Educating Dental Students About Diet-Related Behavior Change: Does Experiential Learning Work?

Relationship between erosive tooth wear and possible etiological factors among dental students

OBJECTIVES

The aim of this study was to assess the relationship between erosive tooth wear (ETW) and possible etiological factors in a group of dental students.

MATERIALS AND METHODS

A total of 126 dental students from a public dental school were included in this study. A questionnaire was used to investigate the possible etiological factors related to ETW. The Basic Erosive Wear Examination (BEWE) criteria were used to examine the status of ETW. A univariable and multivariable logistic regression models were used to assess the relationship between the presence of ETW and explanatory variables.

RESULTS

Univariable analysis revealed that taking acidic foods and alcohol more than 4-5 times per week increases the odds of ETW by 6.043 and 2.532 times, respectively, and taking dairy products, fruit juice, and milk more than 4-5 times per week decreases the likelihood of ETW by 61%, 66%, and 80%, respectively. The results of multivariable regression analysis showed that the frequency of consumption of especially acidic foods significantly increased the risk of ETW (OR = 9.981, 95% CI 3.577-27.849, p < 0.001).

CONCLUSIONS

Although the ETW status of dental students, who are the future dentists, varies depending on different possible etiological factors, especially the consumption of acidic foods has increased the risk of ETW approximately 10 times.

CLINICAL RELEVANCE

The findings highlight the high relevance of ETW, especially with acidic food consumption, and the importance of controlling potential etiological factors in dental students.

Brief, effective experience to increase first-year medical students' nutrition awareness

Background: Wellness is an important concept for medical students to learn, both for their own health and for their patients. Since nutrition is an essential part of one's wellness that can positively or negatively impact one's health, it is important for medical students to learn approaches to nutritional wellness. Studies have shown that physicians' nutrition attitudes and clinical practices are positively correlated with their dietary practices.Objective: Here, we describe a brief nutrition-based education experience for first-year students offered at the start of the medical school curriculum that is designed to increase their nutrition awareness.Design: The nutrition experience involved five components: 1) having students complete three 24-hour food recalls; 2) comparing their recalls to nutrient standards; 3) emphasizing strategies that include simple, nutritionally sound food choices and preparation; 4) surveying students on their implementation of personal healthy nutritional strategies; and 5) requesting future recommendations for modifying the educational experience.Results: Most students' diets did not meet the recommended dietary levels for several nutrients, and these deficiencies corresponded to specific food group inadequacies. Forty percent of the students responded to a three-month follow-up survey. Of these students, 46% implemented one of the presented strategies to improve their food intake. Most changes included the addition or deletion of a particular food. Seventy-three percent recommended repeating the program in the future.Conclusions: We demonstrate that a brief 2.5-hour nutrition wellness experience can increase nutrition awareness and promote dietary change in incoming medical students. Many felt that the experience was valuable and recommended offering a similar experience to future classes.

Trends in the Number of Behavioural Theory-Based Healthy Eating Interventions Inclusive of Dietitians/Nutritionists in 2000-2020

Nutrition interventions developed using behaviour theory may be more effective than those without theoretical underpinnings. This study aimed to document the number of theory-based healthy eating interventions, the involvement of dietitians/nutritionists and the behaviour theories employed from 2000 to 2020. We conducted a review of publications related to healthy eating interventions that used behaviour change theories. Interventional studies published in English between 2000 and 2020 were retrieved from searching Medline, Cinahl, Embase, Psycinfo and Cochrane Central. Citation, country of origin, presence or absence of dietitian/nutritionist authors, participants, dietary behaviours, outcomes, theories and any behaviour change techniques (BCTs) stated were extracted. The publication trends on a yearly basis were recorded. A total of 266 articles were included. The number of theory-based interventions increased over the two decades. The number of studies conducted by dietitians/nutritionists increased, but since 2012, increases have been driven by other researchers. Social cognitive theory was the most used behaviour theory. Dietitians/nutritionists contributed to growth in publication of theory-based healthy eating interventions, but the proportion of researchers from other professions engaged in this field increased markedly. The reasons for this growth in publications from other professions is unknown but conjectured to result from greater prominence of dietary behaviours within the context of an obesity epidemic.

Advancing Nutrition Education, Training, and Research for Medical Students, Residents, Fellows, Attending Physicians, and Other Clinicians: Building Competencies and Interdisciplinary Coordination

Nutrition plays an important role in health promotion and disease prevention and treatment across the lifespan. Physicians and other healthcare professionals are expected to counsel patients about nutrition, but recent surveys report minimal to no improvements in medical nutrition education in US medical schools. A workshop sponsored by the National Heart, Lung, and Blood Institute addressed this gap in knowledge by convening experts in clinical and academic health professional schools. Representatives from the National Board of Medical Examiners, the Accreditation Council for Graduate Medical Education, the Liaison Committee on Medical Education, and the American Society for Nutrition provided relevant presentations. Reported is an overview of lessons learned from nutrition education efforts in medical schools and health professional schools including interprofessional domains and competency-based nutrition education. Proposed is a framework for coordinating activities of various entities using a public-private partnership platform. Recommendations for nutrition research and accreditation are provided.

