Using behavior change plans to improve medical student self-care

Purpose: To describe an innovative approach to teaching medical students the principles and practice of health behavior change and self-care using a behavior change plan (BCP). Method: Second-year medical students at Northwestern University Feinberg School of Medicine (n = 343) took a required Healthy Living unit in 2008 or 2009. They completed a BCP project in which they selected a personal behavior to change (exercise, nutrition, sleep, personal habits/hygiene, study/work habits, or mental/emotional health), set a goal, tracked progress, and self-assessed success. The authors employed a one-group posttest-only design to conduct a quantitative analysis and a qualitative evaluation of students' BCPs and their attitudes concerning the project. Results: Among the 343 students, 299 (87.2%) set BCP goals related to exercise, nutrition, or sleep. BCP outcomes varied: 139 students (40.5%) achieved their goal, 170 (49.6%) failed to do so, and 34 (9.9%) were uncertain. Factor analysis produced two independent attitude scales: utility (α = .80) and burden (α = .67). Logistic regression showed that success approached statistical significance only in the sleep behavior category and for the utility attitude scale. Qualitative case reports provide insights about BCP targets, management, and results. After completing the assignment, 274 (79.9%) of the students considered themselves to be healthier, and 281 (81.9%) indicated they would use the process again. Conclusions: Completing a BCP is a valuable and effective exercise that enables medical students to practice the strategies and skills and experience the obstacles of changing health behavior.