Last summer, for my MSc Thesis, I carried out a study titled Nutrition education in UK medical schools: a qualitative study of attitudes, barriers and facilitators.
You can read it at my website here.
For this study I interviewed a range of staff members from different UK medical schools and asked them what they thought about the recent calls from Nutritank and others to increase the extent of nutrition education in UK medical schools. This included 3 Deans of Medical Education. As well as gauging attitudes of staff towards nutrition, I also explored what factors are preventing or facilitating more nutrition being taught ( barriers and facilitators).
As a nutritionist I am well aware of the fundamental importance of good nutrition, so in my ideal world doctors across the UK would be regularly giving out evidence-based nutrition advice in order to aid the management of conditions such as heart disease and type 2 diabetes. Unfortunately, evidence shows that medical students have low confidence in discussing dietary guidelines.
Furthermore , before beginning this project I had repeatedly seen UK doctors writing questionable and misleading things about nutrition in articles and books that implied a lack of knowledge of the evidence base. As a result I suspected that nutrition education during medical schools needed improvement, and was encouraged to hear about the excellent work of Nutritank addressing this. I felt a qualitative study exploring what factors are preventing or facilitating more nutrition being taught would be useful for Nutritank and other advocates.
Whilst there have been several online articles and even a feature on mainstream TV calling for more nutrition in medical education, I was unable to find anything regarding the opinions of senior medical school faculty regarding these calls .Therefore I was also keen to explore this in my research and bring more balance to this discussion on nutrition education in the UK.
Below, I will explain some of the main results from my study , Nutrition education in UK medical schools: a qualitative study of attitudes, barriers and facilitators .
There was little support for additional nutrition content in the core curriculum from the most senior participants who oversaw the entire curriculum. This did not appear to stem from negative attitudes about nutrition as a science, but other factors, the most important being lack of perceived time in a crowded curriculum. The attitudes of participants (and their impressions of the attitudes of other staff) were mostly positive or sympathetic towards nutrition as a science. However, one might assume individuals willing to participate were more interested in nutrition than those who did not reply to participation requests. This was a small, non-random sample, so is merely an exploratory work that did not intent to draw firm conclusions.
Key barriers identified from interviews:
- Limited time in a crowded curriculum
- Factors relating to staffing , such as lack of sufficiently trained or motivated staff to deliver and implement content
- Difficult to implement + deliver nutrition education in a consistent manner during clinical placements
Various facilitators were cited, such as enthusiastic and motivated staff, and having a designated ‘nutrition lead’.
Surveys counting ‘hours’ of nutrition taught were criticised by several participants, and several thought students may be failing to identify nutrition when it is taught less explicitly as a part of other topics, contributing to underestimated hours.
Time was repeatedly cited as a key issue, which is why I concluded that going forward advocates for more nutrition may want to focus on providing teaching that is available outside the core curriculum, so at least those who want to learn more about nutrition in clinical practice are able to.
To resolve the issues around nutrition in clinical practice, I do think more explicit content is needed, hence I support the excellent work of Nutritank who are helping to provide nutrition-focused content such as workshops and conferences about how to utilise nutrition in clinical practice.
I also suggest that the Nutrition in Medicine online materials for students utilised in the US could be encouraged and promoted more to UK students – or better yet replicated for a UK audience.