Supporting the Call to Action: A Review of Nutrition Educational Interventions in the Health Professions Literature and MedEdPORTAL

Nutrition education for nursing students: A scoping review

INTRODUCTION

Nutritional care has long been recognized as a vital component of nursing. However, nutrition instruction faces many challenges in nursing education, and few studies have investigated this topic.

AIM

The study's aim was to investigate how nutrition education has been conducted in undergraduate nursing education.

METHOD

A scoping review was conducted according to the Preferred Reporting Items for Scoping Reviews (PRISMA-ScR) and Joanna Briggs Institute (JBI) recommendations. The search was conducted in April 2023, with an updated search in February 2024. We searched in the following EBSCO databases: Academic Search Elite, CINAHL, Education Source and ERIC. We also searched in PubMed and Embase via Ovid and Scopus. A total of 3634 articles were identified from the initial search. Duplicates were removed and articles were then screened by title, abstract and full text by the research team to ensure eligibility. We identified 30 articles for retrieval. Nine articles were ultimately included.

RESULTS

The results were organized into five thematic groups: (a) learning through involving patients, (b) learning contextualized in clinical practice, (c) learning through an active teaching method on campus, (d) learning through interdisciplinary collaboration and (e) combining education on campus and learning in clinical placement.

CONCLUSION

The findings from the scoping review emphasized that nutrition education activities should utilize active, experiential and social learning strategies. Moreover, findings suggest the importance of interdisciplinary collaboration when conducting nutrition education. Nursing education must give due attention to nutrition education, both on campus and in clinical placement, to adequately prepare students for nutritional care in professional practice. Nutrition instruction in nursing education could benefit from addressing nutritional care at both an individual and a systemic level, to support nursing students to cope with various challenges related to nutritional care in the patient setting.

Medical Nutrition Education for Health, Not Harm: BMI, Weight Stigma, Eating Disorders, and Social Determinants of Health

Effective nutrition training is fundamental to medical education. Current training is inadequate and can cause harm to students and patients alike; it leaves physicians unprepared to counsel on nutrition, places undue focus on weight and body mass index (BMI), can exacerbate anti-obesity bias, and increase risk for development of eating disorders, while neglecting social determinants of health and communication skills. Physicians and educators hold positions of influence in society; what we say and how we say it matters. We propose actionable approaches to improve nutrition education to minimize harm and pursue evidence-based, effective, and equitable healthcare.

There and Back Again: A Forty-Year Perspective on Physician Nutrition Education

Medical education faces an urgent need for evidence-based physician nutrition education. Since the publication of the 1985 National Academies report "Nutrition Education in the United States Medical Schools," little has changed. Although several key efforts sought to increase nutrition content in undergraduate medical education over the past 40 y, most medical schools still fail to include the recommended minimum of 25 h of nutrition training. Without foundational concepts of nutrition in undergraduate medical education, graduate medical education unsurprisingly falls short of meeting patient needs for nutritional guidance in clinical practice. Meanwhile, diet-sensitive chronic diseases continue to escalate, although largely preventable and treatable by nutritional therapies and dietary lifestyle changes. Fortunately, recent recognition and adoption of Food is Medicine programs across the country increasingly connect patients with healthy food resources and nutrition education as core to their medical care, and physicians must be equipped to lead these efforts alongside their dietitian colleagues. Filling the gap in nutrition training will require an innovative and interprofessional approach that pairs nutrition with personal wellness, interprofessional practice, and community service learning. The intersectional benefits of connecting these domains will help prepare future physicians to address the social, behavioral, and lifestyle determinants of health in a way that recognizes nourishing food access as a core part of clinical practice. There are numerous strategies to integrate nutrition into education pathways, including didactic and experiential learning. Culinary medicine, an evidence-based field combining the culinary arts with nutritional science and medicine, is 1 promising educational framework with a hands-on, interprofessional approach that emphasizes community engagement. Advancing the critical need for widespread adoption of nutrition education for physicians will require support and engagement across societal stakeholders, including co-leadership from registered dietitian nutritionists, health system and payor reform, and opportunities for clinical innovation that bring this essential field to frontline patient care.

