Nutrition beyond drugs and devices: a review of the approaches to enhance the capacity of nutrition care provision by general practitioners

2012 ◽  
Vol 18 (2) ◽  
pp. 90 ◽  
Author(s):  
Jennifer Crowley ◽  
Lauren Ball ◽  
Clare Wall ◽  
Michael Leveritt
Keyword(s):  
Medical Education ◽  
Chronic Disease ◽  
Nutrition Education ◽  
Continuing Medical Education ◽  
Best Practice ◽  
Care Delivery ◽  
Nutrition Knowledge ◽  
Practice Setting ◽  
Care Provision ◽  
Nutrition Care

The prevention and management of chronic disease is a key priority for primary care services. Nutrition-related care is an integral feature of several best practice guidelines for management of chronic disease in the general practice setting. This paper critically reviews the international literature to enhance the nutrition knowledge, skills and overall capacity of GPs to provide nutrition care using examples from nutrition in medical education, continuing medical education, GP-centred and practice-setting approaches. The medical nutrition education approach provides an opportunity for linear translation between desired nutrition competencies and curriculum learning objectives, while that of continuing medical education allows for tailored nutrition education to increase nutrition competencies once a learning need is identified. The GP-centred approach focuses on the determinants of nutrition care provision by GPs as strategies for enhancing nutrition care delivery, whereas the practice setting approach aims to increase the nutrition-related exposure to patients through avenues independent of the GP. In the Australian and New Zealand context, the potential appropriateness of these approaches requires judicious consideration, as it is unlikely that one approach will comprehensively address this topic. Ongoing multifaceted evaluation of each approach is needed to ensure enhancement of GPs’ capacity to provide nutrition care by increasing nutrition knowledge and skills, and improving patient health outcomes.

Is continuing medical education sufficient? Assessing the clinical nutrition knowledge of medical doctors

Nutrition ◽  
2019 ◽  
Vol 57 ◽  
pp. 69-73 ◽  
Author(s):  
Maria G. Grammatikopoulou ◽  
Areti Katsouda ◽  
Kyriaki Lekka ◽  
Kyriakos Tsantekidis ◽  
Emmanouil Bouras ◽  
...  
Keyword(s):  
Medical Education ◽  
Continuing Medical Education ◽  
Nutrition Knowledge ◽  
Clinical Nutrition ◽  
Medical Doctors

scholarly journals Nutrition competence of primary care physicians in Saudi Arabia: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e033443 ◽  
Author(s):  
Osamah Al-gassimi ◽  
Hassan Bin Usman Shah ◽  
Rawan Sendi ◽  
Heba A Ezmeirlly ◽  
Lauren Ball ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Primary Care Physicians ◽  
Cross Sectional Study ◽  
Nutrition Knowledge ◽  
Sectional Study ◽  
Cross Sectional ◽  
Knowledge And Skills ◽  
Nutrition Care ◽  
Dietary Behaviours

ObjectivesPrimary care physicians have an opportunity to support healthy dietary behaviours of patients by providing nutrition care. However, it is unclear whether primary care physicians in the Kingdom of Saudi Arabia (KSA) are sufficiently competent in nutrition. This study aimed to assess the nutrition competence of primary care physicians in KSA and identify whether nutrition competence is associated with the provision of nutrition care to patients living with diet-related chronic disease.DesignA cross-sectional study.SettingChronic disease clinics across 48 primary care centres under the Ministry of Health in the city of Jeddah, KSA.Participants90 primary care physicians completed the survey (response rate: 98%). General practitioners and family medicine residents, specialists, and consultants actively working in chronic disease clinics between February and May 2019 were included.Primary and secondary outcome measuresPrimary outcome measure was nutrition competence of primary care physicians measured via the validated nutrition competence (NUTCOMP) questionnaire.ResultsPrimary care physicians perceived themselves as competent in nutrition care but their reported provision of nutrition care was limited. Confidence in their nutrition knowledge and skills elicited the lowest mean scores of 25.8 (±5.4) out of 35 and 29 (±5.2) out of 40, respectively. The reported provision of nutrition care was closely correlated with physicians’ confidence in their nutrition knowledge (r=0.57) and communication (r=0.52). Three factors were identified as predicting whether physicians provide nutrition care to patients: confidence in counselling about nutrition (p<0.001), having previous nutrition education (p=0.005) and a higher professional qualification (p=0.008).ConclusionsPrimary care physicians felt confident in providing nutrition care to patients living with diet-related chronic disease. Primary care physicians would benefit from higher levels of nutrition knowledge and skills to effectively support patients to improve their dietary behaviours and health conditions, leading to a positive impact on public health.

