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值得思考的问题:对医学实习生和教员对营养教育的看法进行定性评估。

Food for thought: a qualitative assessment of medical trainee and faculty perceptions of nutrition education.

作者信息

Kunitsky Olivia, Taye Mahdi, Feeley Karla, Johnson Hugh, Glynn Abigail, Stivale Avery, Hamers Matthew, Notarianni Alexis, Mamillapalli Sireesha, Waite Gabi, Lobo Sonia

机构信息

Department of Medical Education, Geisinger Commonwealth School of Medicine, Geisinger College of Health Sciences, 525 Pine Street, Scranton, PA, 18509, USA.

Department of Neurology, Thomas Jefferson University Hospital, Philadelphia, PA, 19107, USA.

出版信息

BMC Med Educ. 2024 Dec 30;24(1):1550. doi: 10.1186/s12909-024-06588-4.

Abstract

BACKGROUND

The American Society of Clinical Nutrition recommends 37 to 44 h of undergraduate medical nutrition education. The Total Health Curriculum at Geisinger Commonwealth School of Medicine (GCSOM) contains 14 h of objective-based nutritional instruction. This study aimed to examine the perceptions of key stakeholders regarding the role of nutrition in medicine and to identify barriers, opportunities for improvement, and roles/responsibilities for innovative implementation of nutrition education.

METHODS

This exploratory, qualitative study employed a phenomenological approach and inductive coding process. Purposive sampling recruited medical students, undergraduate medical education (UME) faculty, physicians, and other healthcare professionals at GCSOM and affiliated clinical sites. Semi-structured focus groups and one-on-one interviews were conducted via videoconferencing. Audio recordings were transcribed using NVivo 14. Transcripts were manually reviewed alongside the audio files to ensure accuracy. Data were systematically organized using the qualitative research methodology Rigorous and Accelerated Data Reduction (RADaR). Microsoft Copilot was used to assist with thematic analysis. Outcomes were compared, and consensus was obtained among raters.

RESULTS

Twenty-five individuals were interviewed: 12 UME faculty, five students, and eight healthcare professionals, including two physicians. Participants included 18 females and seven males, aged 23 to 69 years. 92% of participants believed that all physicians should receive nutrition education and 40% felt unsatisfied with their nutritional training. For barriers, the qualitative analysis identified these themes: (1) time constraints, (2) assessment and prioritization, (3) insufficient faculty expertise, and (4) bias and stigma. For improvement opportunities, the qualitative analysis identified these themes: (1) curriculum design, (2) practical application, (3) patient-centered approach, and (4) trainee perceptions. For roles/responsibilities, the qualitative analysis identified these themes: (1) accreditation bodies, (2) stakeholder involvement, (3) public policy and legislation, and (4) multilevel responsibility.

CONCLUSION

Participants acknowledged a need for more medical nutrition education to prepare physicians who are equipped to manage the nutritional needs of patients. They recognized key challenges hindering the advancement of such education, proposed various forms of improvement, and identified roles for successful implementation. Future research will assess community perspectives and expand sample diversity.

摘要

背景

美国临床营养学会建议本科医学营养教育时长为37至44小时。盖辛格联邦医学院(GCSOM)的全面健康课程包含14小时基于目标的营养教学。本研究旨在调查关键利益相关者对营养在医学中作用的看法,并确定障碍、改进机会以及营养教育创新实施的角色/责任。

方法

本探索性定性研究采用现象学方法和归纳编码过程。目的抽样招募了GCSOM及其附属临床机构的医学生、本科医学教育(UME)教师、医生和其他医疗保健专业人员。通过视频会议进行半结构化焦点小组和一对一访谈。使用NVivo 14对音频记录进行转录。将转录本与音频文件一起进行人工审核以确保准确性。使用定性研究方法“严格加速数据缩减”(RADaR)对数据进行系统整理。使用Microsoft Copilot协助进行主题分析。对结果进行比较,并在评分者之间达成共识。

结果

共访谈了25人:12名UME教师、5名学生和8名医疗保健专业人员,包括2名医生。参与者包括18名女性和7名男性,年龄在23至69岁之间。92%的参与者认为所有医生都应接受营养教育,40%的人对自己的营养培训不满意。在障碍方面,定性分析确定了以下主题:(1)时间限制,(2)评估和优先级,(3)教师专业知识不足,(4)偏见和耻辱感。在改进机会方面,定性分析确定了以下主题:(1)课程设计,(2)实际应用,(3)以患者为中心的方法,(4)学员看法。在角色/责任方面,定性分析确定了以下主题:(1)认证机构,(2)利益相关者参与,(3)公共政策和立法,(4)多层次责任。

结论

参与者承认需要更多的医学营养教育,以培养有能力满足患者营养需求的医生。他们认识到阻碍此类教育发展的关键挑战,提出了各种改进形式,并确定了成功实施的角色。未来的研究将评估社区观点并扩大样本多样性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7234/11684099/7829abba58a6/12909_2024_6588_Fig1_HTML.jpg

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