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Abu Farha RJ, Zein MH, Al Kawas S. Introducing integrated case-based learning to clinical nutrition training and evaluating students' learning performance. J Taibah Univ Med Sci 2021; 16:558-564. [PMID: 34408613 PMCID: PMC8348321 DOI: 10.1016/j.jtumed.2021.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 01/09/2023] Open
Abstract
Objectives Clinical nutrition training is an essential course for clinical nutrition and dietetics (CN&D) students. The training combines theoretical knowledge with practical skills. The goal is to prepare competent graduates for future practice. Case-based learning is an active learning method based on cases from the clinical setting. This study aimed to introduce an integrated case-based learning (ICBL) method to the clinical training of a cohort of CN&D students and to evaluate its impact on the students’ knowledge of nutrition care process. Methods This action research project employed an ICBL-method of teaching in the clinical training of senior students in the CN&D course at the University of Sharjah, United Arab Emirates. Ten integrated case-based learning sessions were conducted with 29 students. The record of the nutrition care process was used to evaluate the learners' performance through a pretest-posttest mechanism. Furthermore, a focus group interview was conducted to determine the impact of the ICBL-based training on the students' learning experience. Results All of the students (100%) showed improvement in their learning. There was a 55% improvement in their grades. There was also self-perceived improvement of their life-long learning skills after the ICBL sessions. Conclusion Integraed case-based learning positively influenced learning among CN&D students. Consequently, the students were able to describe appropriate and individualized nutritional care plans. The students were satisfied with the training and considered ICBL to be an effective method of clinical training.
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Affiliation(s)
- Rand J Abu Farha
- Master's in Leadership in Health Professions Education, College of Medicine, University of Sharjah, United Arab Emirates
| | - Mona H Zein
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Sausan Al Kawas
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, United Arab Emirates
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2
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Caccialanza R, De Lorenzo F, Lobascio F, Gnagnarella P, Iannelli E, Traclò F, Delrio P, Tancredi R, Pedrazzoli P. Nutritional care in cancer patients: Initiatives and perspectives of the Italian Intersociety Working Group for Nutritional Support in Cancer Patients. Nutrition 2021; 91-92:111358. [PMID: 34303958 DOI: 10.1016/j.nut.2021.111358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/07/2021] [Accepted: 05/18/2021] [Indexed: 01/07/2023]
Abstract
Malnutrition is a frequent comorbidity in people with cancer, associated with poor tolerance of anticancer treatments, prognosis, and quality of life. Despite the abundance of scientific literature supporting this evidence and the availability of international guidelines for managing nutritional care in people with cancer, attitudes about this issue still vary considerably among oncologists, to the point that many patients who are malnourished do not receive adequate nutritional support. In view of this, the Italian Association of Medical Oncology, the Italian Society of Artificial Nutrition and Metabolism, and the Italian Federation of Volunteer-based Cancer Organizations implemented in 2016 a collaborative working group and initiated a structured project called Integrating Nutritional Therapy in Oncology, with the aim of increasing oncologists' awareness of nutritional issues and consequently improving the nutritional care of cancer patients in Italy. In 2019, the Italian Society of Oncological Surgery and the Technical Scientific Association of Food, Nutrition and Dietetics joined the working group. In this article, we present the updated initiatives and the perspectives of this intersociety project.
