1
|
Cardenas D, Díaz G, Fuchs-Tarlovsky V, Cristina Gonzalez M, Carrasco F, Cano AMP, Bermúdez C, Maza C, Ferraresi E, Lipovestky F, Villafana H, Arenas-Márquez H, Calvo I, Cordova LRA, Canicoba M, Sánchez P, Santana S, Tihista S, Adrianza de Baptista GM, Garcia Y, Correia MITD. Nutrition competencies for undergraduate medical education: Results of an international interdisciplinary consensus. JPEN J Parenter Enteral Nutr 2021; 46:635-645. [PMID: 34117790 DOI: 10.1002/jpen.2203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The gap between the nutrition education provided to medical students and the nutrition competencies and attitudes needed for physicians to provide adequate nutrition care is a global concern. There is no universally accepted benchmark on nutrition competencies for doctors. The objective of this study was to establish, by expert consensus, the objectives of undergraduate nutrition medial education, the nutrition core competencies, and strategies for curriculum development in medical nutrition education. METHODS We administered a Delphi survey to systematically gather the opinion of a panel of Latin American experts in nutrition. The survey questionnaire was constructed considering scientific literature by using a 5-point Likert scale. Consensus was defined as >70% agreement on the importance of an item (Likert scale 4 and 5). RESULTS A four-round Delphi survey was conducted for this research. In the second, third, and fourth rounds, we validated a total of 130 competencies by consensus, which were distributed into four different thematic areas: (1) basic nutrition concepts, (2) public nutrition and nutrition prevention throughout the life cycle, (3) nutrition status and disease, and (4) nutrition care process. CONCLUSION The curricula for general physician education in medical school must include health promotion, prevention, and treatment of diseases related to nutrition. This goal can be reached by integrating ≤130 competencies into four different fundamental areas.
Collapse
Affiliation(s)
- Diana Cardenas
- Faculty of Medicine, Research Institute on Nutrition, Genetics and Metabolism, Universidad El Bosque, Bogotá, Colombia
| | - Gustavo Díaz
- Faculty of Medicine, Research Institute on Nutrition, Genetics and Metabolism, Universidad El Bosque, Bogotá, Colombia
| | | | | | | | | | - Charles Bermúdez
- Surgery department, Clinica la Colina, Clinica del Country, Bogotá, Colombia
| | - Claudia Maza
- Clinical Nutrition Section, Centro Médico Militar, Universidad del Valle de Guatemala, Guatemala
| | - Eduardo Ferraresi
- Hospital Interzonal General de Agudos Profesor Dr Rodolfo Rossi, La Plata, Buenos Aires, Argentina
| | | | - Haydee Villafana
- Faculty of Pharmacy and Biochemistry, Universidad Nacional de Trujillo, Perú
| | | | - Isabel Calvo
- Nutrition service, Hospital General de Tijuana, México
| | | | - Marisa Canicoba
- Hospital National Alejandro Posadas, Universidad de Buenos Aires, Argentina
| | - Paola Sánchez
- Faculty of Medicine, Universidad Hispanoamericana, San José, Costa Rica.,Faculty of Medicina Universidad de Ciencias Médicas, San José, Costa Rica.,Faculty of Medicine Universidad Latina, San José, Costa Rica
| | - Sergio Santana
- Hospital Pediátrico Juan Manuel Márquez, Marianao, Ciudad de la Habana, Cuba
| | | | | | - Yawelida Garcia
- Faculty of Nutrition, Universidad O&M, Santo Domingo, Dominican Republic
| | | |
Collapse
|
2
|
Cardenas D, Díaz G, Cadavid J, Lipovestky F, Canicoba M, Sánchez P, Álvarez L, Duarte Y, Reyes JGG, de Noyola GM, Maza C, Porbén SS, Bermúdez CE, García Y, Calvo I, Arenas H. Nutrition in medical education in Latin America: Results of a cross-sectional survey. JPEN J Parenter Enteral Nutr 2021; 46:229-237. [PMID: 33735516 DOI: 10.1002/jpen.2107] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/07/2021] [Accepted: 03/14/2021] [Indexed: 12/21/2022]
Abstract
RATIONALE The gap between the nutrition education provided to medical students and the nutrition competences and attitudes needed for doctors to provide effective nutrition care is a global concern. The goal of this study was to investigate the curricular content on nutrition education in Latin American medical schools and to evaluate the self-perceived knowledge, attitudes, and barriers to nutrition practice of final-year medical students. METHODS Eighty-five public and private medical schools from 17 Latin American countries were invited to participate in the study. Two close-ended online questionnaires consisting of 25 and 43 questions were sent to medical school directors. Quantitative variables were expressed as frequencies, percentages, mean ± standard deviation, medians, and ranges. RESULTS A total of 22 (26%) medical school directors responded, of which 11 schools (50%) offered stand-alone mandatory nutrition courses in preclinical and 8 (36%) in clinical years. The mean hours dedicated to nutrition education was 47 (range: 0-150). A total of 1530 of 1630 (94%) students from 12 countries responded. Students' average age was 25 ± 3 years, and 59% were female. Most students agreed that improving patients' health through nutrition (91%) is important and that nutrition counseling and assessment should be part of routine care provided by all physicians (89%), but they lack the level of education and training required to address nutrition-related issues. CONCLUSIONS Positive attitude and interest in nutrition among final-year medical students is high, but nutrition education is not perceived as sufficient to adequately prepare doctors in the field of nutrition.
