How does self-perceived nutrition competence change over time during medical training? A prospective longitudinal observational study of New Zealand medical students

Abstract

ObjectivesMedical nutrition education aims to equip doctors with nutrition knowledge, skills, attitudes and confidence to counsel patients to improve their diet. This study aimed to describe changes in medical students’ self-perceived nutrition competence at three time points during medical training.DesignProspective longitudinal observational study.SettingThe University of Auckland, School of Medicine.ParticipantsYear 2 medical students (phase 1, preclinical) were surveyed in May 2016. Participants repeated the survey in February 2018 as Year 4 students and July 2019 (phase 2, clinical) as Year 5 students.Primary outcome measurePrimary outcome measure was self-perceived nutrition competence measured using the validated NUTrition Competence (NUTCOMP) survey.ResultsIn 2016, 102 of 279 eligible Year 2 medical students completed the survey (response rate (RR 36.7%)). In 2018, 89 Year 4 students repeated the survey (RR 87.3%) and 30 students as Year 5 students in 2019 (RR 29.41%). There was a significant increase in total NUTCOMP scores (knowledge, skills, confidence to counsel and attitude towards nutrition) between Year 2 and Year 4 (p=0.012). There was a significant increase in the confidence to counsel construct (mean difference 7.615, 95% CI 2.291 to 12.939, p=0.003) between Year 2 and Year 4. Constructs with lowest scores at all time points were nutrition knowledge and nutrition skills. There was clear desire for more nutrition education from all students: Year 2 (mean=3.8 out of 5 (1.1)), Year 4 (mean=3.9 out of 5 (0.9)), Year 5 (mean=3.8 out of 5 (0.8)).ConclusionMedical students’ self-perceived nutrition competence in providing nutrition care increased modestly at three points throughout medical training. There remains opportunity for further supporting medical students to increase their competence in nutrition care, which could be achieved through mandatory and greater medical nutrition education.

An exploration of the self-perceived nutrition competencies of pharmacists

“…The positive association between nutrition education and greater confidence in nutrition knowledge, skills, attitudes and counselling and communication techniques was broadly in line with previous studies. 29 , 30 A low confidence in keeping up to date with peer-reviewed evidence in nutrition and chronic disease and the ability to formulate a meal plan for individuals was reported in our study. Similarly, low confidence in these questions have been reported in other studies on a mixed samples of qualified healthcare professionals 29 , 31 and personal trainers.…”

Nutrition in Healthcare Education

“…However, given the small sample sizes, this cannot be stated for certain. In contrast to Crowley et al (2020), whose authors reported that across-the-board, students gave themselves low ratings of confidence in nutrition skills, participants in this project had an average pre-intervention score of 3.36, closer to <somewhat confident= and postintervention average score of 3.75 closer to the <very confident= ranking. However, in concordance with the Crowley et al ( 2020) study, all participants, regardless of the intervention, agreed/strongly agreed that they needed further nutrition education to help support them in their healthcare role.…”

“…Residents' barriers to learning and providing nutrition counseling included: lack of time, lack of reimbursement, perceived lack of interest in nutrition, and lack of interest of preceptors in teaching nutrition. Along similar lines, Crowley et al (2020) found that limited exposure to nutrition experts, a lack of interprofessional nutrition collaboration, and a lack of role modeling of nutrition care were all major barriers to students9 learning. Furthermore, even if students received nutrition education in the didactic portion of their learning, it was rare that they experienced any clinical nutrition learning (Crowley et al, 2020).…”

“…Along similar lines, Crowley et al (2020) found that limited exposure to nutrition experts, a lack of interprofessional nutrition collaboration, and a lack of role modeling of nutrition care were all major barriers to students9 learning. Furthermore, even if students received nutrition education in the didactic portion of their learning, it was rare that they experienced any clinical nutrition learning (Crowley et al, 2020). Most residents and medical students lack the opportunity to observe and learn evidence-based nutrition practices from physicians with up-to-date nutrition knowledge or other licensed nutrition experts (Adams et al, 2015).…”

“…The United States is not the only country with inadequate hours devoted to nutrition education. Crowley et al (2020) found that medical students in New Zealand also struggled with nutrition competence. The students consistently gave low ratings of their self-perceived nutrition skills and knowledge throughout the program and at all points in the study the participants marked a high need for more nutrition education.…”