Implementing nutritional medicine into medical curricula: A student-initiated course improves knowledge and attitudes

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.

Culinary Medicine eConsults Pair Nutrition and Medicine: A Feasibility Pilot

The global impact of diet-sensitive disease demands innovative nutrition education for health professionals and widespread, reimbursable clinical models to apply nutrition to practice. Interprofessional collaboration across disciplines and the optimization of emerging telemedicine consultation strategies, including electronic consultation (eConsult), merge to deliver vital innovation in the delivery of nutrition-based clinical care. Aligning with an existing eConsult infrastructure in the institutional electronic health record (EHR), a physician-dietitian team developed a novel Culinary Medicine eConsult. During a pilot phase, the service was introduced to primary care clinicians, and a response algorithm for eConsults was created. During the 12-month pilot phase, the Culinary Medicine team completed 25 eConsults from 11 unique primary care clinicians with a 76% (19/25) insurance reimbursement rate. Topics varied from dietary strategies for preventing and managing common metabolic diseases to specific dietary influences on microbiome health and disease flares. Requesting clinicians reported time saved in their clinic encounters and high patient satisfaction with expert nutrition guidance. EConsults in Culinary Medicine promote the integration of interprofessional nutrition care into existing clinical structures and empower enhanced access to the vital domain of dietary health. EConsults deliver timely answers to clinical questions and create opportunities for further innovation in care delivery as communities, health systems, and payors seek solutions to the growing burden of diet-sensitive diseases.

Implementation of a food science and nutrition module in a dental undergraduate curriculum

INTRODUCTION

To outline the development and implementation of a food science and nutrition module for dental undergraduate students that provides basic knowledge and clinical skills for improving oral health outcomes and understanding their importance for overall health.

MATERIALS AND METHODS

Interdisciplinary discussions with professionals with expertise in food science and nutrition, including dentists, dietitians and nutritionists, were held to agree on core subject areas in line with the evidence base. The module was delivered online to 2nd-year dental students due to COVID-19 restrictions. Students completed an online evaluation on completing the module. Final examination consisted of one essay question.

RESULTS

Subject areas and learning outcomes were derived from current and previous approaches to curriculum development. A total of 14 prerecorded lectures, including healthy eating guidelines, dietary assessment, specific oral effects of diet and food constituents were delivered and tutorials provided. The evaluation survey had a 90% (n = 39/43) response rate. A majority indicated that the course was "interesting," "worth doing" (59%) and "provided a good evidence base to understand nutrition and oral health" (87%). Nearly all students (92%) agreed that the course was "sufficiently structured to allow understanding of the key topics" and that "a good understanding of nutrition is important for a dentist" (95%).

CONCLUSION

A food science and nutrition module developed by a multidisciplinary team enabled dental students to gain an understanding of the role of diet in oral and overall health. The module facilitated the development of skills that enable students to utilise dietary assessment techniques and promote dietary interventions beneficial to oral health. The approach taken may act as a template for other institutions.

Evaluating nutrition education interventions for medical students: A rapid review

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.

Empowering learners to provide dietary counselling

BACKGROUND

Despite calls to increase dietary counselling by physicians to help address the epidemic of lifestyle-related chronic disease, medical education does not equip future physicians with the training to provide effective dietary counselling. In addition to the multiple barriers that clinician educators face in implementing clinically relevant nutrition education curricula, evaluation modalities in the nutrition education literature that assess student skills and behaviour remain limited.

APPROACH

We implemented a brief, virtual nutrition education intervention in a US medical school during the outpatient clinical clerkship and assessed how our curriculum influenced students' development of dietary counselling skills.

