Sandra Mandic1, Hamish Wilson2, Monika Clark-Grill2,3, Diana O’Neill4

1University of Otago, Active Living Laboratory, School of Physical Education, Sport and Exercise Sciences, Dunedin, New Zealand
2University of Otago, Dunedin School of Medicine, Dunedin, New Zealand
3University of Otago, Department of Primary Healthcare and General Practice, Wellington, New Zealand
4Ministry of Health, Wellington, New Zealand

A Physical Activity Learning Module Improves Medical Students’ Skills and Confidence for Advising Patients about Physical Activity

Monten. J. Sports Sci. Med. 2018, 7(1), 31-38 | DOI: 10.26773/mjssm.180304


Physicians’ knowledge, confidence, and prior training will influence physical activity (PA) counselling in general practice. This study evaluated the effects of a PA learning module on knowledge, skills, and attitudes toward PA counselling in third-year medical students. Students (n=216; age: 21.1±2.2 years; 47% males; participation rate 91%) participated in a PA learning module that included tutorials, lectures, and experiential learning through providing health checks to adults. At baseline and four months after the intervention, students completed a paper questionnaire about their awareness of current PA guidelines, benefits of, and attitudes toward PA advising, perceived competence/importance of PA advising skills, and personal PA habits. Data were analysed using a t-test for dependent samples and Chi-square analysis. After the intervention, students reported a greater awareness of the PA guidelines (pre vs. post: 3.1±1.1 vs. 3.8±0.9), the national PA initiative (4.2±0.9 vs. 4.7±0.7), the importance of PA counselling in general practice (4.1±0.8 vs. 4.3±0.8), and their confidence (3.2±0.9 vs. 3.9±0.8), and perceived competence (3.1±0.8 vs. 3.8±0.8, all p<0.05) in providing PA advice compared to baseline. In conclusion, exposure to a PA learning module increased medical students’ awareness and knowledge of the current PA guidelines and improved their confidence and perceived competence in providing PA advice. However, even after the training, students on average perceived themselves to be only moderately competent in providing PA advice. Therefore, clinical training for medical students should be designed to improve students’ competence and skills in PA counselling.


Medical students, education, physical activity, physical activity advising, curriculum, intervention

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Abramson, S., Stein, J., Schaufele, M., Frates, E., & Rogan, S. (2000). Personal exercise habits and counseling practices of primary care physicians: a national survey. Clinical Journal of Sports Medicine, 10(1), 40-48.

Connaughton, A. V., Weiler, R. M., & Connaughton, D. P. (2001). Graduating medical students’ exercise prescription competence as perceived by deans and directors of medical education in the United States: implications for Healthy People 2010. Public Health Reports, 116(3), 226-234.

Croteau, K., Schofield, G., & McLean, G. (2006). Physical activity advice in the primary care setting: results of a population study in New Zealand. Australian and New Zealand Journal of Public Health, 30(3), 262-267.

Dacey, M. L., Kennedy, M. A., Polak, R., & Phillips, E. M. (2014). Physical activity counseling in medical school education: a systematic review. Medical Education Online, 19(1), 24325.

Dyrbye, L. N., Satele, D., & Shanafelt, T. D. (2017). Healthy Exercise Habits Are Associated With Lower Risk of Burnout and Higher Quality of Life Among U.S. Medical Students. Academic Medicine. 92(7):1006-1011

Eakin, E. G., Brown, W. J., Marshall, A. L., Mummery, K., & Larsen, E. (2004). Physical activity promotion in primary care: bridging the gap between research and practice. American Journal of Preventive Medicine, 27(4), 297-303.

Elley, C. R., Kerse, N., Arroll, B., & Robinson, E. (2003). Effectiveness of counselling patients on physical activity in general practice: cluster randomised controlled trial. British Medical Journal, 326(7393), 793.

Frank, E., Hedgecock, J., & Elon, L. K. (2004). Personal health promotion at US medical schools: a quantitative study and qualitative description of deans’ and students’ perceptions. BMC Medical Education, 4(1), 29.

