The NECTAR-Study: development of nutrition modules for general practice vocational training; determinants of nutrition guidance practices of GP-trainees

Abstract

Objective: To identify determinants of nutrition guidance practices of general practitioner-trainees (GPtrainees), to investigate whether these determinants differ from those found by experienced general practitioners; to reveal educational directions towards the development of computer-based instruction on nutrition. Design: Cross-sectional study by means of validated questionnaires. Subjects: All GP-trainees in training at the eight university departments for vocational training in the Netherlands in September, 1998 (n 985). Main outcome measures: Reliability of determinants of nutrition guidance practices was calculated by means of Crohnbach's alpha. The mechanism of action of determinants was identi®ed by means of linear structural relationship analysis (LISREL) using a model developed for GPs. Results: Crohnbach's alphas for factors ranged from 0.58 ± 0.90. The empirical GP-trainee-data ®tted with the corresponding GP-model on the mechanism of action. Conclusions: The same predisposing factors, driving forces and barriers as found with GPs were identi®ed with GP-trainees. Comparing the GP-and GP-trainee-models, only minor differences were found in the path coef®cients between factors. Lack of nutrition training and education proved to be of great in¯uence on the extent of nutrition information given. The GP-trainee-model will be of use in developing computer-based instruction on nutrition. It is expected that GPs may also bene®t from this instruction.

Nutrition Knowledge, Attitudes, and Confidence of Australian General Practice Registrars

“…More than 80% of the registrars in the present study recollected receiving education on nutrition/lifestyle strategies to reduce cardiovascular risk, but it is of concern that only one-third recalled being asked to actually demonstrate their nutrition knowledge. In one other study of GP trainees, in Netherlands, participants agreed that a lack of nutrition training and education was a vital influence on the extent of nutrition information given to patients, the same barriers as for GPs in that country [18]. If medical schools wish to ensure that all graduates exhibit basic nutrition competencies, then it is fundamental that students are provided with assessment opportunities to demonstrate competency.…”

Australian general practitioners' views regarding providing nutrition care: results of a national survey

“…Internationally, there is evidence that when GPs do not feel confident in providing nutrition care to patients, they do not provide it as often or as appropriately as would be ideal. [26][27][28] This suggests that there are gaps in GPs' nutrition knowledge which influence the frequency and quality of nutrition care provided to patients. Future strategies to improve the frequency and quality of nutrition care provided by GPs is warranted given the public health priority of supporting Australians to have healthy dietary behaviours.…”

Present and future of nutrition guidance : lifestyle advice in primary care

“…The title of the second Heelsum workshop (1998) suggested ambiguity and at the same time a sense of realism: "Family doctors and patients: is effective nutrition interaction possible?" (63,(67)(68)(69)(70)(71)(72)(73)(74)(75)(76). The answer was in short: YES, but with quite a number of prerequisite contextual factors.…”