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Closing the "know-do" gap: Training public health professionals in eating disorders prevention via case-method teaching
Abstract
Expansion of our societies' capacity to prevent eating disorders will require strategic integration of the topic into the curricula of professional training programs. An ideal way to integrate new content into educational programs is through the case-method approach, a teaching method that is more effective than traditional teaching techniques. The Strategic Training Initiative for the Prevention of Eating Disorders has begun developing cases designed to be used in classroom settings to engage students in topical, high-impact issues in public health approaches to eating disorders prevention and screening. Dissemination of these cases will provide an opportunity for students in public health training programs to learn material in a meaningful context by actively applying skills as they are learning them, helping to bridge the "know-do" gap. The new curriculum is an important step toward realizing the goal that public health practitioners be fully equipped to address the challenge of eating disorders prevention. © 2013 by Wiley Periodicals, Inc. (Int J Eat Disord 2013; 46:533-537).
... Its priority in the professional sphere is indicated by its implementation into the practice of special discipline study, such as social sciences, economics, medicine, chemistry, psychology, etc. [1][2][3]. Scientists distinguish the case method from other traditional teaching methods, pointing out its professionally-oriented nature as it develops the ability to apply theoretical knowledge to real-life cases [4][5][6][7], developing soft skills [8], self-regulation and teamwork skills [9], critical thinking [10,11] and conceptual understanding [12]. In terms of methodology, it allows realising the human-centred approach necessary for the graduates to succeed at work [13]. ...
... This study revealed many positive outcomes related to the use of case technology in teaching professional law communication to law students, which supports the findings of [4][5][6][7][8][9][10][11][12][18][19][20][21][22]33]. One of the key findings is that students who practiced the case technology in a traditional format completed the task more successfully than those who studied on-line; they covered all the main points with complete details discussed in the prompt, displayed smooth connection and transition of ideas by means of various cohesive devices (logical connectors, a controlling theme, repetition of key words, etc.), their responses were generally meaningful and the conveyed ideas were clearer and easier to understand. ...
Foreign language speaking skills need much practice in order to be improved, which is why it is essential to use different teaching techniques to instruct students effectively. The multiplicity and multitasking of the foreign language teaching process requires the introduction of technology that ensures consistently effective results of professional foreign language learning, i.e., case technology in the algorithmized educational process. The conducted research contributes to the issue of case technology implementation—the algorithm of professional task solutions, aimed at improving students’ English-speaking skills—in teaching professional legal English. The aim of the study is to investigate the effectiveness of case technology in the improvement of ESP speaking skills in the course of distance and face-to-face learning. Comparative analysis of the distance and face-to-face format of case technology implementation in teaching professional foreign communication to law students was carried out in the course of the two-semester study conducted at SPbPU (N 120) in the period from January 2020 to July 2021. Mixed qualitative and quantitative methods were applied to collect and analyse data for the study. The results of the study showed that, for such assessment criteria as task completion, discourse competence and meaningfulness, the use of case technology in a face-to-face format was more effective than the one carried out on-line. As it can have some pedagogical implications on the improvement of English-speaking skills while teaching professional legal English at university, additional effort should be taken to ensure the effectiveness of case technology in the course of distance learning.
... All these advantages could happen in the process of implementation of CMT in a training program. This attention aids learners to follow the educational materials actively and at a greater depth, rather than a situation in which participants are only passive recipients of knowledge (Kleinfeld, 1990;Gray et al., 2006;Watson and Sutton, 2012;Austin and Sonneville, 2013;Roberts and Ryrie, 2014). At the organizational level, CMT enables organizations to empower their staff through the practice of JMD real-world challenges, to compare the competitive potential of their organization with other organizations, to visualize the challenges and opportunities ahead of their organization, to explore solutions for unexpected problems and to benefit from the participation of professional employees in their decision making. ...
Purpose
The purpose of this paper is to introduce case-method teaching (CMT), its advantages and disadvantages for the process of organizational training within organizations, as well as to compare its advantages and disadvantages with current training methods.
Design/methodology/approach
The authors applied a systematic literature review to define, identify and compare CMT with current methods.