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Affiliation(s)
- Riccardo Caccialanza
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | | | - Federica Lobascio
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Patrizia Gnagnarella
- Division of Epidemiology and Biostatistics, European Institute of Oncology IRCSS, Milan, Italy
| | | | - Francesca Traclò
- Italian Federation of Volunteer-based Cancer Organizations, Rome, Italy
| | - Paolo Delrio
- Colorectal Surgical Oncology-Abdominal Oncology Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione Giovanni Pascale IRCCS, Naples, Italy
| | - Richard Tancredi
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Paolo Pedrazzoli
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Internal Medicine, University of Pavia, Pavia, Italy
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3
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Van Horn L, Lenders CM, Pratt CA, Beech B, Carney PA, Dietz W, DiMaria-Ghalili R, Harlan T, Hash R, Kohlmeier M, Kolasa K, Krebs NF, Kushner RF, Lieh-Lai M, Lindsley J, Meacham S, Nicastro H, Nowson C, Palmer C, Paniagua M, Philips E, Ray S, Rose S, Salive M, Schofield M, Thompson K, Trilk JL, Twillman G, White JD, Zappalà G, Vargas A, Lynch C. Advancing Nutrition Education, Training, and Research for Medical Students, Residents, Fellows, Attending Physicians, and Other Clinicians: Building Competencies and Interdisciplinary Coordination. Adv Nutr 2019; 10:1181-1200. [PMID: 31728505 PMCID: PMC6855992 DOI: 10.1093/advances/nmz083] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/13/2019] [Accepted: 07/15/2019] [Indexed: 01/15/2023] Open
Abstract
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.
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Affiliation(s)
- Linda Van Horn
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Carine M Lenders
- Department of Pediatrics, Boston University School of Medicine, Boston, MA, USA
| | - Charlotte A Pratt
- Division of Cardiovascular Sciences, National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Bettina Beech
- Department of Population Health Science, University of Mississippi Medical Center, Jackson, MS, USA
| | - Patricia A Carney
- Department of Family Medicine; of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - William Dietz
- Redstone Global Center for Prevention and Wellness, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Rose DiMaria-Ghalili
- College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Timothy Harlan
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Robert Hash
- American Medical Association, Chicago, IL, USA
| | - Martin Kohlmeier
- Department of Nutrition, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Kathryn Kolasa
- Department of Family Medicine; of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, NC, USA
| | - Nancy F Krebs
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Robert F Kushner
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Mary Lieh-Lai
- Accreditation Council for Graduate Medical Education, Chicago, IL, USA
| | - Janet Lindsley
- Department of Biochemistry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Susan Meacham
- Division of Cardiovascular Sciences, National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Holly Nicastro
- Division of Cardiovascular Sciences, National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Caryl Nowson
- Department of Nutrition and Ageing, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Carole Palmer
- Division of Nutrition & Oral Health, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Miguel Paniagua
- Test Materials Development, National Board of Medical Examiners, Philadelphia, PA, USA
| | - Edward Philips
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
| | - Sumantra Ray
- Global Center for Nutrition and Health, University of Cambridge, Cambridge, United Kingdom
| | - Suzanne Rose
- Department of Medicine, School of Health, University of Connecticut, Farmington, CT, USA
| | - Marcel Salive
- Division of Geriatrics & Clinical Gerontology, National Institutes of Health, National Institute on Aging, Bethesda, MD, USA
| | - Marsha Schofield
- Nutrition Services Coverage, Academy of Nutrition and Dietetics, Chicago, IL, USA
| | - Kathryn Thompson
- Department of Biomedical Sciences, College of Osteopathic Medicine, University of New England, Biddeford, ME, USA
| | - Jennifer L Trilk
- Department of Biomedical Sciences, University of South Carolina School of Medicine, Greenville, SC, USA
| | - Gwen Twillman
- Department of Education & Development, American Society for Nutrition, Rockville, MD, USA
| | - Jeffrey D White
- Division of Cancer Treatment and Diagnosis, National Institutes of Health, National Cancer Institute, Bethesda, MD, USA
| | - Giovanna Zappalà
- Division of Geriatrics and Clinical Gerontology and Head of the Office of Nutrition, National Institutes of Health, National Institute on Aging, Bethesda, MD, USA
