Undergraduate Medical Students’ Perceptions of Nutrition Education at the Northern Ontario School of Medicine

Publication: Canadian Journal of Dietetic Practice and Research
22 November 2022

Abstract

The objective of this evaluation was to determine Northern Ontario School of Medicine (NOSM) undergraduate medical education (UME) students’ perceptions of the curriculum related to their nutrition knowledge, attitudes, and counseling self-efficacy/confidence. A 16-item electronic survey (Qualtrics©) was developed, and it included nutrition competency statements, adult and pediatric nutrition assessment and counseling confidence, and nutrition curriculum satisfaction. Students in Years 2, 3, and 4 (n = 192, 66%–73% female) were invited to answer the survey. Of the 61 respondents, 50.8% were Year 2, 34.9% Year 3, and 10.6% Year 4. Overall, 72.1% of the respondents were dissatisfied. Respondents perceived they were least competent in strategies to prevent and treat disease (72.1%), in applying basic dietary strategies (65.6%), and in ethics and nutrition management (62.3%), whereas 52.5% felt competent in the team approach to nutrition care. Respondents reported lowest confidence (less than 10%–15%) in specialized nutrition support, cancer care, renal nutrition, and mental health/eating disorders for both populations. NOSM medical learners reported curriculum dissatisfaction, nutrition incompetence, and poor levels of perceived confidence in nutrition management. Results will be used to inform nutrition curriculum enhancements and future outcome evaluations. Current and future physicians with enhanced nutrition knowledge, awareness of the Registered Dietitian (RD) roles, and an understanding of when to refer patients to an RD can provide better patient-centred care.

Résumé

L’objectif de cette évaluation était de connaître les perceptions d’étudiants en médecine au premier cycle de l’École de médecine du Nord de l’Ontario (EMNO) quant au programme d’études et à son lien avec leurs connaissances en nutrition, leur attitude et leur autoefficacité/confiance en matière de counseling. Une enquête en ligne (via Qualtrics ©) de 16 questions a été créée pour couvrir les aspects suivants : énoncés de compétences en nutrition, évaluation nutritionnelle des adultes et des enfants et confiance en matière de counseling, et satisfaction à l’égard du programme d’études relativement à la nutrition. Des étudiants des 2e, 3e et 4e années (n = 192, 66 %-73 % de femmes) ont été invités à répondre à l’enquête. Sur les 61 répondants, 50,8 % étaient en 2e année, 34,9 % en 3e année et 10,6 % en 4e année. Dans l’ensemble, 72,1 % des répondants étaient insatisfaits. Les répondants se percevaient moins compétents quant aux stratégies de prévention et de traitement des maladies (72,1 %), à l’application de stratégies alimentaires de base (65,6 %), et à l’éthique et à la gestion de la nutrition (62,3 %), tandis que 52,5 % s’estimaient compétents relativement à l’approche d’équipe en soins nutritionnels. Les répondants ont déclaré se sentir moins confiants (moins de 10 %-15 %) en ce qui concerne le soutien nutritionnel spécialisé, les soins aux personnes atteintes de cancer, la nutrition rénale et la santé mentale/les troubles alimentaires pour les deux populations. Les étudiants en médecine de l’EMNO ont indiqué être insatisfaits du programme d’études, être incompétents en matière de nutrition et percevoir une faible confiance en leur capacité de gestion de la nutrition. Les résultats serviront à améliorer les aspects relatifs à la nutrition du programme d’études et à évaluer de futurs résultats. Les médecins actuels et futurs qui possèdent de meilleures connaissances sur la nutrition, qui connaissent le rôle des diététistes et qui savent quand diriger leurs patients vers les diététistes peuvent offrir de meilleurs soins axés sur le patient.

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Funding: In-kind
Conflict of interest: The authors declare that they have no competing interests.