EVALUATION

Student feedback revealed appreciation for learning how to approach conversations about diet in a non-judgmental manner and specific strategies to use during counselling. We thematically analysed the free-text responses from 81 dietary counselling encounter forms submitted by students. Three emergent themes reflected the key dietary counselling skills students demonstrated during patient encounters: (1) eliciting drivers of current eating patterns and barriers to healthier eating patterns, (2) individualising recommendations and (3) recommending evidence-based strategies.

IMPLICATIONS

After receiving brief, clinically relevant, virtual nutrition education, students were able to successfully apply dietary counselling skills to patient care. In conjunction with indirect skill assessment through targeted documentation, we offer a sustainable approach for feasible nutrition education paired with meaningful evaluation.

Teaching Medical Students How to Teach: A Scoping Review

PHENOMENON

Teaching medical students how to teach is a growing and essential focus of medical education, which has given rise to student teaching programs. Educating medical students on how to teach can improve their own learning and lay the foundation for a professional identity rooted in teaching. Still, medical student-as-teacher (MSAT) programs face numerous obstacles including time constraints, prioritizing curriculum, and determining effective evaluation techniques. The purpose of this scoping review is to map the current landscape of the literature on medical school initiatives designed to train students to teach to describe why medical student teaching programs are started; the benefits and barriers; who teaches them; what content is taught; and how content is delivered. With this new map, the authors aimed to facilitate the growth of new programs and provide a shared knowledge of practices derived from existing programs.

APPROACH

The authors conducted a scoping review, guided by Arksey and O'Malley's framework, to map the literature of MSAT training programs. Six databases were searched using combinations of keywords and controlled vocabulary terms. Data were charted in duplicate using a collaboratively designed data charting tool. This review builds on the Marton et al. review and includes articles published from 2014 to 2020.

FINDINGS

Of the 1,644 manuscripts identified, the full-text of 57 were reviewed, and ultimately 27 were included. Articles included empirical research, synthetic reviews, opinion pieces, and a descriptive study. Analysis focused on modalities for teaching medical students how to teach; content to teach medical students about teaching; benefits and barriers to starting teaching programs; and the value of teaching programs for medical students.

INSIGHTS

The rapid growth of MSAT programs suggests that this curricular offering is of great interest to the field. Literature shows an increase in evaluative efforts among programs, benefits for students beyond learning to teach, and evidence of effective engagement in medical students' designing and implementing programs.

Human rights and nutritional care in nurse education: lessons learned

Background: Food is an important part of nursing care and recognized as a basic need and a human right. Nutritional care for older adults in institutions represents a particularly important area to address in nursing education and practice, as the right to food can be at risk and health personnel experience ethical challenges related to food and nutrition. Objective: The present study investigates the development of coursework on nutritional care with a human rights perspective in a nursing programme for first-year nursing students and draws upon reflections and lessons learned. Research design: The study utilized educational design research. The coursework, developed through two rounds, combined on-campus learning and clinical placement in nursing homes. Nursing studentsʼ perspectives and experiences gathered through focus groups and a written assignment informed the development and evaluation of the coursework. Participants and research context: In the first round, multistage focus group interviews were conducted with 18 nursing students before, during and after placement. In the second round, four focus group interviews with 26 nursing students were conducted shortly after placement. Ethical consideration: The study was approved by the Norwegian Centre for Research Data. Findings: Three main ʽlessons learnedʼ emerged regarding introducing a human rights perspective in nursing education: 1) the contribution of the human rights perspective in changing the narrative of ʽvulnerable and malnourished patientsʼ, 2) the importance of relationships and experiences for learning about human rights and 3) the benefit of combining development of ethical competence with a human rights perspective. Conclusion: A human rights perspective enabled the students to give meaning to nutritional care beyond understanding of food as a basic physical need. Incorporating human rights in nursing education can support nursing students and nurses in recognizing and addressing ethical and structural challenges and being able to fulfil the right to food for patients.