Findings
In CMT, participants get involved with real-world challenges from an action perspective instead of analyzing them from a distance. Also, different reactions of the participants to the same challenge aid instructors to identify the individual differences of participants toward the challenge. Although CMT is still not considered as a popular organizational training method, the advantages of CMT may encourage organizational instructors to further apply it. Improving the long-term memory, enhancing the quality of decision making and understanding the individual differences of individuals are the advantages of CMT.
Research limitations/implications
A lack of sufficient empirical researchers and the high cost of conducting this method may prevent practitioners to apply it.
Originality/value
The review suggested that CMT is able to bring dilemmas from the real world into training settings. Also, it helps organizations to identify the individual reactions before they make a decision.
... Eating disorders (ED) are a nutrition-related issue of concern in public health (Austin 2011;Austin and Sonneville 2013). Various authors have theorized specific pathways by which R/S factors might affect EDs. ...
This chapter reviews theories and empirical evidence on religion and spirituality (R/S) as factors relevant to public health nutrition, the field of concentration of about 3% of public health students nationwide. We discuss R/S-health evidence pertaining to fruit, vegetable, and fat intake, overweight status, eating disorders , and fasting and cholesterol.
Introduction:
The development of effective, cost-effective and widely accessible preventive programs is crucial to reducing the burden of disease related to EDs. Programs using cognitive-behavioral and dissonance-based approaches are most effective for selective prevention. Universal and indicated prevention programs should be further investigated. And programs should be extended to a wider range of ages, races, and cultures, and address multiple public health problems such as obesity and eating disorders, weight-related problems with shared risk factors. The Body Project, MABIC and ZARIMA are successful programs in the prevention of problems related to eating and weight (PRAP). Universal interventions in collaboration with programs for the prevention of drug use or risky sexual behaviors should also be developed. A rigorous evaluation of their efficacy, effectiveness, implementation, and dissemination is necessary. It might be optimal to implement the Body Project with peer-led groups to address the barriers associated with clinician-led interventions. The limitations of traditional programs could be overcome with Internet- and mobile-based interventions. Internet-based interventions could maximize the scope and impact of preventive efforts. However, current scientific evidence for the prevention of EDs online is limited. Internet interventions are less effective than face-to-face ones, with small or medium effect sizes.
The aim of the study is to explore learners' perception of case study method within the context of a Degree in Infant Education. The research is carried out at Salamanca University during the academic year 2017-2018. In order to achieve the goal of the research, a quantitative study is employed. The sample of the research is composed of 77 learners enrolled in the compulsory subject School Organization. To operationalize the variables and collect data researchers use a questionnaire. Analyzing the results, it is highlighted that most learners emphasize the benefits of case study method to be involved in the real context of a classroom setting, and to contribute to the development of different skills such as communication, problem solving, decision-making, organizing and planning, analytical thinking, conflict resolution, negotiation, coordination, cooperation, flexibility, tolerance, and respect. They state that it is a fantastic experience to put into practice the knowledge previously acquired. This research points out how the case study method maximizes the learning experience.
The aim of the study is to explore learners' perception of case study method within the context of a Degree in Infant Education. The research is carried out at Salamanca University during the academic year 2017-2018. In order to achieve the goal of the research, a quantitative study is employed. The sample of the research is composed of 77 learners enrolled in the compulsory subject School Organization. To operationalize the variables and collect data researchers use a questionnaire. Analyzing the results, it is highlighted that most learners emphasize the benefits of case study method to be involved in the real context of a classroom setting, and to contribute to the development of different skills such as communication, problem solving, decision-making, organizing and planning, analytical thinking, conflict resolution, negotiation, coordination, cooperation, flexibility, tolerance, and respect. They state that it is a fantastic experience to put into practice the knowledge previously acquired. This research points out how the case study method maximizes the learning experience.
Case-based instruction is one method of active learning that has proven to be beneficial in many educational settings. This chapter will provide a background in the use of case-based instruction in various settings across higher education, discussing the benefits and the limitations. Instruction on how to write case studies, how to introduce the use of this instructional method to students, and how to implement case-based instruction with excellence will be offered. Every educational setting has a slightly different set of expectations and parameters. The information contained in this chapter will include how to write and implement case studies in higher education. Information concerning the medical fields, business education, and teacher preparation courses will be included.