REFERENCES

1
Anderson TJ, Grégoire J, Pearson GJ, Barry AR, Couture P, Dawes M, et al. 2016 Canadian Cardiovascular Society Guidelines for the Management of Dyslipidemia for the Prevention of Cardiovascular Disease in the Adult. Can J Cardiol. 2016 Nov;32(11):1263–1282.
2
Nerenberg KA, Zarnke KB, Leung AA, Dasgupta K, Butalia S, McBrien K, et al. Hypertension Canada’s 2018 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults and Children. Can J Cardiol. 2018 Mar;34(5):506–525.
3
Wharton S, Lau DCW, Vallis M, Sharma AM, Biertho L, Campbell-Scherer D, et al. Obesity in adults: A clinical practice guideline. CMAJ. 2020 Aug;192(31):E875–E891.
4
Health Canada. Canada’s Dietary Guidelines for Health Professionals and Policy Makers [Internet]. Health Canada. 2019. [cited 2021 Dec 18]. Available from https://food-guide.canada.ca/en/guidelines/
5
Cresci G, Beidelschies M, Tebo J, and Hull A. Educating Future Physicians in Nutritional Science and Practice: The Time Is Now. J Am Coll Nutr. 2019 Nov;38(5):387–394.
6
Hanninen S and Rashid M. Assessment of Students’ Perception of the Nutrition Curriculum in a Canadian Undergraduate Medical Education Program. J Can Assoc Gastroenterol. 2019 Aug;2(3):141–147.
7
Jaroudi SS, Sessions WS, Wang VS, Shriver JL, Helekar AS, Santucci M, et al. Impact of culinary medicine elective on medical students’ culinary knowledge and skills. Baylor Univ Med Cent Proc. 2018 Sep;31(4):1–4.
8
Gramlich LM, Olstad DL, Nasser R, Goonewardene L, Raman M, Innis S, et al. Medical students’ perceptions of nutrition education in Canadian universities. Appl Physiol Nutr Metab. 2010 Jun;35(3):336–343.
9
The Association of Faculties of Medicine of Canada. Graduation Questionnaire National Report 2021 [Internet]. 2021. [cited 2021 Dec 20]. Available from https://www.afmc.ca/sites/default/files/nationalreports/2021_GQ_National_Report_EN.pdf
10
Schlair S, Hanley K, Gillespie C, Disney L, Kalet A, Darby PC, et al. How Medical Students’ Behaviors and Attitudes affect the Impact of a Brief Curriculum on Nutrition Counseling. J Nutr Educ Behav. 2012 Nov-Dec;44(6):653–7.
11
La Puma J. What Is Culinary Medicine and What Does It Do? Population Health Management. 2016 Feb;19(1):1–3.
12
Rothman JM, Bilici N, Mergler B, Schumacher R, Mataraza-Desmond T, Booth M, et al. A Culinary Medicine Elective for Clinically Experienced Medical Students: A Pilot Study. J Altern Complement Med. 2020 Jul;26(7):636–644.
13
Rysdale L, Wakegiig J, Alderton N, Bachiu J, Bessett N, Campbell A, et al. Food for Thought: Northern Ontario Clinicians’ Perspectives in Nutrition-Related Skills + Knowledge Needed for Effective Physician Practice + Medical Learner Wellness. Sudbury, ON; Thunder Bay, ON; 2020.
14
Deakin University. Nutrition Competency Framework (NCF) March 2016 [Internet]. 2016. [cited 2021 Feb 9] Available from http://www.deakin.edu.au/__data/assets/pdf_file/0017/511244/NCFfinal_feb2016.pdf
15
Colbert CY, French JC, Arroliga AC, Bierer SB. Best practice versus actual practice: an audit of survey pretesting practices reported in a sample of medical education journals. Med Educ Online [Internet]. 2019 Dec [cited 2021 Feb 13];24(1):1673596.
16
The Northern Ontario School of Medicine (NOSM) [Internet]. Northern Ontario Dietetic Internship Program (NODIP) [cited 2021 Mar 17]. Available from https://www.nosm.ca/education/nodip/