Frank, E., Rothenberg, R., Lewis, C., & Belodoff, B. F. (2000). Correlates of physicians’ prevention-related practices. Findings from the Women Physicians’ Health Study. Archives of Family Medicine, 9(4), 359-367.

Frank, E., Tong, E., Lobelo, F., Carrera, J., & Duperly, J. (2008). Physical activity levels and counseling practices of U.S. medical students. Medicine & Science in Sports & Exercise, 40(3), 413-421.

Harsha, D. M., Saywell, R. M., Jr., Thygerson, S., & Panozzo, J. (1996). Physician factors affecting patient willingness to comply with exercise recommendations. Clinical Journal of Sport Medicine, 6(2), 112-118.

Haskell, W. L., Lee, I. M., Pate, R. R., Powell, K. E., Blair, S. N., Franklin, B. A., . . . American Heart, A. (2007). Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation, 116(9), 1081-1093.

Jones, P. R., Brooks, J. H., & Wylie, A. (2013). Realising the potential for an Olympic legacy; teaching medical students about sport and exercise medicine and exercise prescribing. British Journal of Sports Medicine, 47(17), 1090-1094.

Keats, M. R., Culos-Reed, S. N., & Courneya, K. S. (2007). An examination of the beliefs, attitudes and counselling practices of paediatric oncologists toward physical activity: A provincial survey. Paediatrics and Child Health, 12(4), 289-293.

Mandic, S., Wilson, H., Clark-Grill, M., & O’Neill, D. (2017). Medical students’ awareness of the links between physical activity and health. Montenegrin Journal of Sports Science and Medicine. 6(2), 5–12.

Ministry of Health. (2016). Green Prescriptions. Retrieved from

Rogers, L. Q., Bailey, J. E., Gutin, B., Johnson, K. C., Levine, M. A., Milan, F., . . . Sherman, S. E. (2002). Teaching resident physicians to provide exercise counseling: a needs assessment. Academic Medicine, 77(8), 841-844.

Rogers, L. Q., Gutin, B., Humphries, M. C., Lemmon, C. R., Waller, J. L., Baranowski, T., & Saunders, R. (2006). Evaluation of internal medicine residents as exercise role models and associations with self-reported counseling behavior, confidence, and perceived success. Teaching and Learning in Medicine, 18(3), 215-221.

Sherman, S. E., & Hershman, W. Y. (1993). Exercise counseling: how do general internists do? Journal of General Internal Medicine, 8(5), 243-248.

Swinburn, B. A., Walter, L. G., Arroll, B., Tilyard, M. W., & Russell, D. G. (1998). The green prescription study: a randomized controlled trial of written exercise advice provided by general practitioners. American Journal of Public Health, 88(2), 288-291.

Vallance, J. K., Wylie, M., & MacDonald, R. (2009). Medical students’ self-perceived competence and prescription of patient-centered physical activity. Preventive Medicine, 48(2), 164-166.

Walsh, J. M., Swangard, D. M., Davis, T., & McPhee, S. J. (1999). Exercise counseling by primary care physicians in the era of managed care. American Journal of Preventive Medicine, 16(4), 307-313.

Warburton, D. E., Nicol, C. W., & Bredin, S. S. (2006). Health benefits of physical activity: the evidence. Canadian Medical Association Journal, 174(6), 801-809.

Wee, C. C., McCarthy, E. P., Davis, R. B., & Phillips, R. S. (1999). Physician counseling about exercise. JAMA, 282(16), 1583-1588.

World Health Organization. (2004). Global strategy on diet, physical activity and health. Geneva, Switzerland: WHO Press.

World Health Organization. (2010). Global Recommendations on Physical Activity for Health. Geneva, Switzerland: WHO Press.

World Health Organization. (2013). Global action plan for the prevention and control of NCDs 2013-2020. Retrieved from

World Health Organization. (2015). Health Topics: Physical Activity. Retrieved from