decision-making shared decision- decision-making to decision-making management to develop a fairly making to develop develop a to develop a plan is non- personalized obe- a comprehensive comprehensive comprehensive personalized for sity management personalized personalized personalized patients with plan for patients obesity manage- obesity man- obesity man- simple weight with simple weight ment plan for agement plan agement plan management management chal- patients with for patients with for patients with challenges. lenges. simple weight moderate weight complex weight management management management challenges. challenges. challenges.
20 I Obesity Medicine Education Collaborative COMPETENCY DOMAIN: MEDICAL KNOWLEDGE (13 COMPETENCIES)
1 Competency: Demonstrates knowledge of obesity epidemiology.
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1 2 3 4 5
Lacks basic Has basic Has average Has above Has exceptional knowledge of knowledge of knowledge of average knowledge of overweight and overweight and overweight and knowledge of overweight and obesity incidence obesity incidence obesity incidence, overweight and obesity incidence, and prevalence, and prevalence, prevalence, and obesity incidence, prevalence, and effects on effects on trends, effects on prevalence, and trends, effects on morbidity and morbidity and morbidity and trends, effects on morbidity and mortality, and mortality, and mortality, and morbidity and mortality, and demographic demographic demographic mortality, and demographic associations and associations and associations and demographic associations and distributions for distributions for distributions associations and distributions for children and adults. children and for children distributions children and Cannot identify adults. Can and adults. for children adults. Demon- common identify common Demonstrates and adults. strates knowledge environmental, environmental, knowledge of Demonstrates of common, subtle, socioeconomic, socioeconomic, common knowledge of and theorized and behavioral and behavioral environmental, common and sub- environmental, contributors to the contributors to the socioeconomic, tle environmental, socioeconomic, obesity epidemic obesity epidemic and behavioral socioeconomic, and behavioral at the population at the population contributors to the and behavioral contributors to the level. level. obesity epidemic contributors to the obesity epidemic at the population obesity epidemic at the population level. at the population level. level.
Obesity Medicine Education Collaborative I 21 COMPETENCY DOMAIN: MEDICAL KNOWLEDGE (13 COMPETENCIES)
2 Competency: Demonstrates knowledge of energy homeostasis and weight regulation.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Lacks basic Has basic Has average Has above average Has exceptional knowledge knowledge knowledge knowledge knowledge of energy of energy of energy of energy of energy homeostasis and homeostasis and homeostasis and homeostasis and homeostasis and weight regulation, weight regulation, weight regulation, weight regulation, weight regulation, including cellular including cellular and can apply including including entero- and biochemical and biochemical that knowledge entero-neuroendo- neuroendocrine energy storage/ energy storage/ to the clinical care crine physiology, physiology, and transfer, thermody- transfer, thermody- of patients. and can apply can apply that namics, and energy namics, and that knowledge knowledge to the expenditure. energy to the clinical care clinical care of expenditure. of patients. complex patients.
22 I Obesity Medicine Education Collaborative COMPETENCY DOMAIN: MEDICAL KNOWLEDGE (13 COMPETENCIES)
3 Competency: Demonstrates knowledge of anthropometric (body composition) measurements* and clinical assessments of energy expenditure.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Lacks basic Has basic Has average Has above Has exceptional knowledge of knowledge of knowledge of average knowledge of body body composition body composition body composition knowledge of body composition measurements measurements measurements measurements composition (including bio- and clinical and clinical (including measurements impedance, skinfold assessments of assessments of bioimpedance, (including measurements, energy expenditure energy expenditure skinfold measure- bioimpedance, DXA, cross- (e.g., Harris- (e.g., HB and MSJ ments) and clinical skinfold measure- sectional imaging, Benedict (HB) equations). assessments of ments, DXA) and underwater weigh- ing) and and Mifflin-St. Jeor energy expenditure clinical assessments clinical assessments (MSJ) equations). (e.g., HB and MSJ of energy expendi- of energy expendi- equations), and ture (e.g., HB and ture (e.g., HB and can apply that MSJ equations, MSJ equations, knowledge to indirect calorime- indirect calorimetry, the clinical care try), and can apply doubly-labeled water, metabolic of patients. that knowledge chamber), and to the clinical can apply that care of patients. knowledge to the Recognizes clinical care of indications, complex patients. limitations, and Can distinguish nuanced differenc- utility of various es between various measurements. technologies and measurements, and is able to apply the appropriate study for clinical or investigational purposes.