17
Razavi AC, Monlezun DJ, Sapin A, Stauber Z, Schradle K, Schlag E, et al. Multisite Culinary Medicine Curriculum Is Associated With Cardioprotective Dietary Patterns and Lifestyle Medicine Competencies Among Medical Trainees. Am J Lifestyle Med. 2020 Jan;14(2):225–233.
18
Crowley J, Ball L, Hiddink GJ. Nutrition in medical education: a systematic review. Lancet Planet Heal. 2019 Sept;3(9):379–89.
19
Monlezun DJ, Leong B, Joo E, Birkhead AG, Sarris L, Harlan TS. Novel Longitudinal and Propensity Score Matched Analysis of Hands-On Cooking and Nutrition Education versus Traditional Clinical Education among 627 Medical Students. Adv Prev Med. 2015 Sep;2015:656780.
20
Van Horn L, Lenders CM, Pratt CA, Beech B, Carney PA, Dietz W, et al. Advancing Nutrition Education, Training, and Research for Medical Students, Residents, Fellows, Attending Physicians, and Other Clinicians: Building Competencies and Interdisciplinary Coordination. Adv Nutr. 2019 Nov;10(6):1181–1200.
21
Barkoukis H, Swain J, Rogers C, and Harris SR. Culinary Medicine and the Registered Dietitian Nutritionist: Time for a Leadership Role. J Acad Nutr Diet. 2019 Oct;119(10):1607–1612.
22
Hauser ME. A Novel Culinary Medicine Course for Undergraduate Medical Education. Am J Lifestyle Med. 2019 May;13(3):262–264.
23
Jacob M, Stewart P, Medina-Walpole A, and Fong CT. A culinary laboratory for nutrition education. Clin Teach. 2016 Jun;13(3):197–201.
24
Asher RC, Shrewsbury VA, Bucher T, Collins, CE. Culinary medicine and culinary nutrition education for individuals with the capacity to influence health related behaviour change: A scoping review. J Hum Nutr Diet. 2021 Aug, 20:1-8.
25
Burch E, Crowley J, Laur C, Ray S, and Ball L. Dietitians’ Perspectives on Teaching Nutrition to Medical Students. J Am Coll Nutr. 2017;36(6):415–421.
26
Hark LA and 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;117(7):1104–1113.
27
Gerbase MW, Germond M, Cerutti B, Vu N V, and Baroffio A. How many responses do we need? Using generalizability analysis to estimate minimum necessary response rates for online student evaluations. Teach Learn Med. 2015;27(4):395–403.
28
Sedgwick P. Non-response bias versus response bias. BMJ 2014;348:g2573.

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Information & Authors

Information

Published In

cover image Canadian Journal of Dietetic Practice and Research
Canadian Journal of Dietetic Practice and Research
Volume 84Number 1March 2023
Pages: 28 - 32
Editor: Naomi Cahill

History

Version of record online: 22 November 2022

Key Words

  1. undergraduate medical students
  2. nutrition competence
  3. confidence
  4. nutrition education
  5. nutrition curriculum
  6. Northern Ontario School of Medicine

Mots-clés

  1. étudiants de premier cycle en médecine
  2. compétence en nutrition
  3. confiance
  4. éducation à la nutrition
  5. programme d’études en nutrition
  6. École de médecine du Nord de l’Ontario

Authors

Affiliations

Erica Dubois BASc, RD
Northern Ontario Dietetic Internship Program, Sudbury, ON
Nicholas Ducharme BSc, RD
Northern Ontario Dietetic Internship Program, Sudbury, ON
Dayna Lalonde BSc, RD
Northern Ontario Dietetic Internship Program, Thunder Bay, ON
Lee Rysdale MEd, RD
Northern Ontario Dietetic Internship Program, Sudbury, ON

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