Implementation of an Interprofessional Nutrition Workshop to Integrate Nutrition Education into a Preclinical Medical School Curriculum

Abstract

Objective: The patient-physician encounter provides an ideal opportunity to assess a patient's dietary history and its impact on total health. However, nutrition assessments and counseling in physician-patient encounters is often lacking. Insufficient nutrition education during medical school may lead to insecurity in assessing and counseling patients. Methods: Physicians and registered dietitians (RD) co-developed and co-facilitated a nutrition workshop for first-year medical students. Goals included increasing recognition of nutrition's impact on health and promoting student confidence and skills when attaining a nutrition history, assessing risk factors, and advising. Results: Seventy percent of students attested to having "sufficient" knowledge to counsel a patient on nutrition after the session compared to 38% before (Z¼ À4.46, p < 0.001). Sixty eight percent felt comfortable completing a nutritional assessment after the session compared to 35% before (Z¼ À4.30, p < 0.001). Sixty-three percent felt confident in advising patients about nutrition after the session compared to 32% before (Z¼ À4.20, p < 0.001). Students also significantly outperformed a control cohort on a nutrition-related component of an Objective Standardized Clinical Examination. Conclusions: Clinical nutrition education can be successfully integrated into the medical school curriculum as early as the first year. Interprofessional collaboration with RDs provided evidencebased content and authentic clinical experience in both the development of the workshop and in facilitating student discussion.

Impact of an Expansion of a Clinical Nutrition Curriculum on Pre-Clerkship Medical Students’ Perception of Their Knowledge and Skills Related to Performing a Nutritional Assessment

“…Prior to attending the Nutrients 2021, 13, 4081 6 of 8 nutrition workshop, only half of our medical students felt that they had sufficient medical knowledge to counsel a patient on nutritional matters, and only a third felt comfortable in completing a nutritional assessment. After the first workshop, students reported that they had adequate knowledge to counsel a patient on nutrition matters, felt comfortable completing a nutrition assessment, and felt confident advising patients about nutrition, which is consistent with our previous findings [12].…”

“…Enhancing confidence is crucial, as it breaks down the insecurity barrier preventing students counseling patients on nutrition and increases their self-efficacy. The design of our workshop was structured similarly to a previous nutrition workshop carried out at ZSOM and aligns with the American Nutrition Association's personalized nutrition model [12,20]. Our workshops helped to integrate the basic science and clinical concepts taught in the existing curriculum using realistic and common patient presentations as the context for learning nutrition concepts and practicing important skills.…”

“…Finally, there was a lack of objective data regarding the effects of the nutrition workshop. In a previous study, we evaluated objective data from student performance using an observed structured clinical exam (OSCE) station to assess the impact of the required nutrition workshop [12]. We planned to evaluate students regarding their nutrition counseling skills during an OSCE; however, due to the COVID-19 pandemic OSCEs were modified and not completed in person.…”

“…Reforming nutrition education, such as incorporating culinary medicine courses into UME curricula that offer a hands-on approach to learning nutrition, has been effective in increasing students' nutritional knowledge and their confidence in providing nutrition and obesity counseling [11]. Other methods of applied learning, such as practical nutrition electives and diet behavior electives, have also shown success at various US medical schools [12]. Our previous work demonstrated that having students apply their knowledge of nutrition in case-based scenarios led to an improvement in their perceived knowledge, comfort, and confidence in providing nutrition counseling to patients [12].…”

“…Other methods of applied learning, such as practical nutrition electives and diet behavior electives, have also shown success at various US medical schools [12]. Our previous work demonstrated that having students apply their knowledge of nutrition in case-based scenarios led to an improvement in their perceived knowledge, comfort, and confidence in providing nutrition counseling to patients [12].…”