*Body composition measurements may include weight for length, BMI, BMI percentile, BMI z-score, BMI % relative to 95th percentile, waist circumference (WC), and waist-to-hip ratio (WHR).
Obesity Medicine Education Collaborative I 23 COMPETENCY DOMAIN: MEDICAL KNOWLEDGE (13 COMPETENCIES)
4 Competency: Demonstrates knowledge of the etiologies, mechanisms and biology of obesity.
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1 2 3 4 5
Lacks basic Has basic Has average Has above Has comprehen- knowledge of knowledge of knowledge of average sive knowledge the etiologies, the etiologies, the etiologies, knowledge of of the etiologies, mechanisms, and mechanisms, and mechanisms, the etiologies, mechanisms, and biology of obesity. biology of obesity. and biology of mechanisms, biology of obesity, obesity, and can and biology of and can apply apply that obesity, and that knowledge knowledge to can apply that to the clinical the clinical care knowledge to care of complex of patients. the clinical care patients. of patients.
24 I Obesity Medicine Education Collaborative COMPETENCY DOMAIN: MEDICAL KNOWLEDGE (13 COMPETENCIES)
5 Competency: Demonstrates knowledge of obesity-related comorbidities and the corresponding benefits of body mass index (BMI) reduction.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Lacks basic Has basic Has average Has above Has exceptional knowledge of knowledge of knowledge of average knowledge of obesity-related obesity-related obesity-related knowledge of obesity-related comorbidities and comorbidities and comorbidities and obesity-related comorbidities and the corresponding the corresponding the corresponding comorbidities and the corresponding benefits of BMI benefits of BMI benefits of BMI the corresponding benefits of BMI reduction. reduction. reduction, and benefits of BMI reduction, and can apply that reduction, and can apply that knowledge to can apply that knowledge to the clinical care knowledge to the clinical care of patients. the clinical care of complex of patients. patients.
Obesity Medicine Education Collaborative I 25 COMPETENCY DOMAIN: MEDICAL KNOWLEDGE (13 COMPETENCIES)
6 Competency: Applies knowledge of the principles of primary, secondary, and tertiary prevention of obesity to the development of a comprehensive, personalized obesity management care plan.*
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Lacks basic Has basic Has average Has above Has exceptional knowledge of knowledge of knowledge of average knowledge of the principles of the principles the principles knowledge of the principles primary, secondary, of primary, of primary, the principles of primary, and tertiary secondary, and secondary, and of primary, secondary, and prevention for tertiary prevention tertiary prevention secondary, and tertiary prevention the prevention for the prevention for the prevention tertiary prevention for the prevention and treatment and treatment of and treatment for the prevention and treatment of obesity. obesity. of obesity, and and treatment of obesity, and can apply that of obesity, and can apply that knowledge to can apply that knowledge to the the clinical care knowledge to clinical care of of patients. the clinical care complex patients. of patients.
*Definitions in the context of obesity. Primary prevention: prevent development of overweight/obesity. Secondary prevention: reduce BMI to prevent development of weight-related complications. Tertiary prevention: reduce BMI to prevent progression or worsening of established weight-related complications.
26 I Obesity Medicine Education Collaborative COMPETENCY DOMAIN: MEDICAL KNOWLEDGE (13 COMPETENCIES)
7 Competency: Applies knowledge of obesity treatment guidelines to the development of a comprehensive, personalized obesity management care plan.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Lacks basic Has basic Has average Has above Has exceptional knowledge of knowledge knowledge of average knowledge knowledge of guidelines for of guidelines guidelines for of guidelines for guidelines for the treatment for the treatment the treatment the treatment the treatment of obesity. of obesity. of obesity, and of obesity, and of obesity, and can apply that can apply that can apply that knowledge to knowledge to knowledge to the the clinical care the clinical care clinical care of of patients. of patients. complex patients. Recognizes Recognizes the limitations of evidence base for guidelines with obesity treatment respect to guidelines, individual limitations of patient care. guidelines with respect to individual patient care, and areas of continued scientific uncertainty.