The state of nutrition in medical education in the United States

Despite the significant impact diet has on health, there is minimal nutrition training for medical students. This review summarizes published nutrition learning experiences in US medical schools and makes recommendations accordingly. Of 902 articles, 29 met inclusion criteria, describing 30 learning experiences. Nutrition learning experiences were described as integrated curricula or courses (n = 10, 33%), sessions (n = 17, 57%), or electives (n = 3, 10%). There was heterogeneity in the teaching and assessment methods utilized. The most common was lecture (n = 21, 70%), often assessed through pre- and/or postsurveys (n = 19, 79%). Six studies (26%) provided experience outcomes through objective measures, such as exam or standardized patient experience scores, after the nutrition learning experience. This review revealed sparse and inconsistent data on nutrition learning experiences. However, based on the extant literature, medical schools should build formal nutrition objectives, identify faculty and physician leadership in nutrition education, utilize preexisting resources, and create nutrition learning experiences that can be applied to clinical practice.

The food diary as a pedagogical strategy in undergraduate nursing nutrition education: A student evaluation

BACKGROUND

Few studies have evaluated educational nutrition activities in undergraduate nursing, and none have published how the established food assessment method, the food diary, can be used as a pedagogical method in this context.

OBJECTIVE

To describe undergraduate nursing students' learning outcomes of basic nutrition and important elements for their learning after conducting a one-day food record with a subsequent seminar (henceforth: "the food diary method").

DESIGN

Cross-sectional.

SETTING

Undergraduate nursing program in Sweden.

PARTICIPANTS

161 students.

METHODS

Participants conducted a one-day food record by documenting their food intake and calculating the nutritional values. After completion, students participated in a seminar, and an evaluative questionnaire was distributed at the end. The questionnaires contained both numerical and free-text questions.

RESULTS

Of 162 students attending the seminar, all but one completed the questionnaire (response rate: 99%). The highest rated learning outcome, on the 5-point Likert scale, was an increased understanding for the nutritional recommendations (Median, M = 5). The highest rated educational aspects were that they compared their records with the nutritional recommendations (M = 5), and the calculations of nutritional values of their records (M = 5). Participants also indicated that they gained information that would be useful for them as practicing nurses (M = 5).

CONCLUSIONS

Overall, the food diary method appeared to be a feasible method in educating and engaging undergraduate nursing students in the field of basic nutrition. These findings support results from previous studies in this area, such that educational nutrition activities that utilize active, experiential, and social learning strategies were appreciated by the students.

Integrating Wikipedia editing into health professions education: a curricular inventory and review of the literature

INTRODUCTION

Wikipedia is an online encyclopedia read by millions seeking medical information. To provide health professions students with skills to critically assess, edit, and improve Wikipedia's medical content, a skillset aligned with evidence-based medicine (EBM), Wikipedia courses have been integrated into health professions schools' curriculum. This literature review and curricular inventory of Wikipedia educational initiatives provides an overview of current approaches and identifies directions for future initiatives and research.

METHODS

Five databases were searched for articles describing educational interventions to train health professional students to edit Wikipedia. Course dashboards, maintained by Wiki Education (Wiki Edu), were searched for curricular materials. From these sources, key details were extracted and synthesized, including student and instructor type, course content, educational methods, and student outcomes.

RESULTS

Six articles and 27 dashboards reported courses offered between 2015 and 2019. Courses were predominantly offered to medical and nursing students. Instructors delivered content via videos, live lectures, and online interactive modules. Course content included logistics of Wikipedia editing, EBM skills, and health literacy. All courses included assignments requiring students to edit Wikipedia independently or in groups. Limited details on assessment of student learning were available.

DISCUSSION

A small but growing number of schools are training health professions education students to improve Wikipedia's medical content. Course details are available on Wiki Edu dashboards and, to a lesser extent, in peer-reviewed publications. While more needs to be done in conducting and sharing assessment of student learning, integrating Wikipedia into health professions education has potential to facilitate learning of EBM and communication skills, improve Wikipedia's online content, and engage students with an autonomous environment while learning. Future considerations should include a thorough assessment of student learning and practices, a final review of student edits to ensure they follow Wikipedia's guidelines and are written in clear language, and improved sharing of teaching resources by instructors.

