Daley Brian J, Cherry-Bukowiec Jill, Van Way Charles W, Collier Bryan, Gramlich Leah, McMahon M Molly, McClave Stephen A
Department of Surgery, University of Tennessee Medical Center at Knoxville, Knoxville, Tennessee
Department of Surgery, University of Michigan, Ann Arbor, Michigan.
JPEN J Parenter Enteral Nutr. 2016 Jan;40(1):95-9. doi: 10.1177/0148607115571155. Epub 2015 Feb 11.
Nutrition leaders surmised graduate medical nutrition education was not well addressed because most medical and surgical specialties have insufficient resources to teach current nutrition practice. A needs assessment survey was constructed to determine resources and commitment for nutrition education from U.S. graduate medical educators to address this problem.
An online survey of 36 questions was sent to 495 Accreditation Council for Graduate Medical Education (ACGME) Program Directors in anesthesia, family medicine, internal medicine, pediatrics, obstetrics/gynecology, and general surgery. Demographics, resources, and open-ended questions were included. There was a 14% response rate (72 programs), consistent with similar studies on the topic.
Most (80%) of the program directors responding were from primary care programs, the rest surgical (17%) or anesthesia (3%). Program directors themselves lacked knowledge of nutrition. While some form of nutrition education was provided at 78% of programs, only 26% had a formal curriculum and physicians served as faculty at only 53%. Sixteen programs had no identifiable expert in nutrition and 10 programs stated that no nutrition training was provided. Training was variable, ranging from an hour of lecture to a month-long rotation. Seventy-seven percent of program directors stated that the required educational goals in nutrition were not met. The majority felt an advanced course in clinical nutrition should be required of residents now or in the future.
Nutrition education in current graduate medical education is poor. Most programs lack the expertise or time commitment to teach a formal course but recognize the need to meet educational requirements. A broad-based, diverse universal program is needed for training in nutrition during residency.
营养领域的领导者推测，研究生医学营养教育未得到妥善解决，因为大多数医学和外科专业缺乏足够资源来教授当前的营养实践。为解决这一问题，我们开展了一项需求评估调查，以确定美国研究生医学教育工作者在营养教育方面的资源和投入情况。
向麻醉学、家庭医学、内科、儿科、妇产科和普通外科的495名研究生医学教育认证委员会（ACGME）项目主任发送了一份包含36个问题的在线调查问卷。问卷内容包括人口统计学信息、资源情况以及开放式问题。回复率为14%（72个项目），与该主题的类似研究结果一致。
回复的项目主任中，大多数（80%）来自初级保健项目，其余来自外科（17%）或麻醉科（3%）。项目主任自身缺乏营养知识。虽然78%的项目提供了某种形式的营养教育，但只有26%有正式课程，且只有53%的项目由医生担任教员。16个项目没有明确的营养专家，10个项目表示未提供营养培训。培训方式各不相同，从一小时讲座到为期一个月的轮转。77%的项目主任表示，营养方面的教育目标未达成。大多数人认为，现在或将来应要求住院医师学习临床营养高级课程。
当前研究生医学教育中的营养教育状况不佳。大多数项目缺乏教授正式课程的专业知识或时间投入，但认识到需要满足教育要求。住院医师期间需要一个基础广泛、多样化的通用营养培训项目。