Collapse
Affiliation(s)
- Diana Cardenas
- Faculty of Medicine, Research Institute on Nutrition, Genetics and Metabolism, Universidad El Bosque, Bogotá, Colombia
| | - Gustavo Díaz
- Faculty of Medicine, Research Institute on Nutrition, Genetics and Metabolism, Universidad El Bosque, Bogotá, Colombia
| | - Jessika Cadavid
- Faculty of Medical Sciences, Federal University of Mato Grosso, Cuiaba, Brazil
| | - Fernando Lipovestky
- Faculty of Medicine, Universidad Abierta Interamericana, Buenos Aires, Argentina
| | - Marisa Canicoba
- Faculty of Medicine, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Paola Sánchez
- Faculty of Medicine, Universidad Latina de Costa Rica, San José, Costa Rica
| | - Ludwig Álvarez
- Nutrition department, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Yan Duarte
- Faculty of Medicine, Universidad Estatal de Guayaquil, Guayaquil, Ecuador
| | | | | | - Claudia Maza
- Faculty of Nutrition, Centro Médico Militar, Ciudad de Guatemala, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Sergio Santana Porbén
- Nutrition department, Hospital Pediatrico Docente "Juan Manuel Marquez,", La Habana, Cuba
| | - Charles Elleri Bermúdez
- Surgery and Nutrition Department, Clínica La Colina and Clínica del Country, Bogotá, Colombia
| | - Yawelida García
- Faculty of Nutrition, Universidad O&M, Santo Domingo, Dominican Republic
| | - Isabel Calvo
- Nutrition service, Hospital General de Tijuana, Tijuana, Mexico
| | - Humberto Arenas
- Integrated Practice Unit on Intestinal Failure, Hospital San Javier, Guadalajara, Mexico
| |
Collapse
|
3
|
Cardenas D, Díaz G, Cadavid Sierra J, Lipovestky F, Canicoba M, Duarte Vera Y, Gutierrez Reyes J, Sanchez P, Maza C, Calvo I, Garcia Y, Jimenez M, Arenas H, Bermúdez C. Nutrition education in Latin-American medical schools: Results of an international survey. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
4
|
Canicoba M, Feldman N, Lipovetzky S, Moyano O. [Nutritional status assessment in leprous hospitalized patients in Argentina]. NUTR HOSP 2007; 22:377-81. [PMID: 17612381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
INTRODUCTION Leprosy is a regional problem of public health in the Argentine Republic. It has seen a continuous decrease of the prevalence in the last 10 years, with value is about 0.17/10000 citizen and the detection rate is constant about 0.10/10000 citizen. Even the death rate is low, its importance is given for the physicals, socials, permanents and the progressive disabilities that its produce if there no early diagnostic and a regular and complete treatment. The Dr. Baldomero Sommer National Hospital, that give a complete assistance to the leprosy patients either to the pavilion patients or the ill patients that help oneselves and live in houses with their families and where it is given food assistance to promote and increase their quality of life. OBJECTIVES Evaluate The nutritional state of the ill patients that help oneselves and live in houses with their families. Analyze the caloric and proteic brought by the institution. MATERIAL AND METHODS It is a transversal and descriptive study. We made a nutritional evaluation of the patients that live in each of the 4 suburb of the hospital, whom has been previously appointed by the coordinator of the zone, with the porpoise of identify the nutritional state of each one of the patients, quantify the nutritional risk, and indicate, adequate and monitories the nutritional support. The diagnostic was realized by the dietician through: anthropometric parameters (weight, height and body mass index), biochemical parameters, according to the clinical history: albumin, cholesterol, urea, hematocrito and associated illness. RESULTS We evaluated 219 patients of 246, with a middle age of 56.4 years, 62.2% males and 57.8% females. We detected that obesity was the nutritional disorder with mayor prevalence in these population (74.3%) and with mayor incidence in the moderate obesity in males and mayor incidence in severe obesity in females. The prevalence of malnourishment was 3.6% and well-nourished was 23.7%, 27 of the patients (10.9%) did not go to the nutritional evaluation. The 2.8% of the patients did not have an actual laboratory for more than 2 years. In the clinical histories, we found that the dosage of albumin in an average of 4.2 g/dl, and the 2.8% of the patients did not have any value of albumin. The values of hematocrito and urea determinate an adequate brought of proteins in the evaluated population. Inside the nutritional diagnostic we considerate the search of diabetes (present ion the 9.7% of the patients), dislipemia (present ion the 32.8% of the patients, taken a level of 200 mg / dl of cholesterol), chronic renal deficiency (present in the 9.3% of the patients), and arterial hypertension (present in the 33.6% of the patients). CONCLUSIONS Exist a high prevalence of moderate-severe obesity in the studied population that have no coincidence with the universal literature. These data shows the necessity to adequate the caloric and proteic brought to the patients. The majority of the patients presented Dislipemia and or diabetes and or arterial hypertension. Promote the development of educational programs to better the nutritional state of the risk population, better the quality of life and reduce cardiovascular risks, using an international model that include strategies for the following of a health diet and an increase of physical activity.
Collapse
Affiliation(s)
- M Canicoba
- Hospital Nacional Baldomero Sommer, Buenos Aires, Argentina.
| | | | | | | |
Collapse
|