Developing professional education for primary healthcare providers about nutrition

Nutrition care is an important component of primary health care as a way to promote positive lifestyle behaviours and reduce risks of chronic disease. Despite this, it appears that primary healthcare settings, including antenatal care, miss opportunities to deliver nutrition care. Time constraints, lack of nutrition knowledge and lack of confidence have been identified as barriers for primary healthcare providers in delivering nutrition care. Nutrition training to upskill primary healthcare providers to deliver nutrition care in a timely manner therefore appears warranted. This forum article discusses models and methods of continuing professional development (CPD) and the effectiveness of nutrition CPD for primary healthcare professionals. It includes a case study as an example of developing nutrition CPD for midwives using adult learning theory and concludes with implications for developing nutrition education resources for primary healthcare providers.

Selected Abstracts From the Proceedings of the 2019 Society of Teachers of Family Medicine Conference on Medical Student Education

From January 31 through February 3, 2019 the Society of Teachers of Family Medicine (STFM) held its 45th annual Conference on Medical Student Education in Jacksonville, Florida. STFM is a collaborative organization composed of members who are dedicated to teaching the discipline to learners of any level. The conference brings together members including physicians, administrators, behavioral scientists, researchers, residents, and students to learn from one another and improve the quality of family medicine education in the United States and Canada. Abstracts for all conference submissions can be found on the STFM website.1 Plenary speakers addressed topics related to health equity (Joanne Rooney, JD, LLM, EdD); discrimination and bias in the medical workplace (Roberto E. Montenegro, MD, PhD); and mentoring in family medicine (Beat Steiner, MD, MPH, STFM President). The STFM Committee on Medical Student Education reviewed the 14 completed educational research projects and selected six exemplary abstracts as the best of the conference. Criteria for inclusion included relevance to medical student education with a focus on family medicine education, study quality, and meaningful conclusions. Five of the abstracts appear in this collection. One has been published in the intervening time.2.

Hidden curriculum within nutrition education in medical schools

INTRODUCTION

Previous attempts to enhance medical nutrition education have typically focussed on students' acquiring nutrition knowledge or skills. Given that medical training uses an apprenticeship model of training, surprisingly few studies have explored the 'hidden curriculum' that students experience regarding expectations of behaviour, roles and responsibilities regarding nutrition. This study explored medical students' perceptions and experiences regarding medical nutrition education, focussing on the context in which nutrition teaching has been provided, the presented place of nutrition within medicine and their subsequent views on their role in providing nutrition care.

METHODS

Individual semi-structured qualitative interviews were conducted with 14 postgraduate medical students at different stages of their medical degree in Australia. The interviews were conducted using case studies followed by interview questions. Data were audio recorded, transcribed, coded and then underwent inductive thematic analysis.

RESULTS

Three themes were discovered (i) Valuing nutrition in the medical management of patients whereby students perceived nutrition to be a foundational and central component of ideal medical management for patients, particularly those with chronic disease; (ii) Fluctuating emphasis on nutrition which showed that students experienced diversity in the importance placed on nutrition by others and (iii) Working with others whereby students expressed their understanding of their role in nutrition and the roles of team members such as dietitians.

CONCLUSION

To enhance medical nutrition education, consideration needs to extend beyond counting dedicated teaching hours and mapping nutrition content, to a more contextual understanding of the situated learning that occurs for medical students.

