1. LESSONS LEARNED FROM A PILOT NUTRITION ELECTIVE AT AN OSTEOPATHIC MEDICAL SCHOOL
an MSEDI project
Audra Lehman MD, Glenn Davis MS - Touro University California, Vallejo, California
Introduction
Results
Discussion
Physicians occupy a front line position in the promotion of good nutrition and lifestyle practices, but medical school education continues to inadequately prepare physicians to counsel patients about nutrition-related health conditions such as obesity, diabetes, cardiovascular disease, cerebrovascular disease and cancer. 1,2 Our strategy to address this was to offer advanced nutrition training to an interprofessional group of preclinical students in a course designed to overcome faculty time constraints and leverage the principles of adult learning theory.
Legend
Exceeds Expectations
Meets Expectations
Below Expectations
Course was successful with all students achieving at least “Meets Expectations” for all CSLOs.
The highest percentage of “Exceeds Expectations” was in Teaching Skills. This may be the domain where most learning occurred, or perhaps peer grading is inflated.
Overall enrollment was low, especially compared to expressed student interest. Contributing factors likely include a lack of ‘marketing’, scheduling conflicts especially for non-COM programs, and significantly, the self-directed learning format, an observation which points out the over-simplified view of medical students as “adult learners” 4.
Variability of student presentation content and quality may have been improved with closer faculty supervision, more clearly articulated expectations, and increased attention to EBM skills in the core curriculum.
Participating students and faculty both expressed enthusiasm for the course especially citing the one on one interactions as meaningful.
Faculty time spent was not measured so comparison to conventional course delivery could not be made.
Methods
The course was offered to all students from programs in Osteopathic Medicine, Pharmacology, Physician Assistant and Public Health on the Touro University California campus.
The course was a peer-taught, seminar-style elective, designed to appeal to “adult learners” who would prefer active and independent learning on a topic of their own choosing.” 3
The course student learning objectives (CSLOs) were:
Acquire knowledge about specific nutrition topics
Interact professionally with a faculty mentor
Access and evaluate the medical literature on a topic of interest in the field of clinical nutrition
Develop teaching skills including articulating learning objectives, multimedia presentation, test question writing
CSLOs were assessed using standardized questions with narrative feedback responses interpreted on a scale ranging from “Exceeds Expectations”, “Meets Expectations” or “Below Expectations”.
CSLOs Knowledge, Professionalism and Research were evaluated by Faculty mentors.
CSLO Teaching was evaluated by student peers and faculty.
Although students from all schools expressed interest, only 8 students enrolled in and completed the course; all were from the College of Osteopathic Medicine.
Inconsistent quality of performance was noted in research and teaching skills.
Participating students rated course high overall.
Non-participating students cited preference for conventional directed learning format and difficulty with scheduling as predominant reasons in informal convenience sample interviews.
Future Directions
2015 course adopted Nutrition In Medicine (NIM), a directed learning, online curriculum focusing exclusively on CSLO Knowledge. Enrollment has more than doubled, notably with involvement from other programs.
Ultimately we hope to mainstream a Nutrition content into our core curriculum, while offering an advanced elective to motivated students.
References
Adams, et al. Nutrition in Medicine: nutrition education for medical students and residents, Nutr Clin Pract. 2010
Kris-Etherton et al. The Need to Advance Nutrition Education in the Training of Health Care Professionals and Recommended Research to Evaluate Implementation and Effectiveness. Am J Clin Nut 2014.
Knowles. The Adult Learner. Taylor & Francis;
Misch. Andragogy and Medical Education: are medical students internally motivated to learn? Advances in Health Sciences Education 2002.