Obesity Medicine Education Collaborative I 27 COMPETENCY DOMAIN: MEDICAL KNOWLEDGE (13 COMPETENCIES)
8 Competency: Applies knowledge of using nutrition interventions to de- velop a comprehensive, personalized obesity management care plan.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Lacks basic Has basic Has average Has above Has exceptional knowledge of knowledge knowledge average knowledge nutrition of nutrition of nutrition knowledge of nutrition interventions interventions interventions of nutrition interventions for the treatment for the treatment for the treatment interventions for the treatment of obesity. of obesity. of obesity, and for the treatment of obesity, and can apply that of obesity, and can apply that knowledge to can apply that knowledge to the the clinical care knowledge to clinical care of of patients. the clinical care complex patients. of patients.
28 I Obesity Medicine Education Collaborative COMPETENCY DOMAIN: MEDICAL KNOWLEDGE (13 COMPETENCIES)
9 Competency: Applies knowledge of using physical activity interventions to develop a comprehensive, personalized obesity management care plan.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Lacks basic Has basic Has average Has above Has exceptional knowledge of knowledge of knowledge of average knowledge of physical activity physical activity physical activity knowledge of physical activity guidelines and guidelines and guidelines and physical activity guidelines and interventions for interventions for interventions for guidelines and interventions for the treatment of the treatment of the treatment interventions for the treatment obesity. obesity. of obesity, and the treatment of obesity, and can apply that of obesity, and can apply that knowledge to can apply that knowledge to the the clinical care knowledge to clinical care of of patients. the clinical care complex patients. of patients.
Obesity Medicine Education Collaborative I 29 COMPETENCY DOMAIN: MEDICAL KNOWLEDGE (13 COMPETENCIES)
10 Competency: Applies knowledge of using behavioral interventions* to develop a comprehensive, personalized obesity management care plan.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Lacks basic Has basic Has average Has above Has exceptional knowledge of knowledge of knowledge average knowledge behavioral behavioral of behavioral knowledge of of behavioral interventions interventions interventions for behavioral interventions for for the treatment for the treatment the treatment interventions the treatment of obesity. of obesity. of obesity, and for the treatment of obesity, and can apply that of obesity, and can apply that knowledge to can apply that knowledge to the the clinical care knowledge to clinical care of of patients. the clinical care complex patients. of patients.
*e.g., behavior therapy strategies, psychological counseling, sleep regulation, stress reduction
30 I Obesity Medicine Education Collaborative COMPETENCY DOMAIN: MEDICAL KNOWLEDGE (13 COMPETENCIES)
11 Competency: Applies knowledge of using pharmacological treatments of obesity as part of a comprehensive, personalized obesity management care plan.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Does not Recognizes an- Has average Has above average Has exceptional recognize anti- ti-obesity medi- knowledge of the knowledge of the knowledge of the obesity medication cation as an ap- age-appropriate age-appropriate age-appropriate as an appropriate propriate form of pharmacothera- pharmacothera- pharmacothera- form of therapy. therapy, and has peutic options for peutic options for peutic options for Lacks basic basic knowledge of the treatment of the treatment of the treatment of knowledge of the the age-appropri- obesity, including obesity, including obesity, including age-appropriate ate pharmacother- their indications, their indications, their indications, pharmacothera- apeutic options for contraindications, contraindications, contraindications, peutic options for the treatment of side effects, and side effects, and side effects, and the treatment of obesity, including mechanisms mechanisms of mechanisms of obesity, including their indications, of action, and action, and can action, and can their indications, contraindications, can apply that apply that apply that contraindications, side effects, and knowledge to knowledge to knowledge to side effects, and mechanisms the clinical care the clinical care the clinical care mechanisms of action. of patients. of patients. of complex of action. patients.