| | - Ashley Vargas
- Office of Disease Prevention, National Institutes of Health, Rockville, MD, USA
| | - Christopher Lynch
- Office of Nutrition Research, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
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Cuerda C, Muscaritoli M, Donini LM, Baqué P, Barazzoni R, Gaudio E, Jezek D, Krznaric Z, Pirlich M, Schetgen M, Schneider S, Vargas JA, Van Gossum A. Nutrition education in medical schools (NEMS). An ESPEN position paper. Clin Nutr 2019; 38:969-974. [DOI: 10.1016/j.clnu.2019.02.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 02/01/2019] [Indexed: 01/25/2023]
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5
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Aspry KE, Van Horn L, Carson JAS, Wylie-Rosett J, Kushner RF, Lichtenstein AH, Devries S, Freeman AM, Crawford A, Kris-Etherton P. Medical Nutrition Education, Training, and Competencies to Advance Guideline-Based Diet Counseling by Physicians: A Science Advisory From the American Heart Association. Circulation 2018; 137:e821-e841. [DOI: 10.1161/cir.0000000000000563] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Growing scientific evidence of the benefits of heart-healthy dietary patterns and of the massive public health and economic burdens attributed to obesity and poor diet quality have triggered national calls to increase diet counseling in outpatients with atherosclerotic cardiovascular disease or risk factors. However, despite evidence that physicians are willing to undertake this task and are viewed as credible sources of diet information, they engage patients in diet counseling at less than desirable rates and cite insufficient knowledge and training as barriers. These data align with evidence of large and persistent gaps in medical nutrition education and training in the United States. Now, major reforms in undergraduate and graduate medical education designed to incorporate advances in the science of learning and to better prepare physicians for 21st century healthcare delivery are providing a new impetus and novel ways to expand medical nutrition education and training. This science advisory reviews gaps in undergraduate and graduate medical education in nutrition in the United States, summarizes reforms that support and facilitate more robust nutrition education and training, and outlines new opportunities for accomplishing this goal via multidimensional curricula, pedagogies, technologies, and competency-based assessments. Real-world examples of efforts to improve undergraduate and graduate medical education in nutrition by integrating formal learning with practical, experiential, inquiry-driven, interprofessional, and population health management activities are provided. The authors conclude that enhancing physician education and training in nutrition, as well as increasing collaborative nutrition care delivery by 21st century health systems, will reduce the health and economic burdens from atherosclerotic cardiovascular disease to a degree not previously realized.
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6
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Pham THQ, Worsley A, Lawrence M, Marshall B. Awareness of nutrition problems among Vietnamese health and education professionals. Health Promot Int 2018; 32:840-849. [PMID: 27006367 DOI: 10.1093/heapro/daw016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Professionals who provide nutrition education and consulting to the public are encouraged to take into account the health, environmental and social contexts that influence health-related attitudes and behaviours in the population. This paper examined the awareness of shifts in population health outcomes associated with the nutrition transition in Vietnam among university nutrition lecturers, health professionals and school education professionals. Most of these professionals held accurate views of the current population health issues in Vietnam. However, they differed in their awareness of the seriousness of overweight and obesity. Although the majority indicated that the prevalence of obesity and non-communicable diseases (NCDs) had increased, nearly half believed that the government should complete its attempts to control undernutrition before trying to control obesity. More health professionals believed that food marketing was responsible for the growing prevalence of children's obesity, and more of them disapproved of the marketing of less healthy food to children. In contrast, the university nutrition lecturers were least aware of food marketing and the seriousness of obesity. Of the three groups, the university nutrition lecturers held less accurate perceptions of nutrition transition problems and their likely drivers. There is an urgent need for greater provision of public nutrition education for all three groups of professionals.