Dissemination and implementation of evidence-based treatments are among the biggest challenges facing clinical psychiatry. Developing scalable evidence-based treatments is a major priority and fraught with challenges. This article describes the development of 3 technology-based innovations. It discusses the use of massive open online courses (MOOCs) and mobile applications. Three projects are presented: (1) the modification of a MOOC methodology for psychotherapy training clinicians in manualized family-based therapy (FBT) for adolescents with anorexia nervosa; (2) a modified MOOC platform for the delivery of FBT; and (3) the development of mobile applications for treatment augmentation and delivery.
Background
The societal burden of eating disorders is clear, and though there is a compelling need for a public health approach to eating disorders prevention, public health professionals have yet to take up the challenge.
Discussion
The article lays out an argument for what steps need to be taken to bring a public health approach to eating disorders prevention. First, stock is taken of what the field has achieved so far, using tools from the prevention science literature, and, second, a research plan of action is offered that plays to the unique strengths of public health, drawing on a triggers-to-action framework from public health law. Minimal participation was found from public health professionals in eating disorders prevention research, and the vast majority of prevention research to date was found to be concentrated within the disciplines of psychology and psychiatry. Extreme disciplinary concentration of the research has led to a preponderance of individually targeted prevention strategies with little research focused on environmental targets, particularly at the macro level. New environmental initiatives are now emerging, such as a government-sponsored mass media anti-dieting campaign, and legal bans on extremely thin models in advertising, but for the most part, they have yet to be evaluated. A triggers-to-action framework, which focuses on evidentiary base, practical considerations, and political will, developed in public health law provides a basis for a strategic research plan for a public health approach to eating disorders prevention.
Summary
There is enormous potential for growth in the scope and diversity of eating disorder prevention research strategies, particularly those targeting the macro environment. A public health approach will require a strategic plan for research that leverages the macro environment for prevention. The full engagement of public health professionals will bring to the field the much broader range of preventive strategies and perspectives needed to tackle the problem of eating disorders.
Objective:
This study examined public perceptions of obesity-related public health media campaigns with specific emphasis on the extent to which campaign messages are perceived to be motivating or stigmatizing.
Method:
In summer 2011, data were collected online from a nationally representative sample of 1014 adults. Participants viewed a random selection of 10 (from a total of 30) messages from major obesity public health campaigns from the United States, the United Kingdom and Australia, and rated each campaign message according to positive and negative descriptors, including whether it was stigmatizing or motivating. Participants also reported their familiarity with each message and their intentions to comply with the message content.
Results:
Participants responded most favorably to messages involving themes of increased fruit and vegetable consumption, and general messages involving multiple health behaviors. Messages that have been publicly criticized for their stigmatizing content received the most negative ratings and the lowest intentions to comply with message content. Furthermore, messages that were perceived to be most positive and motivating made no mention of the word 'obesity' at all, and instead focused on making healthy behavioral changes without reference to body weight.
Conclusion:
These findings have important implications for framing messages in public health campaigns to address obesity, and suggest that certain types of messages may lead to increased motivation for behavior change among the public, whereas others may be perceived as stigmatizing and instill less motivation to improve health.
Objective:
The serious consequences of obesity and eating disorders (ED), difficulties encountered in treatment and the high prevalence of these conditions are important reasons to develop efforts aimed at their prevention. The implementation of integrated interventions aimed at preventing risk factors for both obesity and ED constitutes a very exciting development. In the present paper we discuss and review the main reasons for an integrated approach to the spectrum of eating- and weight-related problems, which include anorexia nervosa, bulimia nervosa, anorexic and bulimic behaviours, unhealthy dieting practices, body dissatisfaction, binge-eating disorder, overweight and obesity. Given differences between the fields with regard to current perspectives and objectives, key barriers to an integrated approach to prevention are discussed. In order to show the possibilities of development of this approach, we review the main contributions made to date in the fields of both obesity and ED prevention. In particular, environmental approaches in the prevention of obesity and ED are reviewed, given their potential for preventing a broad spectrum of eating- and weight-related problems. Furthermore, several examples of initiatives that have utilized an integrated approach to prevention are discussed.
Design:
Narrative review.
Conclusions:
We recommend a scenario in which the two fields share knowledge to enhance the difficult work of preventing and treating both ED and obesity.