Obesity Medicine Education Collaborative I 31 COMPETENCY DOMAIN: MEDICAL KNOWLEDGE (13 COMPETENCIES)
12 Competency: Applies knowledge of the surgical treatments of obesity as part of a comprehensive, personalized obesity management care plan.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Does not recognize Recognizes Has average Has above average Has exceptional bariatric surgery age-appropriate knowledge of the knowledge of the knowledge of the as an appropriate bariatric surgery surgical options surgical options evidence-based form of therapy as an appropriate for the treatment for the treatment patient selection or the options form of therapy of obesity, of obesity, mech- for surgical options available. Lacks ba- and the options mechanisms anisms of action, for the treatment sic knowledge available. Has of action, and and metabolic/ of obesity, of the mechanisms basic knowledge of metabolic/clinical clinical outcomes, mechanisms of action and the mechanisms outcomes, and and can apply that of action, and metabolic/clinical of action and can apply that knowledge to the metabolic/clinical outcomes. metabolic/clinical knowledge to pre- and post- outcomes, and outcomes. the clinical care operative clinical can apply that of patients. care of patients. knowledge to the pre- and post- operative clinical care of complex patients.
32 I Obesity Medicine Education Collaborative COMPETENCY DOMAIN: MEDICAL KNOWLEDGE (13 COMPETENCIES)
13 Competency: Applies knowledge of emerging treatment modalities* for obesity to the development of a comprehensive, personalized obesity management care plan.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Lacks basic Has basic Has average Has above Has exceptional knowledge knowledge knowledge average knowledge of emerging of emerging of emerging knowledge of emerging modalities modalities modalities of emerging modalities for the treatment for the treatment for the treatment modalities for the treatment of obesity. of obesity. of obesity, and for the treatment of obesity, and can apply that of obesity, and can apply that knowledge to can apply that knowledge to the clinical care knowledge to the clinical care of patients. the clinical care of complex of patients. patients.
*e.g., devices, medications, procedures/surgeries, endoscopic bariatric therapies (EBTs), electronic applications/technologies
Obesity Medicine Education Collaborative I 33 COMPETENCY DOMAIN: PRACTICE-BASED LEARNING AND IMPROVEMENT (5 COMPETENCIES)
1 Competency: Evaluates strengths and deficiencies in knowledge of obe- sity medicine and sets and achieves goals for improvement.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Unable to evaluate Able to evaluate Able to evaluate Able to evaluate Able to strengths and few strengths some strengths most strengths comprehensively deficiencies in and deficiencies and deficiencies and deficiencies evaluate strengths knowledge of in knowledge of in knowledge of in knowledge of and deficiencies obesity medicine, obesity medicine, obesity medicine, obesity medicine, in knowledge and unable to and able to set and able to set and and able to set of obesity set goals for and achieve achieve some goals and achieve medicine, and able improvement. limited goals for for improvement. most goals for to consistently set improvement. improvement. and achieve goals for improvement.
34 I Obesity Medicine Education Collaborative COMPETENCY DOMAIN: PRACTICE-BASED LEARNING AND IMPROVEMENT (5 COMPETENCIES)
2 Competency: Analyzes practice systems using quality improvement methods to monitor and optimize obesity care.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Unable to analyze Able to analyze Able to analyze Able to analyze Consistently practice systems some practice a wide range of more advanced able to analyze using quality systems using basic practice practice systems complex practice improvement quality improve- systems using using quality systems using methods to ment methods quality improve- improvement quality improve- monitor and to monitor ment methods methods to ment methods optimize and optimize to monitor monitor to monitor obesity care. obesity care. and optimize and optimize and optimize obesity care. obesity care. obesity care.
Obesity Medicine Education Collaborative I 35 COMPETENCY DOMAIN: PRACTICE-BASED LEARNING AND IMPROVEMENT (5 COMPETENCIES)
3 Competency: Utilizes resources to locate, interpret, and apply evidence from scientific studies regarding obesity treatment and its co-morbidities.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Unable to utilize Able to utilize Able to utilize Able to utilize Consistently resources to locate, resources to resources to resources to utilizes resources interpret, or apply locate evidence, locate evidence locate and to locate, interpret, evidence from but unable to and beginning interpret evidence, and apply evidence scientific studies interpret or apply to interpret, but and begins to from scientific regarding obesity evidence from not able to apply apply evidence studies regarding treatment and its scientific studies evidence from from scientific obesity treatment co-morbidities. regarding obesity scientific studies studies regarding and its treatment and its regarding obesity obesity treatment co-morbidities. co-morbidities. treatment and its and its co-morbidities. co-morbidities.