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Affiliation(s)
| | | | | | - Bernie Marshall
- School of Health and Social Development, Deakin University, 221 Burwood Hwy, Burwood, VIC 3125, Australia
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7
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Hark LA, Deen D. Position of the Academy of Nutrition and Dietetics: Interprofessional Education in Nutrition as an Essential Component of Medical Education. J Acad Nutr Diet 2017. [DOI: 10.1016/j.jand.2017.04.019] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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8
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Hu J, Raman M, Gramlich L. Current Status of and Recommendations for Nutrition Education in Gastroenterology Fellowship Training in Canada. Nutr Clin Pract 2017; 33:191-197. [DOI: 10.1177/0884533617700852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Jing Hu
- University of Alberta, Edmonton, Alberta, Canada
| | | | - Leah Gramlich
- University of Alberta, Royal Alexandra Hospital, Edmonton, Alberta, Canada
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9
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Donini LM, Leonardi F, Rondanelli M, Banderali G, Battino M, Bertoli E, Bordoni A, Brighenti F, Caccialanza R, Cairella G, Caretto A, Cena H, Gambarara M, Gentile MG, Giovannini M, Lucchin L, Migliaccio P, Nicastro F, Pasanisi F, Piretta L, Radrizzani D, Roggi C, Rotilio G, Scalfi L, Vettor R, Vignati F, Battistini NC, Muscaritoli M. The Domains of Human Nutrition: The Importance of Nutrition Education in Academia and Medical Schools. Front Nutr 2017; 4:2. [PMID: 28275609 PMCID: PMC5320893 DOI: 10.3389/fnut.2017.00002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Accepted: 01/17/2017] [Indexed: 12/02/2022] Open
Abstract
Human nutrition encompasses an extremely broad range of medical, social, commercial, and ethical domains and thus represents a wide, interdisciplinary scientific and cultural discipline. The high prevalence of both disease-related malnutrition and overweight/obesity represents an important risk factor for disease burden and mortality worldwide. It is the opinion of Federation of the Italian Nutrition Societies (FeSIN) that these two sides of the same coin, with their sociocultural background, are related to a low "nutritional culture" secondary, at least in part, to an insufficient academic training for health-care professionals (HCPs). Therefore, FeSIN created a study group, composed of delegates of all the federated societies and representing the different HCPs involved in human nutrition, with the aim of identifying and defining the domains of human nutrition in the attempt to more clearly define the cultural identity of human nutrition in an academically and professionally oriented perspective and to report the conclusions in a position paper. Three main domains of human nutrition, namely, basic nutrition, applied nutrition, and clinical nutrition, were identified. FeSIN has examined the areas of knowledge pertinent to human nutrition. Thirty-two items were identified, attributed to one or more of the three domains and ranked considering their diverse importance for academic training in the different domains of human nutrition. Finally, the study group proposed the attribution of the different areas of knowledge to the degree courses where training in human nutrition is deemed necessary (e.g., schools of medicine, biology, nursing, etc.). It is conceivable that, in the near future, a better integration of the professionals involved in the field of human nutrition will eventually occur based on the progressive consolidation of knowledge, competence, and skills in the different areas and domains of this discipline.
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Affiliation(s)
- Lorenzo M. Donini
- Università di Roma La Sapienza – on behalf of the Italian Society of Parenteral and Enteral Nutrition (SINPE), Rome, Italy
| | - Francesco Leonardi
- Azienda Ospedale “Cannizzaro”, Catania – on behalf of the Italian Federation of Nutrition Societies (FeSIN), Catania, Italy
| | - Mariangela Rondanelli
- Università di Pavia – on behalf of the Italian Society of Parenteral and Enteral Nutrition (SINPE), Pavia, Italy
| | - Giuseppe Banderali
- ASST Santi Paolo e Carlo Presidio Ospedaliero San Carlo, Milano – on behalf of the Italian Society of Human Pediatric Nutrition (SINUPE), Milano, Italy
| | - Maurizio Battino
- Università Politecnica delle Marche – on behalf of the Italian Dietetic Association (ADI), Ancona, Italy
| | - Enrico Bertoli
- Università di Ancona – on behalf of the Italian Dietetic Association (ADI), Ancona, Italy
| | - Alessandra Bordoni
- Università di Bologna – on behalf of the Italian Society of Human Nutrition (SINU), Bologna, Italy
| | - Furio Brighenti
