Singh Harminder, Duerksen Donald R
Department of Medicine, University of Manitoba, Winnipeg, Manitoba.
Can J Gastroenterol. 2006 Aug;20(8):527-30. doi: 10.1155/2006/835462.
Nutrition education is a required part of gastrointestinal training programs. The involvement of gastroenterologists in clinical nutrition once their training has been completed is unknown. The aim of the present study was to determine the practice pattern of gastroenterologists in clinical nutrition and their perceived adequacy of nutrition training during their gastroenterology (GI) fellowship.
The Canadian Association of Gastroenterology mailed a survey to all of its 463 Canadian clinician members and 88 trainee members. Components of the survey included knowledge of nutritional assessment and total parenteral nutrition, involvement in a nutrition support service, physician involvement in nutritional assessment and nutrition support teams, obesity management, insertion of gastrostomy (G) tubes and management of tube-related complications, and adequacy of training in clinical nutrition.
Sixty per cent (n=279) of the Canadian Association of Gastroenterology clinicians and 38% (n=33) of the fellows responded. Of the clinicians, 80% were practicing adult gastroenterologists with the following demographics: those practicing full time in academic centres (42%), community practice (45%), completed training in the last 10 years (32%) and those that completed training in the United States (14%). Although only 6% had a primary focus of nutrition in their GI practices, 65% were involved in nutrition support (including total parenteral nutrition), 74% placed G tubes and 68% managed at least one of the major complications of G tube insertion. Respondents felt a gastroenterologist should be the physician's consultant on nutrition support services (89%). Areas of potential inadequate training included nutritional assessment, indications for nutrition support, management of obesity and management of G tube-related complications. The majority of clinicians (67%) and trainees (73%) felt that nutrition training in their GI fellowship was underemphasized.
The majority of Canadian gastroenterologists are involved in nutrition support. However, this survey demonstrated that nutritional training is underemphasized in most training programs. It is important for GI fellowship programs to develop standardized nutrition training that prepares trainees for their practice.
营养教育是胃肠病培训项目的必要组成部分。胃肠病学家完成培训后参与临床营养工作的情况尚不清楚。本研究的目的是确定胃肠病学家在临床营养方面的实践模式，以及他们在胃肠病（GI）专科培训期间对营养培训的认知是否充分。
加拿大胃肠病协会向其463名加拿大临床医生会员和88名实习会员发送了一份调查问卷。调查内容包括营养评估和全胃肠外营养的知识、参与营养支持服务的情况、医生参与营养评估和营养支持团队的情况、肥胖管理、胃造口（G）管的插入及与管相关并发症的管理，以及临床营养培训的充分性。
加拿大胃肠病协会60%（n = 279）的临床医生和38%（n = 33）的实习医生回复了问卷。在临床医生中，80%是从事成人胃肠病学的医生，其人口统计学特征如下：在学术中心全职工作的（42%）、社区执业的（45%）、在过去10年完成培训的（32%）以及在美国完成培训的（14%）。虽然只有6%在其胃肠病实践中主要关注营养，但65%参与了营养支持（包括全胃肠外营养），74%放置了G管，68%管理了至少一种G管插入的主要并发症。受访者认为胃肠病学家应作为医生在营养支持服务方面的顾问（89%）。潜在培训不足的领域包括营养评估、营养支持的指征、肥胖管理以及G管相关并发症的管理。大多数临床医生（67%）和实习医生（73%）认为他们在胃肠病专科培训中的营养培训未得到足够重视。
大多数加拿大胃肠病学家参与营养支持。然而，这项调查表明，大多数培训项目中营养培训未得到足够重视。胃肠病专科培训项目制定标准化的营养培训，使实习生为实践做好准备很重要。