36 I Obesity Medicine Education Collaborative COMPETENCY DOMAIN: PRACTICE-BASED LEARNING AND IMPROVEMENT (5 COMPETENCIES)
4 Competency: Uses information technology related to obesity treatment to optimize delivery of care including EHRs, software applications, and related devices (i.e., accelerometers, resting metabolic rate, and body composition analysis technology).
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Unable to use Able to use a Able to use Able to use Very proficient any forms of few limited forms basic forms most forms of in the use of information of information of information information information technology technology related technology technology technology related to obesity to obesity related to related to related to treatment to treatment, but obesity treatment obesity treatment obesity treatment optimize delivery with an incomplete to optimize to optimize to optimize of care including comprehension, delivery of care delivery of delivery of EHRs, software and therefore including care including care including applications, and unable to optimize EHRs, software EHRs, software EHRs, software related devices. delivery of care applications, and applications, and applications, including EHRs, related devices. related devices. and related software devices. applications, and related devices.
Obesity Medicine Education Collaborative I 37 COMPETENCY DOMAIN: PRACTICE-BASED LEARNING AND IMPROVEMENT (5 COMPETENCIES)
5 Competency: Effectively educates patients, students, residents, and oth- er health professionals on the disease of obesity.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Unable to educate Provides ineffective Effectively Effectively Consistently patients, students, or incomplete provides basic edu- educates patients, and effectively residents, and education to cation to students, residents, educates patients, other health patients, students, patients, students, and other health students, residents, professionals residents, and residents, and professionals and other health on the disease other health other health on the disease professionals on of obesity. professionals professionals of obesity in the disease of on the disease on the disease common, more obesity in a full of obesity. of obesity in basic advanced spectrum of clinical cases. clinical cases. scenarios, including challenging clinical cases.
38 I Obesity Medicine Education Collaborative COMPETENCY DOMAIN: INTERPERSONAL AND COMMUNICATION SKILLS (3 COMPETENCIES)
1 Competency: Uses appropriate language in verbal,* nonverbal, and written communication that is non-biased, non-judgmental, respectful, and empathetic when communicating with patients with obesity.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Verbal, Occasionally Utilizes verbal, non- Consistently Consistently nonverbal, utilizes verbal, verbal, utilizes appropriate and effortlessly and written nonverbal, and and written verbal, nonverbal, utilizes appropriate communication written communication and written verbal, nonverbal, is biased, communication that is appropriate communication and written judgmental, that is when engaging that is tailored communication disrespectful, and/ inappropriate with patients with to individual that is clear, or not empathetic when engaging obesity. circumstances concise, and when communicat- with patients with when engaging tailored to ing with obesity, but with patients with individual patients with corrects when obesity, including circumstances obesity. pointed out. challenging when engaging situations. with patients with obesity in all situations.
*Verbal – includes people-first and weight-friendly language
Obesity Medicine Education Collaborative I 39 COMPETENCY DOMAIN: INTERPERSONAL AND COMMUNICATION SKILLS (3 COMPETENCIES)
2 Competency: Uses appropriate language in verbal1, nonverbal, and written communication that is non-biased, non-judgmental, respectful, and empathetic when communicating about patients with obesity with colleagues within one’s profession and other members of the healthcare team.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Verbal, nonverbal, Occasionally Utilizes verbal, non- Consistently Consistently and written utilizes verbal, verbal, utilizes appropriate and effortlessly communication nonverbal, and written verbal, nonverbal, utilizes appropriate is biased, and written communication and written verbal, nonverbal, judgmental, communication that is appropriate communication and written and/or that is when engaging that is tailored communication disrespectful when inappropriate healthcare to individual that is clear, communicating when engaging professionals circumstances concise, and with healthcare in clinical and when engaging tailored to healthcare professionals non-clinical healthcare individual professionals in clinical and settings. professionals circumstances in clinical and non-clinical in clinical and when engaging non-clinical settings, non-clinical healthcare settings.2 but corrects settings, professionals when pointed out. including in clinical and challenging non-clinical situations. settings and in all situations.