- Università di Parma – on behalf of the Italian Society of Human Nutrition (SINU), Parma, Italy
| | - Riccardo Caccialanza
- Fondazione IRCCS Policlinico San Matteo, Pavia – on behalf of the Italian Society of Parenteral and Enteral Nutrition (SINPE), Pavia, Italy
| | - Giulia Cairella
- ASL RMB, Rome – on behalf of the Italian Society of Human Nutrition (SINU), Rome, Italy
| | - Antonio Caretto
- Perrino Hospital, Brindisi – on behalf of the Italian Dietetic Association (ADI), Brindisi, Italy
| | | | - Manuela Gambarara
- Bambino Gesu Children Hospital, Roma – on behalf of the Italian Society of Human Pediatric Nutrition (SINUPE), Rome, Italy
| | - Maria Gabriella Gentile
- Niguarda Hospital, Milan – on behalf of the Italian Dietetic Association (ADI), Milan, Italy
| | - Marcello Giovannini
- University of Milan – on behalf of the Italian Society of Human Pediatric Nutrition (SINUPE), Milan, Italy
| | - Lucio Lucchin
- Regional General Hospital, Bolzano – on behalf of the Italian Dietetic Association (ADI), Bolzano, Italy
| | - Pietro Migliaccio
- On behalf of the Italian Society of Food Science (SISA), Rome, Italy
| | - Francesco Nicastro
- Università di Bari – on behalf of the Italian Society of Food Science (SISA), Bari, Italy
| | - Fabrizio Pasanisi
- Università degli Studi di di Napoli Federico II – on behalf of the Italian Society of Human Nutrition (SINU), Napoli, Italy
| | - Luca Piretta
- Università di Roma La Sapienza – on behalf of the Italian Society of Food Science (SISA), Rome, Italy
| | - Danilo Radrizzani
- AO Ospedale Civile di Legnano – on behalf of the Italian Society of Parenteral and Enteral Nutrition (SINPE), Legnano, Italy
| | | | - Giuseppe Rotilio
- Università di Roma Tor Vergata – on behalf of the Federation of Italian Nutrition Societies (FeSIN), Rome, Italy
| | - Luca Scalfi
- Università degli Studi di Napoli Federico II – on behalf of the Italian Society of Human Nutrition (SINU), Napoli, Italy
| | - Roberto Vettor
- Università di Padova – on behalf of the Italian Society of Obesity (SIO), Padova, Italy
| | - Federico Vignati
- Niguarda Hospital, Milano – on behalf of the Italian Society of Obesity (SIO), Milan, Italy
| | - Nino C. Battistini
- University of Modena and Reggio Emilia – on behalf of the Italian Society of Human Nutrition (SINU), Modena, Italy
| | - Maurizio Muscaritoli
- Università di Roma La Sapienza – on behalf of the Italian Society of Parenteral and Enteral Nutrition (SINPE), Rome, Italy
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Sacks GS. The Shrinking of Formalized Nutrition Education in Health Professions Curricula and Postgraduate Training. JPEN J Parenter Enteral Nutr 2017; 41:217-225. [DOI: 10.1177/0148607116685049] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Gordon S. Sacks
- Department of Pharmacy Practice, Harrison School of Pharmacy, Auburn University, Auburn, Alabama, USA
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Jacob M, Stewart P, Medina-Walpole A, Fong CT. A culinary laboratory for nutrition education. CLINICAL TEACHER 2015; 13:197-201. [PMID: 26109349 DOI: 10.1111/tct.12403] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Proficiency in medical nutrition requires an understanding of food-related biochemistry and the application of this knowledge in the context of culinary, cultural, psychosocial and interprofessional components. CONTEXT Our aim was to develop a teaching format where medical students could learn the biochemistry of nutrition in the context of patient narratives, interactive cooking and dialogues with nutrition professionals. INNOVATION We designed and implemented a day-long culinary laboratory intervention (lab), which is taught to first-year medical students at the University of Rochester with the help of dietetic interns from Cornell University. Here, we present the details of the intervention, the resources used and the preliminary outcomes on student attitudes. We designed and implemented a day-long culinary lab, which is taught to first-year medical students METHODS AND RESULTS A questionnaire with quantitative rating scales and open-ended questions was used to probe student attitudes regarding the educational approach used in the lab. Our preliminary findings suggest that the lab was well received and that the dietetic interns were viewed as effective teachers in this context. IMPLICATIONS A culinary lab is a feasible educational environment for integrating the breadth of topics within the discipline of nutrition. The experiential, food-based format appears to stimulate questions central to current nutritional controversies, particularly challenges related to translating biochemical mechanism into practical nutrition interventions. Close involvement with basic science faculty members, clinical faculty members and allied health professions are essential for this type of endeavour.