Obesity education in medical schools, residencies, and fellowships throughout the world: a systematic review

Obesity is pandemic throughout the world, and there is concern that physicians are inadequately trained to treat their patients with obesity despite its prevalence. This review explores obesity education in medical students, resident, and fellow physicians throughout the world from 2005 to 2018. Previous reviews on obesity education were conducted before 2011, focused solely on medical students, and only explored obesity education in the United States. We systematically searched MEDLINE, EMBASE, PsycINFO, and ERIC databases for studies which included the search terms "obesity education" AND either "medical students", "residency", or "fellowship" that met PICOS (Population, Interventions, Comparators, Outcomes, Study Design) criteria for articles published in English for obesity education and evaluation of outcomes. Our initial search yielded 234 articles, and 27 studies met criteria for our review. We described and analyzed these studies for their study design and graded quality, quantity, and consistency for each measured outcome. We applied an evidence grading system that has been previously applied in the literature in which each outcome measure was graded on a scale from A to D. We evaluated obesity education programs for outcomes regarding implicit and explicit bias, changes in attitude towards obesity, weight change, obesity knowledge, counseling confidence, intent to counsel, and counseling quality. There was a significant degree of heterogeneity in the studies included. While obesity knowledge was most frequently studied, counseling confidence was the only outcome with an overall grade A. There is currently a paucity of obesity education programs for medical students, residents, and fellow physicians in training programs throughout the world despite high disease prevalence. However, these programs often improve outcomes when they are administered. Our review suggests that more obesity education should be administered in undergraduate and graduate medical education to ensure optimal treatment of patients with obesity.

Medical Student Attitudes on Nutrition Counseling After Implementation of a Novel Curricular Activity

Objective: The aim of this research was to determine the changes in medical student attitudes toward nutrition counseling after implementation of a novel curricular activity during a required third-year clerkship.Method: All third-year medical students completing their required family medicine clerkship were invited to participate in a voluntary survey composed of the Nutrition in Patient Care Survey (NIPS) and demographics before their required curricular clerkship activity consisting of two separate case-based modules focused on nutritional aspects of patient care. Students and faculty facilitators met via web platform at an assigned time to review and discuss questions. All students were invited to complete the postsurvey composed of only the NIPS.Results: Completion rate was 31% for both pre- and postsurveys. Students' intended specialty choice did not lead to a significant difference in scores on any of the five subscales on pre-intervention surveys. Almost half (43.9%) of the students who completed the surveys reported offering nutrition-related counseling despite lack of formal training. The Physician-Patient Relationship score went from 4.29 to 4.37 (p < 0.03) and the Physician Efficacy score went from 3.18 to 3.34 (p < 0.01). The was no significant difference identified pre- versus postintervention for the Clinical Behavior scales.Conclusions: The modules used in this pilot study resulted in positive changes in student attitudes toward counseling patients about nutrition. The inclusion of required case-based modules focused on nutrition is feasible and can positively impact student attitudes regarding their efficacy in counseling patients.

Show Me Your Objectives: Nutrition Education in a US Medical School Curriculum

BACKGROUND

Health authorities around the globe have called for improvement in nutrition education in medical schools. It was deemed necessary to study our current curriculum to document what exists and identify gaps. This project surveyed nutrition education objectives within a US medical school during 1 year followed by informal interviews of faculty aimed toward improvement in the curriculum.

METHODS

A survey tool was created using the list of competencies in Table 1 of "Nutrition Competencies for Graduating Medical Students" from the Nutrition in Medicine (NIM) project. Educational objectives for all 26 courses encompassing the first-, second-, and third-year curriculum at the University of New Mexico School of Medicine (UNM SOM) were surveyed in order to identify the current nutrition curriculum content. Faculty course directors were contacted after data collection to verify accuracy and fill in any missing information.

RESULTS

Out of 61 competencies, at least one was covered in 16 of 26 courses (62%) by survey of objectives. Additional content in nutrition education was identified for 4/16 (25%) of these courses through follow-up faculty interviews. Findings were discussed with three key curricular groups.

DISCUSSION

The study results highlighted the importance of accurately publishing objectives to fully reflect course content. This project demonstrates an approach that may be utilized at other medical schools to assess nutrition education curricula and create a structure for dialog within their own institutions.