scholarly journals General practitioners’ views on providing nutrition care to patients with chronic disease: a focus group study

2016 ◽  
Vol 8 (4) ◽  
pp. 357 ◽  
Author(s):  
Jennifer Crowley ◽  
Lauren Ball ◽  
Anne-Thea McGill ◽  
Stephen Buetow ◽  
Bruce Arroll ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Focus Groups ◽  
General Practitioners ◽  
Nutrition Knowledge ◽  
Focus Group Study ◽  
Knowledge And Skills ◽  
Practice Nurses ◽  
Nutrition Care ◽  
Descriptive Approach ◽  
Consultation Time

ABSTRACT INTRODUCTION Nutrition care refers to practices conducted by health professionals to support patients to improve their dietary intake. General practitioners (GPs) are expected to provide nutrition care to patients for prevention and management of chronic disease. AIM This study explores GPs’ opinions regarding nutrition care provision to patients with chronic disease. METHODS An interpretive descriptive approach to qualitative research using seven semi-structured focus groups with 48 GPs in Auckland was used. Focus groups investigated how GPs felt about providing nutrition care; the perceived barriers to and support required for this care; the development of further nutrition knowledge and skills; and possible roles for Practice Nurses. Recorded interviews were transcribed verbatim and analysed using a thematic approach. RESULTS GPs indicated routine provision of basic nutrition care to patients with chronic disease, but perceived their limited consultation time and nutrition competence constrained their capacity to provide nutrition care. GPs felt they needed further information to provide culturally, socially and economically sensitive nutrition care. GPs displayed variable opinions on the benefits of developing their nutrition knowledge and skills, and the idea of Practice Nurses providing nutrition care. CONCLUSIONS Despite perceiving that nutrition care is important for patients with chronic disease and facing barriers to providing nutrition care, GPs appear reluctant to further develop their knowledge and skills and for Practice Nurses to provide this care. Strategies to enhance GPs’ nutrition-related self-efficacy, nutrition cultural competence and attitudes towards further training care may be warranted.

Nutrition Science for Health and Longevity: What Every Clinician Needs to Know

2021 ◽  
Author(s):  
Keyword(s):  
Medical Education ◽  
Clinical Practice ◽  
Food Insecurity ◽  
Motivational Interviewing ◽  
Continuing Medical Education ◽  
Nutrition Knowledge ◽  
Nutrition Science ◽  
Clinical Scenarios ◽  
Nutrition Course ◽  
Solid Foundation

This online nutrition course for clinicians, approved for 4 hours of continuing medical education, is designed to provide a solid foundation of clinically relevant nutrition knowledge, and outlines practical strategies to incorporate nutritional counseling into a busy clinical practice. Course elements include: 1) Clickable links to more than 100 key references; 2) Sections on clinician self-care, fad diets, screening for patients with food insecurity, and motivational interviewing; 3) Over 20 immersive clinical scenarios; 4) Downloadable summaries of each section with key takeaways.

scholarly journals Physicians’ Dietary Knowledge, Attitudes, and Counseling Practices: The Experience of a Single Health Care Center at Changing the Landscape for Dietary Education

2018 ◽  
Vol 13 (3) ◽  
pp. 292-300 ◽  
Author(s):  
Nicole Harkin ◽  
Emily Johnston ◽  
Tony Mathews ◽  
Yu Guo ◽  
Arthur Schwartzbard ◽  
...  
Keyword(s):  
Medical Education ◽  
Nutrition Education ◽  
Clinical Care ◽  
Care Center ◽  
Nutrition Knowledge ◽  
Lifestyle Interventions ◽  
Nutritional Knowledge ◽  
New York University ◽  
Health Care Center ◽  
Attitudes And Practices

