Background. Physicians are inadequately equipped to respond to the global obesity and nutrition-associated chronic disease epidemics. We investigated superiority of simulation-based medical education with deliberate practice (SBME-DP) hands-on cooking and nutrition elective in a medical school-based teaching kitchen versus traditional clinical education for medical students. Materials and Methods. A 59-question panel survey was distributed to an entire medical school twice annually from September 2012 to May 2014. Student diet and attitudes and competencies (DACs) counseling patients on nutrition were compared using conditional multivariate logistic regression, propensity score-weighted, and longitudinal panel analyses. Inverse-variance weighted meta-analysis (IVWM) was used for planned subgroup analysis by year and treatment estimates across the three methods. Results. Of the available 954 students, 65.72% (n = 627) unique students were followed to produce 963 responses. 11.32% (n = 109) of responses were from 84 subjects who participated in the elective. SBME-DP versus traditional education significantly improved fruit and vegetable diet (OR = 1.38, 95% CI: 1.07–1.79, p = 0.013) and attitudes (OR = 1.81, 95% CI: 1.40–2.35, p < 0.001) and competencies (OR = 1.72, 95% CI: 1.54–1.92, p < 0.001). Conclusions. This study reports for the first time superiority longitudinally for SBME-DP style nutrition education for medical students which has since expanded to 13 schools.

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A holistic environmental flows (EFlows) assessment, undertaken as part of Ecological Reserve determination studies for selected surface water, groundwater, estuaries and wetlands in the Usuthu/Mhlatuze Water Management Area, South Africa, led to recommendations for modified releases from the Jozini Dam to support the socially, economically and ecologically important Pongola Floodplain situated downstream of the dam. The EFlows study analysed various permutations of flow releases from the dam based on the recommendations of pre-dam studies, and augmented by more recent observations, inputs from farmers and fishermen who live adjacent to the floodplain and discussion with the operators of Jozini Dam. The EFlows method used, DRIFT, allowed for the incorporation of detailed information, data and recommendations from a decades-old research project on the Pongola Floodplain that was undertaken prior to the construction of the Jozini Dam into a modern-day decision-making framework. This was used to assess the impact of a series of different flow releases on nature and society downstream of the dam. It was concluded that, within historic volumetric allocations to the floodplain, a release regime could be designed that considerably aided traditional fishing and grazing without necessarily prejudicing other uses, such as agriculture.

Inadequate nutritional education can result in what Vetter et al. (2008) demonstrated as only 14% of responding physicians reporting confidence in patient nutritional counseling. Wash et al. (2011) of Harvard Medical School report their integrated nutritional curriculum was unable to produce changes in medical student attitude and nutritional competence. Tulane School of Medicine recently responded to this growing need by creating its innovative medical student curriculum through the Tulane Center for Culinary Medicine. The curriculum includes pre‐session peer‐reviewed readings, lecture sessions, live cooking demonstrations, and clinical discussions. Medical students then translate clinically relevant culinary lessons into leading their own community‐based cooking demos. Curriculum validation is accomplished through longitudinal collection of participant surveys of competence and nutritional attitudes, correlated with their standardized board exams in their third and fourth clinical years, as well as their graduate medical education as residents. Research support: Tulane University Center for Culinary MedicineGrant Funding Source: Tulane University Center for Culinary Medicine