Optimum nutritional support in adults receiving veno-venous extracorporeal membrane oxygenation is possible but underfeeding is common, especially in those with more severe organ dysfunction

Abstract

The aim of this study was to survey the nutrition training provided by UK medical schools and assess the importance of nutrition leads. A fourteen-item questionnaire was sent to academics representing all UK medical schools. The data generated was analysed using SPSS version 21.0 and significance was determined using a two-tailed Fischer's exact test. The response rate was 34% (11/32). Nutrition was given a high priority by two respondents, intermediate by eight and low by one. Students' knowledge was assessed in 8/11(73%) of responding medical schools. The mean total time devoted to nutrition throughout the courses was 8.4 hrs (range of 4 to 40+ hrs). Seven of 10 responded that they taught all four core nutrition topics as part of their undergraduate curriculum. Three of 9 responded that there was a nutrition thread throughout their curriculum. Five of 10 responded that there was a named nutrition lead. Three of 9 responded that their training was adequate. Of those who reported adequate training, all cited 'increased formal teaching time devoted to nutrition' and 'better organisation of the nutrition teaching' as improvements that facilitated adequate training. Of those who reported inadequate training, 83% cited 'lack of prioritisation' and 67% cited 'being unable to devote more teaching time to nutrition' and 'difficulty organising topics and teaching sessions' as hindrances towards improving training. The presence of a nutrition lead was associated with a trend to greater mean total time allocated to structured teaching (25.4 vs 16.2 hours), and greater likelihood of teaching all four core areas (5 of 5 vs 2 of 5, p¼0.08), but an equal likelihood of formally assessing nutrition knowledge (4 of 5 v. 4 of 5). In conclusion, indicators of good training appear to be more common in courses placing a higher priority on nutrition. Despite a decrease in the percentage of respondents reporting adequate training compared to a previous study in 2009 [1] (33% vs 50%), indicators of good training appear to have increased. This may reflect medical schools becoming more aware of the standards required as a result of the development of a standardised national nutrition curriculum [4]. A named nutrition lead may have a positive impact on nutrition training.