Morbidity and mortality associated with cardiovascular disease can be significantly modified through lifestyle interventions, yet there is little emphasis on nutrition and lifestyle in medical education. Improving nutrition education for future physicians would likely lead to improved preparedness to counsel patients on lifestyle interventions. An online anonymous survey of medical residents, cardiology fellows, and faculty in Internal Medicine and Cardiology was conducted at New York University Langone Health assessing basic nutritional knowledge, self-reported attitudes and practices. A total of 248 physicians responded (26.7% response rate). Nutrition knowledge was fair, but few (13.5%) felt adequately trained to discuss nutrition with patients. A majority (78.4%) agreed that additional training in nutrition would allow them to provide better clinical care. Based on survey responses, a dedicated continuing medical education (CME) conference was developed to improve knowledge and lifestyle counseling skills of healthcare providers. In postconference evaluations, attendees reported improved knowledge of evidence-based lifestyle interventions. Most noted that they would prescribe a Mediterranean or plant-based diet and would make changes to their practice based on the conference. An annual CME conference on diet and lifestyle can effectively help interested providers overcome barriers to lifestyle change in clinical practice through improved nutrition knowledge.

scholarly journals Australian practice nurses’ perceptions of their role and competency to provide nutrition care to patients living with chronic disease

2014 ◽  
Vol 20 (2) ◽  
pp. 203 ◽  
Author(s):  
Sarah Cass ◽  
Lauren Ball ◽  
Michael Leveritt
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Nutrition Education ◽  
Care Setting ◽  
Primary Care Setting ◽  
Practice Nurses ◽  
Nutrition Care ◽  
Nurses Perceptions ◽  
Basic Level

Nutrition is important in the management of chronic disease, and practice nurses in the Australian primary care setting are increasingly providing nutrition care to patients living with chronic disease. The aim of the present study was to investigate practice nurses’ perceptions of their role and competency to provide nutrition care to patients living with chronic disease in Australia. Twenty practice nurses currently employed in general practice participated in an individual semi-structured telephone interview. Interviews were transcribed verbatim and thematically analysed. Practice nurses perceived themselves to be in a prime position to provide opportunistic nutrition care to patients. Participants perceived that the ideal role of a practice nurse is to advocate for nutrition and provide a basic level of nutrition care to patients; however, the interpretation of the term ‘basic’ varied between participants. Participants perceived that practice nurses are highly trusted and approachable, which they valued as important characteristics for the provision of nutrition care. Barriers to providing nutrition care included time constraints, lack of nutrition knowledge and lack of confidence. Participants were concerned about the availability and accessibility of nutrition education opportunities for practice nurses. The present study has demonstrated that practice nurses perceive themselves as having a significant role in the provision of nutrition care to patients with chronic disease in the Australian primary care setting. Further investigation of strategies to enhance the effectiveness of nutrition care provision by practice nurses is warranted.

scholarly journals Australian and New Zealand Medical Students’ Attitudes and Confidence towards Providing Nutrition Care in Practice

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 598 ◽  
Author(s):  
Breanna Lepre ◽  
Jennifer Crowley ◽  
Dineo Mpe ◽  
Harsh Bhoopatkar ◽  
Kylie J. Mansfield ◽  
...  
Keyword(s):  
New Zealand ◽  
Medical Students ◽  
Focus Groups ◽  
Nutrition Education ◽  
Undergraduate Students ◽  
Nutrition Knowledge ◽  
Medical Practitioners ◽  
Nutrition Care ◽  
Students Attitudes