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Affiliation(s)
- Michael Jacob
- Department of Psychiatry, University of California, San Francisco, USA
| | - Patricia Stewart
- Department of Pediatrics, University of Rochester, New York, USA
| | | | - Chin-To Fong
- Department of Pediatrics, University of Rochester, New York, USA
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12
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Ball L, Crowley J, Laur C, Rajput-Ray M, Gillam S, Ray S. Nutrition in medical education: reflections from an initiative at the University of Cambridge. J Multidiscip Healthc 2014; 7:209-15. [PMID: 24899813 PMCID: PMC4038452 DOI: 10.2147/jmdh.s59071] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Landmark reports have confirmed that it is within the core responsibilities of doctors to address nutrition in patient care. There are ongoing concerns that doctors receive insufficient nutrition education during medical training. This paper provides an overview of a medical nutrition education initiative at the University of Cambridge, School of Clinical Medicine, including 1) the approach to medical nutrition education, 2) evaluation of the medical nutrition education initiative, and 3) areas identified for future improvement. The initiative utilizes a vertical, spiral approach during the clinically focused years of the Cambridge undergraduate and graduate medical degrees. It is facilitated by the Nutrition Education Review Group, a group associated with the UK Need for Nutrition Education/Innovation Programme, and informed by the experiences of their previous nutrition education interventions. Three factors were identified as contributing to the success of the nutrition education initiative including the leadership and advocacy skills of the nutrition academic team, the variety of teaching modes, and the multidisciplinary approach to teaching. Opportunities for continuing improvement to the medical nutrition education initiative included a review of evaluation tools, inclusion of nutrition in assessment items, and further alignment of the Cambridge curriculum with the recommended UK medical nutrition education curriculum. This paper is intended to inform other institutions in ongoing efforts in medical nutrition education.
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Affiliation(s)
- Lauren Ball
- Nutrition and Dietetics, School of Allied Health Sciences, Centre for Health Practice Innovation, Griffith University, Queensland, Brisbane, Australia
| | - Jennifer Crowley
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Celia Laur
- Need for Nutrition Education/Innovation Programme, Medical Research Council Human Nutrition Research, Cambridge, UK
| | - Minha Rajput-Ray
- Need for Nutrition Education/Innovation Programme, Medical Research Council Human Nutrition Research, Cambridge, UK
| | - Stephen Gillam
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Sumantra Ray
- Need for Nutrition Education/Innovation Programme, Medical Research Council Human Nutrition Research, Cambridge, UK
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13
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Kris-Etherton PM, Akabas SR, Bales CW, Bistrian B, Braun L, Edwards MS, Laur C, Lenders CM, Levy MD, Palmer CA, Pratt CA, Ray S, Rock CL, Saltzman E, Seidner DL, Van Horn L. The need to advance nutrition education in the training of health care professionals and recommended research to evaluate implementation and effectiveness. Am J Clin Nutr 2014; 99:1153S-66S. [PMID: 24717343 PMCID: PMC3985217 DOI: 10.3945/ajcn.113.073502] [Citation(s) in RCA: 149] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Nutrition is a recognized determinant in 3 (ie, diseases of the heart, malignant neoplasms, cerebrovascular diseases) of the top 4 leading causes of death in the United States. However, many health care providers are not adequately trained to address lifestyle recommendations that include nutrition and physical activity behaviors in a manner that could mitigate disease development or progression. This contributes to a compelling need to markedly improve nutrition education for health care professionals and to establish curricular standards and requisite nutrition and physical activity competencies in the education, training, and continuing education for health care professionals. This article reports the present status of nutrition and physical activity education for health care professionals, evaluates the current pedagogic models, and underscores the urgent need to realign and synergize these models to reflect evidence-based and outcomes-focused education.
