P2.201: The Impact of a Service-Learning Program on Medical Students’ Self-Efficacy in Lifestyle Counseling

Background: Lifestyle counseling and motivational interviewing are essential skills for today’s healthcare professionals. Studies show that medical students lack confidence in these domains, particularly in pediatric nutrition counseling. Service-learning opportunities can fill a critical gap in medical education for medical students, providing hands-on experience with the complex realities of behavioral choices outside the clinical setting. Team Kid Power! (KiPOW!) is a school-based program which implements health policy in underserved communities and employs evidence-based methods to improve pediatric diet and exercise practice. Trained medical student KiPOW! mentors visit schools weekly to mentor elementary school students on healthy lifestyle behaviors. This study aims to determine the impact that participation in KiPOW! as a mentor has on medical student self-efficacy in lifestyle counseling.

Methods: Medical students at KiPOW! Weill Cornell Medical College underwent a one-day theoretical and practical orientation, then mentored students on healthy lifestyle behaviors weekly by teaching an interactive health curriculum, sharing a healthy snack to model healthy behaviors, and leading students in active play. The Childhood Obesity Prevention Self-Efficacy (COPS-E) survey, an 18-question validated instrument, was electronically distributed via REDCap to medical students before and after participation in the KiPOW! mentor orientation and at least one after-school session. Data collection took place over two academic years with identical orientations and mentoring sessions. Goal sample size was 100.

Results: A total of 104 responses (62 pre-surveys; 42 post-surveys) were collected from September 2023 to December 2024. Independent t-test analyses comparing pre- and post-survey responses across all 18 COPS-E survey questions demonstrated a statistically significant increase in confidence (p < 0.05) in lifestyle counseling after participation in KiPOW!. This includes greater confidence in describing to a child how to choose healthy foods to consume (p=2 ×10-7), how to increase fruit and vegetable consumption (p=2 ×10-7), and discussing the health impacts of obesity with a child’s family members (p=2 ×10-4) (Figure 1). Furthermore, Spearman’s rank-order correlation analysis revealed that participation in a greater number of KiPOW! sessions was associated with increased confidence in pediatric nutrition counseling (Figure 2). To corroborate these findings, a paired t-test analysis was conducted using data from 17 students who completed both pre- and post-surveys. Among these paired responses, 10 of the 18 COPS-E survey questions demonstrated statistically significant increases in confidence, with all questions trending toward improved self-efficacy.

Conclusion: Medical student mentors gained confidence across multiple subdomains of pediatric lifestyle counseling through KiPOW! participation. Level of confidence in pediatric nutrition counseling was directly related to time as a mentor. Service-learning initiatives like KiPOW! can provide opportunities for medical students to improve their self-efficacy in lifestyle counseling. They can supplement learning in traditional classroom and clinical environments while also improving pediatric healthcare delivery.