1Verbal – includes people-first and weight-friendly language 2Non-clinical – includes discussions outside of patient care setting such as back office, hallways, cafeteria, or social settings
40 I Obesity Medicine Education Collaborative COMPETENCY DOMAIN: INTERPERSONAL AND COMMUNICATION SKILLS (3 COMPETENCIES)
3 Competency: Demonstrates awareness of different cultural views regarding perceptions of desired weight and preferred body shape when communicating with the patient, family, and other members of the healthcare team.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Exhibits specific Exhibits lack Demonstrates an Consistently Consistently episodes of cultural of appreciation appreciation of demonstrates demonstrates an insensitivity when for cultural cultural diversity an appreciation appreciation of communicating diversity and and preferences of cultural diversity cultural diversity with others.1 preferences when when communi- and preferences and preferences communicating cating with others when communi- when communi- with others, but and makes use cating with others, cating with others corrects when of interpreter consistently in all situations, pointed out. services when uses interpreter role models and indicated. services when teaches these indicated and qualities to other in challenging members of the situations, healthcare team. addresses Recognizes and adversity3 addresses implicit or denial to and explicit bias change. in patients, family, Recognizes staff, and self. implicit and explicit bias in patients, family, staff, and self.
1 Others = including patient, family and other members of the healthcare team 2 Diversity and preferences = including language, ideal body weight and shape, family rituals, lifestyle practices, food choices, and/or use of alternative medicines 3 Adversity = including thorough exploration of cultural barriers or any additional comments
Obesity Medicine Education Collaborative I 41 COMPETENCY DOMAIN: PROFESSIONALISM (2 COMPETENCIES)
1 Competency: Demonstrates ethical behavior and integrity when coun- seling patients and their families who are living with overweight or obesity.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Exhibits lack Exhibits lack of Exhibits Consistently Consistently of competence, competence, competence, exhibits exhibits honesty, honesty, honesty, competence, competence, responsibility, and/ responsibility, responsibility, honesty, honesty, or trustworthiness trustworthiness, trustworthiness, responsibility, responsibility, and exhibits bias and/or exhibits bias and lack of bias trustworthiness, trustworthiness, when counseling when when counseling and lack of bias and lack of bias patients and counseling most if not all when counseling when counseling families who patients and patients and patients and patients and are living with families who are families who families who are families who overweight or living with are living with living with are living with obesity, and fails overweight or overweight or overweight or overweight or to acknowledge obesity, but obesity. obesity, including obesity in all or correct when corrects when in challenging situations, and pointed out. pointed out. situations. acts as a role model to teach these qualities to others.
42 I Obesity Medicine Education Collaborative COMPETENCY DOMAIN: PROFESSIONALISM (2 COMPETENCIES)
2 Competency: Displays compassion and respect toward all patients and families who are living with overweight or obesity.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Exhibits lack of Exhibits lack of Exhibits Consistently Consistently compassionate, compassionate, compassionate exhibits exhibits respectful behavior respectful and respectful compassionate compassionate and/or exhibits bias behavior and behavior and lack and respectful and respectful when working with exhibits bias when of bias when work- behavior and lack behavior and lack patients and working with ing with most if of bias when of bias when families who patients and not all patients and working with working with are living with families who families who are patients and patients and overweight or are living with living with over- families who families who are obesity, and fails overweight or weight or obesity. are living with living with over- to acknowledge obesity, but overweight or weight or obesity or correct when corrects when obesity, including in all situations, pointed out. pointed out. in challenging and acts as a role situations. model to teach these qualities to others.
Obesity Medicine Education Collaborative I 43 COMPETENCY DOMAIN: SYSTEMS-BASED PRACTICE (4 COMPETENCIES)
1 Competency: Works collaboratively within an interdisciplinary team dedicated to obesity prevention and treatment strategies.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Limited Able to describe, Able to describe, Effectively engages Exemplifies understanding in detail, the scope in detail, the scope multidisciplinary leadership within of the role of the of practice for of practice for phy- team members both clinical and physician (both physicians, sicians, advanced in the clinical community generalist and advanced practice practice providers, setting to provide settings. Effectively specialist), providers, and and allied health comprehensive organizes medical- advanced practice allied health professionals, as obesity treatments, community providers, other professionals, well as the roles and works collaboratives allied health but inconsistently various community collaboratively with to design and professionals, engages interpro- members, agencies, interdisciplinary implement and community fessional team and policy makers team members obesity prevention members, members. Has play in the to advance obesity and intervention agencies, and a superficial prevention and prevention and initiatives and policy makers in understanding treatment of intervention guide the prevention of the role of obesity. Clearly efforts in multidisciplinary and treatment various community articulates community settings. teams to impact of obesity. members, agen- mechanisms Has a superficial policy-level cies, and policy in which understanding of change. makers in the interdisciplinary policy-level change prevention and teams work processes, but may treatment of together to achieve begin to obesity. a common goal. participate in Actively broader advocacy participates in efforts. multidisciplinary teams within the clinical setting.