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Affiliation(s)
- Penny M Kris-Etherton
- Department of Nutritional Sciences, Penn State University, University Park, PA (PMK-E); the Institute of Human Nutrition, Columbia University, New York, NY (SRA); Duke University Medical Center, Durham, NC (CWB); Harvard University Medical School, Boston, MA (BB); Rush University Medical Center, Chicago, IL (LB); University of Texas Medical School, Houston, TX (MSE); the UK Medical Research Council, Human Nutrition Research Unit, Cambridge, United Kingdom (CL and SR); the Division of Pediatric Nutrition, Boston Medical Center, Boston, MA (CML); the Division of Primary Care and General Pediatrics, Department of Pediatrics, Medstar Georgetown University Hospital, Washington, DC (MDL); Tufts University School of Dental Medicine, Boston, MA (CA Palmer); the National Heart, Lung, and Blood Institute, NIH, Bethesda, MD (CA Pratt); the Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA (CLR); the Department of Nutrition Sciences, Tufts University School of Medicine, Boston, MA (ES); the Vanderbilt Center for Human Nutrition, Vanderbilt University Medical Center, Nashville, TN (DLS); and the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (LVH)
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Lenders C, Gorman K, Milch H, Decker A, Harvey N, Stanfield L, Lim-Miller A, Salge-Blake J, Judd L, Levine S. A novel nutrition medicine education model: the Boston University experience. Adv Nutr 2013; 4:1-7. [PMID: 23319117 PMCID: PMC3648731 DOI: 10.3945/an.112.002766] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Most deaths in the United States are preventable and related to nutrition. Although physicians are expected to counsel their patients about nutrition-related health conditions, a recent survey reported minimal improvements in nutrition medicine education in US medical schools in the past decade. Starting in 2006, we have developed an educational plan using a novel student-centered model of nutrition medicine education at Boston University School of Medicine that focuses on medical student-mentored extracurricular activities to develop, evaluate, and sustain nutrition medicine education. The medical school uses a team-based approach focusing on case-based learning in the classroom, practice-based learning in the clinical setting, extracurricular activities, and a virtual curriculum to improve medical students' knowledge, attitudes, and practice skills across their 4-y period of training. We have been using objectives from the NIH National Academy Awards guide and tools from the Association of American Medical Colleges to detect new areas of nutrition medicine taught at the medical school. Although we were only able to identify 20.5 h of teaching in the preclerkship years, we observed that most preclerkship nutrition medicine objectives were covered during the course of the 4-y teaching period, and extracurricular activities provided new opportunities for student leadership and partnership with other health professionals. These observations are very encouraging as new assessment tools are being developed. Future plans include further evaluation and dissemination of lessons learned using this model to improve public health wellness with support from academia, government, industry, and foundations.
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Affiliation(s)
| | - Kathy Gorman
- Boston University Medical Center,Boston University School of Medicine, and the
| | | | | | | | | | | | - Joan Salge-Blake
- Boston University School of Health and Rehabilitation, Sargent College, Boston, MA
| | - Laura Judd
- Boston University School of Health and Rehabilitation, Sargent College, Boston, MA
| | - Sharon Levine
- Boston University Medical Center,Boston University School of Medicine, and the
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15
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Crowley J, Ball L, Wall C, Leveritt M. Nutrition beyond drugs and devices: a review of the approaches to enhance the capacity of nutrition care provision by general practitioners. Aust J Prim Health 2012; 18:90-5. [PMID: 22551828 DOI: 10.1071/py11116] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Accepted: 12/06/2011] [Indexed: 11/23/2022]
Abstract
The prevention and management of chronic disease is a key priority for primary care services. Nutrition-related care is an integral feature of several best practice guidelines for management of chronic disease in the general practice setting. This paper critically reviews the international literature to enhance the nutrition knowledge, skills and overall capacity of GPs to provide nutrition care using examples from nutrition in medical education, continuing medical education, GP-centred and practice-setting approaches. The medical nutrition education approach provides an opportunity for linear translation between desired nutrition competencies and curriculum learning objectives, while that of continuing medical education allows for tailored nutrition education to increase nutrition competencies once a learning need is identified. The GP-centred approach focuses on the determinants of nutrition care provision by GPs as strategies for enhancing nutrition care delivery, whereas the practice setting approach aims to increase the nutrition-related exposure to patients through avenues independent of the GP. In the Australian and New Zealand context, the potential appropriateness of these approaches requires judicious consideration, as it is unlikely that one approach will comprehensively address this topic. Ongoing multifaceted evaluation of each approach is needed to ensure enhancement of GPs' capacity to provide nutrition care by increasing nutrition knowledge and skills, and improving patient health outcomes.