To report on a new modelling approach developed for the assessing cost-effectiveness in obesity (ACE-Obesity) project and the likely population health benefit and strength of evidence for 13 potential obesity prevention interventions in children and adolescents in Australia.
We used the best available evidence, including evidence from non-traditional epidemiological study designs, to determine the health benefits as body mass index (BMI) units saved and disability-adjusted life years (DALYs) saved. We developed new methods to model the impact of behaviours on BMI post-intervention where this was not measured and the impacts on DALYs over the child's lifetime (on the assumption that changes in BMI were maintained into adulthood). A working group of stakeholders provided input into decisions on the selection of interventions, the assumptions for modelling and the strength of the evidence.
The likely health benefit varied considerably, as did the strength of the evidence from which that health benefit was calculated. The greatest health benefit is likely to be achieved by the 'Reduction of TV advertising of high fat and/or high sugar foods and drinks to children', 'Laparoscopic adjustable gastric banding' and the 'multi-faceted school-based programme with an active physical education component' interventions.
The use of consistent methods and common health outcome measures enables valid comparison of the potential impact of interventions, but comparisons must take into account the strength of the evidence used. Other considerations, including cost-effectiveness and acceptability to stakeholders, will be presented in future ACE-Obesity papers. Information gaps identified include the need for new and more effective initiatives for the prevention of overweight and obesity and for better evaluations of public health interventions.
A cognitive model of human learning with understanding is introduced. Empirical research supporting the model, which is called the generative model, is summarized. The model is used to suggest a way to integrate some of the research in cognitive development, human learning, human abilities, information processing, and aptitude-treatment interactions around the notion of transfer of experience and abilities.
This meta-analysis has two aims: (a) to address the main effects of problem based learning on two categories of outcomes: knowledge and skills; and (b) to address potential moderators of the effect of problem based learning. We selected 43 articles that met the criteria for inclusion: empirical studies on problem based learning in tertiary education conducted in real-life classrooms. The review reveals that there is a robust positive effect from PBL on the skills of students. This is shown by the vote count, as well as by the combined effect size. Also no single study reported negative effects. A tendency to negative results is discerned when considering the effect of PBL on the knowledge of students. The combined effect size is significantly negative. However, this result is strongly influenced by two studies and the vote count does not reach a significant level. It is concluded that the combined effect size for the effect on knowledge is non-robust. As possible moderators of PBL effects, methodological factors, expertise-level of students, retention period and type of assessment method were investigated. This moderator analysis shows that both for knowledge- and skills-related outcomes the expertise-level of the student is associated with the variation in effect sizes. Nevertheless, the results for skills give a consistent positive picture. For knowledge-related outcomes the results suggest that the differences encountered in the first and the second year disappear later on. A last remarkable finding related to the retention period is that students in PBL gained slightly less knowledge, but remember more of the acquired knowledge.
To assess the economic effect of the school-based obesity prevention program Planet Health on preventing disordered weight control behaviors and to determine the cost-effectiveness of the intervention in terms of its combined effect on prevention of obesity and disordered weight control behaviors.
On the basis of the intervention's short-term effect on disordered weight control behaviors prevention, we projected the number of girls who were prevented from developing bulimia nervosa by age 17 years. We further estimated medical costs saved and quality-adjusted life years gained by the intervention over 10 years. As a final step, we compared the intervention costs with the combined intervention benefits from both obesity prevention (reported previously) and prevention of disordered weight control behaviors to determine the overall cost-effectiveness of the intervention.
Middle schools.
A sample of 254 intervention girls aged 10 to 14 years.
The Planet Health program was implemented during the school years from 1995 to 1997 and was designed to promote healthful nutrition and physical activity among youth.
Intervention costs, medical costs saved, quality-adjusted life years gained, and cost-effectiveness ratio.
An estimated 1 case of bulimia nervosa would have been prevented. As a result, an estimated $33 999 in medical costs and 0.7 quality-adjusted life years would be saved. At an intervention cost of $46 803, the combined prevention of obesity and disordered weight control behaviors would yield a net savings of $14 238 and a gain of 4.8 quality-adjusted life years.
Primary prevention programs, such as Planet Health, warrant careful consideration by policy makers and program planners. The findings of this study provide additional argument for integrated prevention of obesity and eating disorders.