A whole-food plant-based experiential education program for health care providers results in personal and professional changes

Diet-related diseases are the primary contributor to morbidity and mortality. The risk for these diseases can be reduced with a whole-food plant-based (WFPB) diet, but most people are never counseled on this dietary pattern. An experiential education program was designed and conducted in which sample of 30 nurse practitioners, registered nurses, and physicians learned about and followed a WFPB diet for 3 weeks. The objective was for the health care providers to increase their knowledge and acceptance of WFPB diets and increase their likelihood of counseling patients on this dietary pattern. Participants completed preintervention and postintervention questionnaires assessing dietary intake, knowledge, weight, mood, energy, benefits, barriers, self-efficacy, and likelihood of continuing to follow, or counsel patients about a WFPB diet. Participants decreased intake of animal-derived foods, increased intake of WFPB foods, had improvements in mood and energy, and lost weight. Perceived barriers to following and counseling about a WFPB diet declined and self-efficacy improved. Participants were likely to continue a WFPB diet and discuss the diet with their patients. The three-week intervention changed providers' knowledge, skills, and attitudes about WFPB diets. If nurse practitioners and other providers accept WFPB diets, more patients may be educated on this dietary pattern, helping to reduce the burden of diet-related chronic diseases.

Evaluation of an Experiential and Self-Learning Approach to Teaching Evidence-Based Decision Making to Dental Students

The aim of this study was to evaluate the impact on predoctoral dental students of an experiential and self-learning pedagogical approach to evidence-based decision making. Dental students at one U.S. dental school in 2014 and 2015 participated in an evidence-based decision making course that consisted of minimal lecturing, learning through assigned readings and open-book online quizzes, and individual assignments to reach an evidence-based decision on a clinically relevant question. Before and after the course, each cohort completed a validated survey assessing students' knowledge, attitudes, access of evidence, and confidence related to evidence-based practice. In 2014, of 43 students enrolled in the course, all 43 (100%) completed the pre-course survey, and 33 (77%) completed the post-course survey. In 2015, of 35 students enrolled in the course, all 35 (100%) completed the pre-course survey, and 34 (97%) completed the post-course survey. Of those, the identifier codes for 23 students in 2014 and 25 students in 2015 matched for the pre-course and post-course surveys, allowing direct comparisons. Both cohorts of students showed a significant increase in knowledge regarding critical appraisal of the literature from the pre-course survey results to after the course (p<0.001). Students' reported frequency of accessing evidence from various sources also significantly increased from before to after the course for both cohorts (p<0.01). Students' confidence in evaluating various aspects of a published research report also increased significantly from before to after the course for both cohorts (p<0.001). However, no consistent change was found in students' attitudes about evidence-based practice. In this study, an experiential and self-learning approach to teaching evidence-based decision making in the classroom appeared to be successful in improving students' knowledge, use of evidence, and confidence in critical appraisal skills, though it did not have a consistent impact on their attitudes about evidence-based practice.

Attitudes and barriers to providing dietary advice: perceptions of dental hygienists and oral health therapists

OBJECTIVES

Effective dietary counselling in a dental setting can significantly reduce the risk of oral disease. However, studies suggest that dental professionals are not instigating dietary advice on a regular basis, and there is a lack of current information of the barriers experienced that limit the delivery of dietary advice. The aim of this study was to investigate the current attitudes and practice behaviours of dental hygienists and oral health therapists in NSW, Australia, regarding dietary advice, and identify the barriers that limit its delivery.

METHODS

A convenience sample of dental hygienists and oral health therapists were surveyed using a mail-out questionnaire. The questionnaire investigated the demographic data of participants, the attitudes and practice behaviours of participants, the perceived barriers and current dietary resources accessed by participants.

RESULTS

Of 987 dental hygienists and oral health therapists, 426 participants responded. The study results suggest that many dental hygienists and oral health therapists have positive beliefs regarding the importance of dietary counselling. However, there are a multitude of barriers preventing the delivery of dietary advice; these include time, patient compliance, patient knowledge of nutrition topics, personal counselling skills and practitioners' knowledge of nutrition.

CONCLUSION

Whilst dental hygienists and oral health therapists recognize the importance of diet and have positive attitudes towards providing dietary advice to patients, this study identified many barriers preventing implementation in practice. This information may be used to develop targeted strategies aimed at overcoming these barriers and improving behaviours.