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Original research
Time for nutrition in medical education
  1. Elaine Macaninch1,
  2. Luke Buckner2,
  3. Preya Amin3,
  4. Iain Broadley4,
  5. Dominic Crocombe5,
  6. Duleni Herath3,
  7. Ally Jaffee4,
  8. Harrison Carter6,
  9. Rajina Golubric6,
  10. Minha Rajput-Ray7,
  11. Kathy Martyn8 and
  12. Sumantra Ray2
  1. 1 Nutrition and Dietetics, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
  2. 2 NNEdPro Global Centre for Nutrition and Health, St John’s Innovation Centre, NNEdPro, Cambridge, UK
  3. 3 School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
  4. 4 Bristol Medical School, University of Bristol, Bristol, UK
  5. 5 York Teaching Hospital NHS Foundation Trust, York, UK
  6. 6 NNEdPro, Cambridge, UK
  7. 7 Cambridge, UK
  8. 8 SHS, University of Brighton, Brighton, UK
  1. Correspondence to Dr Kathy Martyn, SHS, University of Brighton, Brighton BN21 1 NP, UK; k.j.martyn{at}brighton.ac.uk

Abstract

Aim To synthesise a selection of UK medical students’ and doctors’ views surrounding nutrition in medical education and practice.

Methods Information was gathered from surveys of medical students and doctors identified between 2015 and 2018 and an evaluation of nutrition teaching in a single UK medical school. Comparative analysis of the findings was undertaken to answer three questions: the perceived importance of nutrition in medical education and practice, adequacy of nutrition training, and confidence in current nutrition knowledge and skills.

Results We pooled five heterogeneous sources of information, representing 763 participants. Most agreed on the importance of nutrition in health (>90%) and in a doctor’s role in nutritional care (>95%). However, there was less desire for more nutrition education in doctors (85%) and in medical students (68%). Most felt their nutrition training was inadequate, with >70% reporting less than 2 hours. There was a preference for face-to-face rather than online training. At one medical school, nutrition was included in only one module, but this increased to eight modules following an increased nutrition focus. When medical students were asked about confidence in their nutrition knowledge and on advising patients, there was an even split between agree and disagree (p=0.869 and p=0.167, respectively), yet few were confident in the UK dietary guidelines. Only 26% of doctors were confident in their nutrition knowledge and 74% gave nutritional advice less than once a month, citing lack of knowledge (75%), time (64%) and confidence (62%) as the main barriers. There was some recognition of the importance of a collaborative approach, yet 28% of doctors preferred to get specialist advice rather than address nutrition themselves.

Conclusion There is a desire and a need for more nutrition within medical education, as well as a need for greater clarity of a doctor’s role in nutritional care and when to refer for specialist advice. Despite potential selection bias and limitations in the sampling frame, this synthesis provides a multifaceted snapshot via a large number of insights from different levels of training through medical students to doctors from which further research can be developed.

  • precision nutrition
  • nutritional treatment
  • malnutrition
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjnph-2019-000049

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    Footnotes

    • EM and LB are joint first authors.

    • KM and SR are joint senior authors.

    • Twitter @macaninch

    • Contributors EM: analysis of Brighton data and synthesis of study findings. LB: analysis of junior doctor data and synthesis of study findings. PA: Cambridge data analysis and student interviews. IB: design and analysis of Nutritank online survey (students and doctors). HC: design and analysis of Cambridge junior doctors survey. DC: design and analysis of junior doctors online survey. RG: Cambridge junior doctors survey and medical students survey. DH: Cambridge junior doctors survey and medical students survey. AJ: design and analysis of Nutritank online survey (students and doctors). MR-R: guidance on data analysis and synthesis of findings. KM: planning of project and collection of University of Brighton data, and identified method for synthesis of heterogeneous data sources. SR: contributed to data synthesis and planning of Cambridge data.

    • Funding The study was funded by an education grant from MNI Award and AIM Foundation.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. Data are held at the University of Brighton repository and are available upon reasonable request through the corresponding author (KM) on publication.