Public health attention to childhood obesity has increased in tandem with the growing epidemic, but despite this intense focus, successes in prevention have lagged far behind. There is a blind spot in our drive for childhood obesity prevention that prevents us from generating sufficiently broad solutions.
Eating disorders and the constellation of perilous weight-control behaviors are in that blind spot. Evidence is mounting that obesity and eating disorders are linked in myriad ways, but entrenched myths about eating disorders undermine our ability to see the full range of leverage points to target in obesity preventive intervention studies.
Our efforts to prevent childhood obesity can no longer afford to ignore eating disorders and the assemblage of related behaviors that persist unabated.
This Seminar adds to the previous Lancet Seminar about eating disorders, published in 2003, with an emphasis on the biological contributions to illness onset and maintenance. The diagnostic criteria are in the process of review, and the probable four new categories are: anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorder not otherwise specified. These categories will also be broader than they were previously, which will affect the population prevalence; the present lifetime prevalence of all eating disorders is about 5%. Eating disorders can be associated with profound and protracted physical and psychosocial morbidity. The causal factors underpinning eating disorders have been clarified by understanding about the central control of appetite. Cultural, social, and interpersonal elements can trigger onset, and changes in neural networks can sustain the illness. Overall, apart from studies reporting pharmacological treatments for binge eating disorder, advances in treatment for adults have been scarce, other than interest in new forms of treatment delivery.
Pediatric obesity has reached epidemic proportions in the USA and Europe. The use of BMI report cards is one approach to addressing the epidemic that is gaining popularity across the USA and in the UK.
Recent findings suggest that parents of overweight children underestimate child weight status and the majority of pediatric overweight and obesity goes undiagnosed in primary care settings in the USA. Although there is no argument against the efficacy of tracking a child's BMI and informing parents of their child's weight status, there is considerable controversy surrounding whether schools should be involved in BMI screening. Research on the efficacy of BMI report cards suggests that parental awareness of weight status is not improved by BMI report cards. Findings are inconclusive on whether BMI report cards lead to changes in weight-related health behaviors, and there is no evidence to suggest that report cards ultimately impact weight status. Additionally, research indicates that BMI report cards may increase dieting, a risk factor for both increased weight and eating disorders in adolescents.
Research does not suggest that BMI report cards will be effective in reducing rates of pediatric overweight and obesity. Instead, recent findings show that the potential for harm may outweigh possible benefits. States and countries that mandate the use of BMI report cards should make evaluation of these policies a priority.
Medical students must learn the principles of epidemiology and biostatistics to critically evaluate the medical literature. However, this subject has traditionally been difficult to teach. In 1997 at the Albert Einstein College of Medicine, the required first-year course in epidemiology and biostatistics was revised to use the case-discussion teaching method. In preparation for the course, experienced faculty participated in an intensive, two-day training workshop. The course, taught to 163 first-year medical students, was structured in two parts: (1) three lectures complemented by a detailed syllabus, followed by a multiple-choice midterm exam; and (2) six case-discussion seminars, followed by a short answer/essay final exam. There were seven case-discussion groups with 23-24 students each. The program was evaluated using subjective faculty feedback, examination scores, and student evaluation questionnaires. Faculty noted excellent student preparation and participation. Multiple-choice exam scores were comparable to those from earlier years, and a short answer/essay exam demonstrated good student mastery of the required material. Student evaluation was overwhelmingly positive, and significantly improved from prior years of the course. Positive student evaluations of the course using this teaching method continued over the next four years; National Board of Medical Examiners examination scores indicated success in mastery of the material; and student assessment of the course improved on the AAMC Graduation Questionnaire. This favorable experience suggests that case-discussion teaching can be employed successfully in teaching principles of epidemiology and biostatistics to medical students.
Calls for reforms in the ways we teach science at all levels, and in all disciplines, are wide spread. The effectiveness of the changes being called for, employment of student-centered, active learning pedagogy, is now well supported by evidence. The relevant data have come from a number of different disciplines that include the learning sciences, cognitive psychology, and educational psychology. There is a growing body of research within specific scientific teaching communities that supports and validates the new approaches to teaching that have been adopted. These data are reviewed, and their applicability to physiology education is discussed. Some of the inherent limitations of research about teaching and learning are also discussed.
Revisiting the cone of learning-Is it a reliable way to link instruction method with knowledge recall?
- Lord
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