The prevalence of lifestyle-related chronic disease is increasing. Doctors in primary care are ideally placed to support patient nutrition care, but recent reviews show education is still lacking. This study aimed to identify medical students’ attitudes towards the role of nutrition in health, nutrition knowledge, and perceptions of nutrition education, in postgraduate (Australia) and undergraduate (New Zealand) programs in order to identify gaps in nutrition knowledge and skills to better inform future education. Second-year graduate and third-year undergraduate students participated in semi-structured focus groups and interviews. A general inductive approach was used to investigate students’ (1) attitudes toward the role of nutrition in health, (2) nutrition knowledge based on nutrition-specific competencies and (3) perceived adequacy of nutrition education received. Interviews (nine) and focus groups (seven) identified four common themes: (1) role of medical practitioners in nutrition care, (2) barriers to nutrition education, (3) nutrition knowledge, and (4) nutrition-related skills. Students perceive that doctors are well-placed to provide some level of nutrition care, but poor translation of nutrition knowledge to clinical contexts is a key limitation in nutrition education. In summary, nutrition education may be insufficient to support the nutrition-related competency development of the undergraduate and postgraduate student participants in this study. Focusing on the integration of these skills into the curriculum may be a priority.

46. Did the CME/CPD train leave with half the passengers? A needs assessment of Québec specialist associations' CPD units

2007 ◽  
Vol 30 (4) ◽  
pp. 52
Author(s):  
G. Hudon ◽  
R. Laprise ◽  
L. Guindon
Keyword(s):  
Medical Education ◽  
Needs Assessment ◽  
Continuing Medical Education ◽  
Delphi Study ◽  
Best Practice ◽  
Professional Associations ◽  
Learning Needs ◽  
Structured Interviews ◽  
Academic Organizations ◽  
Canadian Association

This presentation reports on the results of a needs assessment conducted amongst the 34 Quebec specialist associations, which are accredited as CME/CPD providers by Quebec’s College of Physicians, in accordance with the Canadian Association of Continuing Medical Education’s criteria. In 2006, a mix of methods (survey, semi-structured interviews and program documentation review) were used to assess CPD units’ learning needs in the areas of CME and CPD, the extent to which they carried out a list of specific tasks associated to providers’ responsibilities, barriers encountered in meeting standards, and the kind of help needed to improve performance. Although CME/CPD fields have evolved considerably in the past 20 years, results indicate that few of the advances have made their way down to the associations. The majority still provides education in the form of traditional CME, where speakers talk about new developments in medicine. Whereas the systematic approach of CME is well integrated in most units, few go beyond perceptions in their needs assessments, use problem-based learning methods, enablers, reinforcement and outcome evaluations, or help specialists self-evaluate and reflect on their practice. These methods and approaches are believed to increase CME effectiveness. Most Canadian specialists get a large proportion of their CE from non academic medical organizations such as professional associations and learned societies. However, information available in the literature does not allow generalization of our observations to other organizations of this nature. Since non academic organizations are important CME/CPD providers, we propose that more attention be given on the way trainers are trained and innovations are shared in our CE system. What minimal knowledge and skills should be required of a CME/CPD professional today? Together with its affiliated associations and academic partners, the Federation of Medical Specialists of Quebec (FMSQ) has decided to tackle this important issue in the coming years. Olson CA, Tooman TR, Leist JC. Contents of a core library in continuing medical education: a delphi study. JCEHP 2005; 25:278-88. Davis DA, Thomson MA, Oxman AD, Haynes RB. Changing physician performance: a systematic review of the effect of continuing medical education strategies. JAMA 1995; 274:700-5. Grol R, Grimshaw J. From best evidence to best practice: effective implementation of change in patients' care. Lancet 2003; 362:1225-30.

scholarly journals Time for nutrition in medical education

2020 ◽  
Vol 3 (1) ◽  
pp. 40-48 ◽  
Author(s):  
Elaine Macaninch ◽  
Luke Buckner ◽  
Preya Amin ◽  
Iain Broadley ◽  
Dominic Crocombe ◽  
...  
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Medical School ◽  
Nutrition Education ◽  
School Nutrition ◽  
Nutrition Knowledge ◽  
Dietary Guidelines ◽  
Sources Of Information ◽  
Nutritional Care ◽  
Nutrition Training

AimTo synthesise a selection of UK medical students’ and doctors’ views surrounding nutrition in medical education and practice.MethodsInformation 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.ResultsWe pooled five heterogeneous sources of information, representing 853 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.ConclusionThere 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.

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