Evidence of inadequate nutrition education in medical training has been extensively documented over decades. But with the global lockdown creating a greater acceptance for communicating online, and fast improving global networks, there is new opportunity to address this major public health issue, Professor Caryl Nowson, from the School of Exercise and Nutrition Sciences, Deakin University, points out in her recent editorial published in 'BMJ Nutrition, Prevention & Health'.
Whilst there has been previously been little evidence of sustained initiatives that have effectively addressed the inadequacy of nutrition training within these professions, more recently, there has been a shift to a greater multidisciplinary team approach to medical care and this provides an ideal opportunity to develop nutritional and lifestyle educational material suitable for the wide range of health professionals involved in patient care.
A recent UK survey undertaken by a multidisciplinary team reported that doctors preferred in-person rather than online teaching, while students preferred workshops and lectures. However Nowson points out that the ongoing COVID-19 pandemic will most likely have altered this view.
"A greater number of professional groups are now interacting online and the pandemic has led to the development of innovations in online delivery of medical education.
"In one Australian medical school, this move to online learning led to review of the curriculum, streamlining of the clinical training components and have reported a high level of student satisfaction and engagement with online learning activities."
"The benefits of utilising telehealth for health delivery to patients are now being recognised by patients, health professionals and governments. This greater acceptance for communicating via video using the online environment provides another opportunity to engage health professionals and patients in practical interactive learning activities at home."
Prof Nowson explains that academics who teach professional health education courses generally lack adequate training in nutrition and so it's not appropriate for them to teach this aspect themselves.
On the other hand, if training institutions recruit ad hoc sessional staff to provide isolated lectures, they will usually have insufficient knowledge of the curriculum and therefore the nutrition content delivered lacks integration with the teaching of other aspects of patient care.
She argues it is important to develop appropriate nutrition educational resources together with agreement on the nutrition competencies required by the range of health professions in order to create a common evidence-based core that could be shared and delivered either online or face-to-face by trained nutrition educators.
"The development of set of interactive nutritional education resources that could be utilised by a much larger pool of health professionals means that the financial and staffing costs of maintaining and updating such a resource could be reduced."
The 'hidden curriculum'
Prof Nowson notes that another barrier to overcome is the issue of medical training often placing a greater emphasis on treatment, over preventative lifestyle management.
"In addition to formally integrating nutrition into health professional training, the negative impact of the ‘hidden curriculum’ particularly in medical training that places greatest emphasis on treatment (with drugs or surgery), rather than preventative and lifestyle management of chronic disease, has been shown to undermine efforts to integrate nutrition in the medical curriculum."
As times are changing and a new generation of healthcare students with a greater interest in nutrition and food come through the ranks, its becoming more common for medical students to advocate to be taught more nutrition and lifestyle strategies within their training courses.
This has been recognised by UK medical and health professional students who have established an organisation ‘Nutritank’, which has had a worldwide impact in raising awareness of the importance of diet and lifestyle factors to health providing further impetus for updating the curriculum.
Nutrition Education Collection
She adds that 'BMJ Nutrition, Prevention & Health' is currently is seeking submissions to the Nutrition Education Collection that address knowledge and training needs of the wide range of health professionals.
Particularly helpful would be submissions outlining some strategic research and implementation initiatives, which have attempted to address the nutritional content deficiencies in a systematic manner in professional training.
She concludes: "There are many challenges to effectively embed the achievement of nutrition competencies in health professional education, but with a greater capacity to interact virtually, internationally within and across professions, we now have an opportunity to collaborate globally to integrate evidence-based nutrition in health professional education.
"Currently, we have a much greater range of communication and educational delivery options and existing global networks, which are promoting good nutrition and healthy lifestyle practices across the spectrum of medical care. Furthermore, the benefits of a multidisciplinary team are now clearly recognised.
"All these factors provide a platform to effectively increase the nutrition competencies of health professionals, which have the potential to be sustainable and therefore likely to be effective in reducing the global burden of chronic disease."