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Sousa JR, Afreixo V, Carvalho J, Silva P. Nutrition and Physical Activity Education in Medical School: A Narrative Review. Nutrients 2024; 16:2809. [PMID: 39203945 PMCID: PMC11357297 DOI: 10.3390/nu16162809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Revised: 08/10/2024] [Accepted: 08/19/2024] [Indexed: 09/03/2024] Open
Abstract
This review explores the diverse landscape of integrating nutrition and physical activity education into medical school curricula, focusing on the imperative role of physicians in promoting health through lifestyle changes. By examining global medical education structures, we uncovered disparities in nutrition and physical activity training, and highlighted the need for a shared framework to address international and regional challenges. Despite acknowledging the importance of both nutrition and physical activity, studies have consistently uncovered deficiencies in medical school curricula, especially in skills related to providing lifestyle advice and behavioral counseling. Survey studies among medical students have illuminated various perceptions and knowledge gaps, emphasizing the need for more comprehensive and mandatory nutrition and physical activity training. While acknowledging progress, challenges, such as time constraints, resource availability, and faculty expertise, persist. Integrating lifestyle education results in resistance, a demand for strategic communication, and faculty buy-ins. These findings underscore the importance of a holistic approach that balances theoretical knowledge, practical skills, and confidence that medical students need to promote effective nutrition and physical activity in healthcare.
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Affiliation(s)
- Joana Rodrigues Sousa
- Laboratory of Histology and Embryology, Institute of Biomedical Sciences Abel Salazar (ICBAS), Rua de Jorge Viterbo Ferreira n.° 228, 4050-313 Porto, Portugal
| | - Vera Afreixo
- Center for Research & Development in Mathematics and Applications (CIDMA), Department of Mathematics, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Joana Carvalho
- Research Centre in Physical Activity, Health and Leisure of University of Porto, 4200-450 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
| | - Paula Silva
- Laboratory of Histology and Embryology, Institute of Biomedical Sciences Abel Salazar (ICBAS), Rua de Jorge Viterbo Ferreira n.° 228, 4050-313 Porto, Portugal
- iNOVA Media Lab, ICNOVA-NOVA Institute of Communication, NOVA School of Social Sciences and Humanities, Universidade NOVA de Lisboa, 1069-061 Lisbon, Portugal
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Dumm M, Moll K, Helbach A, Leineweber CG, Böttrich T, Ruhtenberg CS, Polidori MC, Matthes J. Implementing nutritional medicine into medical curricula: A student-initiated course improves knowledge and attitudes. Clin Nutr ESPEN 2023; 57:181-189. [PMID: 37739654 DOI: 10.1016/j.clnesp.2023.06.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/22/2023] [Accepted: 06/27/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND & AIMS Although the risks and opportunities of nutrition in health trajectories are well known, it is rarely addressed in doctors' daily routine. This is partly related to physicians' lack of confidence in their ability to provide nutritional counselling, possibly due to insufficient training in medical school. Our study aimed at assessing the status quo of nutrition in the German medical curricula and the impact of a recently implemented, student-initiated online teaching initiative on perceived competence, knowledge and attitudes. METHODS "Eat This!" was the first Germany-wide initiative for online nutritional medicine (NM) education, consisting of 11 digital lectures on nutrition basics, nutrition medicine and public health nutrition. The contact time with NM during studies as well as the effects on students' attitudes towards NM, their self-perceived competence in NM and their nutrition knowledge were assessed from October 2020 to February 2021 in a cross-sectional as well as a prospective study using online questionnaires. RESULTS Over 1500 medical students from 42 German faculties participated in the lecture series and the online survey. One hundred and twenty-two students formed a control group. Although considering the topic relevant, students rated their training in NM as insufficient, in terms of both quality and quantity. Initially, they did not feel able to counsel patients and rated their knowledge as low. However, self-ratings and the score in a 33-item multiple-choice test knowledge improved by participating in Eat This! as did their attitude towards nutrition and planetary health. No such changes were observed in the control group of 122 students not attending the course. CONCLUSION Our results show that education in NM at German medical schools is perceived insufficient despite high student interest. But even low-threshold educational options like "Eat This!" can improve students' perceived competence, knowledge, and attitudes, and thus be an efficient and cost-effective way to address related deficits.