Impact of interprofessional education for medical and nursing students on the nutritional management of in-patients

Introduction: Despite its frequency, malnutrition is underestimated in its importance for morbidity and mortality. Interprofessional nutrition management can improve patient safety and clinical outcomes. An interprofessional education is considered as the basis for good team cooperation. So far, little data is available on the effects of interprofessional education on measurable outcomes for patients. The objective is to determine to what extent student feedback leads to a change of in-patient nutritional management for a selected internal medical ward. Methodology: In a teaching project based on the method of research oriented learning, medical and nursing students conducted an analysis of the nutritional situation of patients and developed individual treatment plans. The students orally reported their findings to the care teams as well as via a poster presentation to decision-makers of the clinic. A prospective cohort intervention study was conducted to assess the nutritional status of patients before and after student interventions using established screening tools. Differences were tested using t-test and Fisher's exact test. Institutional consequences for nutrition management were recorded descriptively. The teaching unit was evaluated by the students before and after. Results: Malnutrition was found in 59% of patients. Inspired by student feedback, institutional consequences followed: a) routine inpatient screening using Nutritional Risk Screening; and b) the use of pie charts to estimate food intake. Conclusion: The feedback from the results of student interprofessional cooperation led to a sensitization of decision-makers and enabled new measures to improve nutritional management. These can increase patient safety.

MEDICAL AND SOCIAL CHARACTERISTICS OF PHYSICIANS ATTENDING POSTGRADUATE TRAINING COURSES (SOCIAL SURVEY)

The paper studies professional, social and psychological aspects concerned with a practical activity of physicians referred to attend postgraduate training courses at Danylo Halytsky Lviv National Medical University. Aim. To develop the recommendations on the improvement in the system of postgraduate medical education under the conditions of general reform in the health care system. The research was done by the survey method in the form of standardized (formalized) interview that was applied as the main approach to the process of collecting social and psychological information.The survey included 823 physicians referred to attend postgraduate training courses at Danylo Halytsky Lviv National Medical University. The working experience of postgraduate course attendants was the following: up to 5 years – 25.39±1.52 %, 5–10 years – 21.39±1.43 %, 11–15 years – 11.79±1.12 %, 16–20 years – 9.96±1.04 %, 21–30 years – 16.89±1.31 %, more than 30 years – 14.58±1.23 %. The majority of questioned medical workers (74.24±1.52 %) feel calm and happy at their working place. However, the received data indicates that 23.09±1.47 % of the responders feel disturbance and 1.94±0.48 % experience fear at work. The analysis of the research results allowed differentiating five sharp problems which are very topical and significant at the medical institution where the physicians have been performing their practice. They can be ranged in the following way: the job compensation (42.93±2.09 %), absence of modern medical equipment (26.65±1.87 %), organization of the working process (22.90±1.78 %), reorganization (7.69±1.13 %), extra documentation (7.33±1.10 %). The carried out survey permitted to determine the psychological atmosphere at medical institutions there the course attendants have been practicing. The conflicts are not a characteristic feature of medical institutions, since almost half of the responders indicated the absence of conflicts with higher managers (52.86±1.74 %), direct managers (43.01±1.73 %), subordinate personnel (43.38±1.73 %). This index is somewhat lower concerning the colleagues and patients. It amounts for 36.33±1.68 % and 33.17±1.64 % respectively. The physicians practicing in medicine and prevention as well as dentistry branches are most disturbed by the lack of financial sources. More than a half of responders (73.86±2.70 %) indicated it by their answers. Other responses included the absence of perspectives – 68.18±2.87 %, extreme, stressful living conditions – 25.38±2.68 %, personal present health status – 20.08±2.47 %, personal lack of confidence – 9.47±1.80 % (the number of responses was not restricted). The carried out work has showed the necessity of introducing the specialized course “State medical policy”. It should be aimed at delivering the information on the status, perspectives, reforming changes and the expected outcomes resulting from these factors in the branch of medicine. In order to decrease the negative influence of the professional burnout, it is recommended to plan the specialized training classes that are directed on the prevention of the listed above phenomena.