44 I Obesity Medicine Education Collaborative COMPETENCY DOMAIN: SYSTEMS-BASED PRACTICE (4 COMPETENCIES)
2 Competency: Advocates for policies which are respectful and free of weight bias.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Knowledge of Aware of the Is a role model Efforts to reduce Effectively utilizes the professional professional for peers in weight bias within the professional literature and literature and demonstrating the clinical setting literature and currently available currently available respectful patient are robust; currently available resources regard- resources regard- care; proactively effectively utilizes resources regard- ing weight bias is ing weight bias; seeks to reduce the professional ing weight bias to limited. however, proactive weight bias within literature and advocate on behalf efforts to reduce the clinical setting; currently available of his/her patients weight bias within however, efforts to resources regarding beyond the clinical the clinical setting reduce the effects weight bias to setting. This may are limited. of weight bias at educate peers; include educating the community actively engages community and policy levels other professionals members and are limited. to reduce weight policy makers bias. or lobbying to healthcare administrators/ payers for resources that improve patient outcomes and delivery of care or decrease potential for bias.
Obesity Medicine Education Collaborative I 45 COMPETENCY DOMAIN: SYSTEMS-BASED PRACTICE (4 COMPETENCIES)
3 Competency: Utilizes chronic disease treatment and prevention models to advance obesity intervention and prevention efforts within the clinical, community, and public policy domains.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Has knowledge Able to describe, in Utilizes population- Effectively and Actively of chronic disease detail, the various based data to drive efficiently advocates for treatment and chronic disease clinical practice coordinates public policy prevention models treatment and decision-making comprehensive, changes that is superficial. prevention models; in the care of patient-centered reduce environ- however, applica- individuals with care in both clinical mental barriers tion within clinical, overweight or and community to health, reduce community, and obesity; actively settings; application health care public policy set- engages individuals within the public systems tings is limited. with overweight or policy domain is inefficiencies, obesity and their limited. improve health families to reduce care accessibility barriers to health for individuals within the environ- with overweight ment and health or obesity, and care delivery reduce barriers to systems; however, care coordination care coordination between the health is inefficient and care team and limited to health community care delivery agencies. systems; application within community and public policy domains is limited.
RELEVANT METRICS: Clearly articulates the impact of health care delivery systems and accessibility, care coordination, environmental conditions, psychological wellbeing, and various systems of influence (e.g., interpersonal, community, policy) on health and health behaviors.
RELEVANT MODELS: Social ecological model I Social determinants of health I Chronic care model I Biopsychosocial model
46 I Obesity Medicine Education Collaborative COMPETENCY DOMAIN: SYSTEMS-BASED PRACTICE (4 COMPETENCIES)
4 Competency: Describes the costs of obesity intervention and prevention with regards to the individual, the health care system, and community.
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Knowledge Describes, in Compares and Effectively and Has an advanced regarding the detail, the direct, contrasts the efficiently educates and detailed direct, indirect indirect, and direct, indirect, peers and com- understanding and human costs of human costs and human costs munity members of the costs of obesity is of obesity. of obesity with the concerning the obesity and superficial. Knowledge costs of obesity costs of obesity obesity regarding the intervention and in relation to the intervention and costs of obesity prevention efforts costs of obesity prevention efforts. intervention and at the individual, intervention and Participates in prevention efforts health care system, prevention efforts. cost-benefit at the individual, community, and Applies knowledge analysis and health care system, population of the costs of contributes community, and levels. Uses this obesity and to peer-reviewed population levels information to obesity prevention literature. is limited. inform clinical and intervention Effectively and decision-making. to clinical decision- efficiently making, quality educates policy improvement makers with projects, and regards to the advocacy efforts. costs of obesity in relation to the costs of obesity intervention and prevention.
Obesity Medicine Education Collaborative I 47