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Affiliation(s)
- Moritz Dumm
- University Hospital Cologne, Centre of Pharmacology, Gleueler Straße 24, 50931 Cologne, Germany; University of Cologne, Faculty of Medicine, Joseph-Stelzmann-Straße 20, 50931 Cologne, Germany; Gemeinschaftskrankenhaus Havelhöhe, Department Intensive Care, First Aid & Cardiology, Kladower Damm 221, 14089 Berlin, Germany
| | - Katharina Moll
- University of Hamburg, Faculty of Medicine, Martinistraße 52, 20246 Hamburg, Germany
| | - Anna Helbach
- Institute of General Practice, Faculty of Medicine, University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Can Gero Leineweber
- Medical Department B of Internal Medicine, Brandenburg Medical School, University Hospital Ruppin-Brandenburg, Fehrbelliner Straße 38, 16816, Germany
| | - Tim Böttrich
- University of Gießen, Faculty of Medicine, Klinikstraße 29, 35392 Gießen, Germany
| | | | - Maria Cristina Polidori
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany; Cologne Excellence Cluster on Cellular Stress-Responses in Aging-Associated Diseases (CECAD), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jan Matthes
- University Hospital Cologne, Centre of Pharmacology, Gleueler Straße 24, 50931 Cologne, Germany; University of Cologne, Faculty of Medicine, Joseph-Stelzmann-Straße 20, 50931 Cologne, Germany.
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Patel P, Kassam S. Evaluating nutrition education interventions for medical students: A rapid review. J Hum Nutr Diet 2022; 35:861-871. [PMID: 34842308 PMCID: PMC9546301 DOI: 10.1111/jhn.12972] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Unhealthy diets account for 20% of all deaths globally. Most medical schools do not sufficiently teach their students the clinical application of nutrition science. Evaluating the efficacy of nutrition education interventions is therefore important for their widespread implementation. METHODS A rapid review of the literature published between 2015 and 2020 was conducted to identify nutrition education interventions delivered to undergraduate medical students. The modified Kirkpatrick hierarchy score was used to evaluate the outcome measures. Study characteristics and outcomes were charted and discussed using narrative synthesis. Included studies were appraised using the MERSQI criteria. RESULTS Fifteen nutrition education interventions met the inclusion criteria. Twelve were from the USA and most were optional rather than compulsory. Interventions involved a mixture of methods including cooking sessions, lectures, and student-led programs. The content covered was variable and the median duration was 11 h (range 90 min to 75 h). The modified Kirkpatrick scores varied and the median MERSQI score was 12.8/18. No studies reported the use of national or standardised guidance to inform the learning objectives of the interventions. CONCLUSIONS The interventions reviewed are heterogenous in their nature and outcomes. This review highlights the advantages of utilising interprofessional learning, focusing on student's personal health behaviours and harnessing novel teaching methods such as hands-on cooking. Using national guidance to develop learning outcomes will help to standardise the content taught. Future studies may aim to use validated assessment tools and investigate the long-term impacts on delivery of care and patient outcomes.
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Affiliation(s)
- Priya Patel
- College of Medicine and Health, St Luke's CampusUniversity of ExeterExeterUK
| | - Shireen Kassam
- Department of HaematologyKings College HospitalDenmark HillLondon
- Faculty of Health and WellbeingUniversity of WinchesterWinchesterHampshire
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Keel T, Olvet DM, Cavuoto Petrizzo M, John JT, Dougherty R, Sheridan EM. 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. Nutrients 2021; 13:4081. [PMID: 34836343 PMCID: PMC8625690 DOI: 10.3390/nu13114081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/01/2021] [Accepted: 11/12/2021] [Indexed: 11/16/2022] Open
Abstract
Learning how to provide nutritional counseling to patients should start early in undergraduate medical education to improve the knowledge, comfort, and confidence of physicians. Two nutrition workshops were developed for first-year medical students. The first workshop, co-led by physicians and registered dieticians, focused on obtaining nutrition assessments. The second workshop focused on the appropriate dietary counseling of patients with chronic kidney disease and cardiovascular risk. We surveyed students before workshop 1, after workshop 1, and after workshop 2 to assess their perceptions of the value of physician nutrition knowledge and counseling skills as well as their own comfort in the area of nutritional knowledge, assessment, and counseling. We found a significant improvement in their self-assessed level of knowledge regarding counseling patients, in their comfort in completing a nutritional assessment, and in their confidence in advising a patient about nutrition by the end of the first workshop. By the time of the second workshop five months later, students continued to report a high level of knowledge, comfort, and confidence. The implementation of clinical nutrition workshops with a focus on assessment, management, and counseling was found to be effective in increasing student's self-assessed level of knowledge as well as their confidence and comfort in advising patients on nutrition. Our findings further support the previous assertion that clinical nutrition education can be successfully integrated into the pre-clerkship medical school curriculum.
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Affiliation(s)
| | - Doreen M. Olvet
- Department of Science Education, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, USA; (T.K.); (M.C.P.); (J.T.J.); (R.D.); (E.M.S.)
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