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Affiliation(s)
- Jennifer Crowley
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
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16
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Nutrition in Medical Education. TOP CLIN NUTR 2011. [DOI: 10.1097/tin.0b013e318219318d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Friedman G, Kushner R, Alger-Mayer S, Bistrian B, Gramlich L, Marik PE. Proposal for medical school nutrition education: topics and recommendations. JPEN J Parenter Enteral Nutr 2011; 34:40S-6S. [PMID: 21149834 DOI: 10.1177/0148607110376200] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The mission of increasing the number of physician nutrition experts requires focused nutrition education directed at medical students across the 4-year curriculum and into postgraduate training. Courses should be horizontally and vertically integrated, bridging the basic sciences and clinical medicine. It is anticipated that the Liaison Committee on Medical Education and Association of American Medical Colleges will require competency in nutrition with emphasis on preventive and therapeutic applications. Barriers to implementation of nutrition courses can be overcome by using innovative teaching in association with cooperative course directors. Analysis of prior governmental efforts, through the Nutrition Academic Award, provides a basis for targeting fundamental knowledge and creative methods for achieving educational goals. Recommendations for short-term and long-term ideas for increasing the number of adequate physician nutrition experts are offered.
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Affiliation(s)
- Gerald Friedman
- Department of Medicine, Mount Sinai School of Medicine, 68 Mamaroneck Rd., Scarsdale, NY 10583, USA.
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18
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Kolasa KM, Rickett K. Barriers to providing nutrition counseling cited by physicians: a survey of primary care practitioners. Nutr Clin Pract 2011; 25:502-9. [PMID: 20962310 DOI: 10.1177/0884533610380057] [Citation(s) in RCA: 120] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
In a 1995 pivotal study, Kushner described the attitudes, practice behaviors, and barriers to the delivery of nutrition counseling by primary care physicians. This article recognized nutrition and dietary counseling as key components in the delivery of preventive services by primary care physicians. Kushner called for a multifaceted approach to change physicians' counseling practices. The prevailing belief today is that little has changed. Healthy People 2010 and the U.S. Preventive Task Force identify the need for physicians to address nutrition with patients. The 2010 objective was to increase to 75% the proportion of office visits that included ordering or providing diet counseling for patients with a diagnosis of cardiovascular disease, diabetes, or hypertension. At the midcourse review, the proportion actually declined from 42% to 40%. Primary care physicians continue to believe that providing nutrition counseling is within their realm of responsibility. Yet the gap remains between the proportion of patients who physicians believe would benefit from nutrition counseling and those who receive it from their primary care physician or are referred to dietitians and other healthcare professionals. The barriers cited in recent years continue to be those listed by Kushner: lack of time and compensation and, to a lesser extent, lack of knowledge and resources. The 2010 Surgeon General's Vision for a Healthy and Fit Nation and First Lady Obama's "Let's Move Campaign" spotlight the need for counseling adults and children on diet and physical activity.
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Affiliation(s)
- Kathryn M Kolasa
- Department of Family Medicine and of Pediatrics, East Carolina University, Greenville, NC 27834, USA.
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19
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Edwards MS. Preface. Am J Clin Nutr 2006. [DOI: 10.1093/ajcn/83.4.933s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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