scholarly journals Hidden curriculum within nutrition education in medical schools

2020 ◽  
Vol 3 (1) ◽  
pp. 18-23 ◽  
Author(s):  
Stephen Martin ◽  
Elizabeth Sturgiss ◽  
Kirsty Douglas ◽  
Lauren Ball
Keyword(s):  
Medical Students ◽  
Nutrition Education ◽  
Situated Learning ◽  
Medical Management ◽  
Hidden Curriculum ◽  
Medical Training ◽  
Qualitative Interviews ◽  
Central Component ◽  
Team Members ◽  
Medical Nutrition

IntroductionPrevious attempts to enhance medical nutrition education have typically focussed on students’ acquiring nutrition knowledge or skills. Given that medical training uses an apprenticeship model of training, surprisingly few studies have explored the ‘hidden curriculum’ that students experience regarding expectations of behaviour, roles and responsibilities regarding nutrition. This study explored medical students’ perceptions and experiences regarding medical nutrition education, focussing on the context in which nutrition teaching has been provided, the presented place of nutrition within medicine and their subsequent views on their role in providing nutrition care.MethodsIndividual semi-structured qualitative interviews were conducted with 14 postgraduate medical students at different stages of their medical degree in Australia. The interviews were conducted using case studies followed by interview questions. Data were audio recorded, transcribed, coded and then underwent inductive thematic analysis.ResultsThree themes were discovered (i) Valuing nutrition in the medical management of patients whereby students perceived nutrition to be a foundational and central component of ideal medical management for patients, particularly those with chronic disease; (ii) Fluctuating emphasis on nutrition which showed that students experienced diversity in the importance placed on nutrition by others and (iii) Working with others whereby students expressed their understanding of their role in nutrition and the roles of team members such as dietitians.ConclusionTo enhance medical nutrition education, consideration needs to extend beyond counting dedicated teaching hours and mapping nutrition content, to a more contextual understanding of the situated learning that occurs for medical students.

scholarly journals How does self-perceived nutrition competence change over time during medical training? A prospective longitudinal observational study of New Zealand medical students

2020 ◽  
pp. bmjnph-2020-000080
Author(s):  
Jennifer Crowley ◽  
Lauren Ball ◽  
Clare Wall
Keyword(s):  
Medical Students ◽  
Nutrition Education ◽  
Primary Outcome ◽  
Outcome Measure ◽  
Medical Training ◽  
Primary Outcome Measure ◽  
Nutrition Care ◽  
Longitudinal Observational Study ◽  
Prospective Longitudinal ◽  
Medical Nutrition

ObjectivesMedical nutrition education aims to equip doctors with nutrition knowledge, skills, attitudes and confidence to counsel patients to improve their diet. This study aimed to describe changes in medical students’ self-perceived nutrition competence at three time points during medical training.DesignProspective longitudinal observational study.SettingThe University of Auckland, School of Medicine.ParticipantsYear 2 medical students (phase 1, preclinical) were surveyed in May 2016. Participants repeated the survey in February 2018 as Year 4 students and July 2019 (phase 2, clinical) as Year 5 students.Primary outcome measurePrimary outcome measure was self-perceived nutrition competence measured using the validated NUTrition Competence (NUTCOMP) survey.ResultsIn 2016, 102 of 279 eligible Year 2 medical students completed the survey (response rate (RR 36.7%)). In 2018, 89 Year 4 students repeated the survey (RR 87.3%) and 30 students as Year 5 students in 2019 (RR 29.41%). There was a significant increase in total NUTCOMP scores (knowledge, skills, confidence to counsel and attitude towards nutrition) between Year 2 and Year 4 (p=0.012). There was a significant increase in the confidence to counsel construct (mean difference 7.615, 95% CI 2.291 to 12.939, p=0.003) between Year 2 and Year 4. Constructs with lowest scores at all time points were nutrition knowledge and nutrition skills. There was clear desire for more nutrition education from all students: Year 2 (mean=3.8 out of 5 (1.1)), Year 4 (mean=3.9 out of 5 (0.9)), Year 5 (mean=3.8 out of 5 (0.8)).ConclusionMedical students’ self-perceived nutrition competence in providing nutrition care increased modestly at three points throughout medical training. There remains opportunity for further supporting medical students to increase their competence in nutrition care, which could be achieved through mandatory and greater medical nutrition education.

A Place for Plant-Based Nutrition in US Medical School Curriculum: A Survey-Based Study

2021 ◽  
pp. 155982762098867
Author(s):  
Kara F. Morton ◽  
Diana C. Pantalos ◽  
Craig Ziegler ◽  
Pradip D. Patel
Keyword(s):  
Medical Students ◽  
Family Medicine ◽  
Medical School ◽  
Nutrition Education ◽  
Medical Training ◽  
Lifestyle Modification ◽  
School Curriculum ◽  
Medical School Curriculum ◽  
Curricular Reform ◽  
Family Medicine Residents

Purpose. To evaluate medical students’ and family medicine residents’ perceptions of their current degree of nutrition training in general and regarding a whole-foods, plant-based (WFPB) diet. Methods. An original survey instrument was administered to medical students and family medicine residents. Quantitative and qualitative data were collected to evaluate perceptions of nutrition education in medical training, a WFPB diet, and ideas for nutrition-focused curricular reform. Results. Of the 668 trainees surveyed, 200 responded (response rate = 30%). Of these, 22% agreed that they received sufficient nutrition education in medical school and 41% agreed that a WFPB diet should be a focus. Respondents with personal experiences with a plant-based diet were more willing to recommend it to future patients. Common ideas for curricular reform were instruction on a WFPB diet along with other healthy dietary patterns, patient counseling, a dedicated nutrition course, and electives. Conclusions. Nutrition education in US medical training needs improvement to address the growing burden of obesity-related chronic disease. Proper nutrition and lifestyle modification should therefore play a larger role in the education of future physicians. A focus on plant-predominant diets, such as the WFPB diet, may be an acceptable and effective addition to current medical school curriculum, and deserves further study.

scholarly journals Uncovering cynicism in medical training: a qualitative analysis of medical online discussion forums

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e022883 ◽  
Author(s):  
Jenny Peng ◽  
Chantalle Clarkin ◽  
Asif Doja
Keyword(s):  
Medical Students ◽  
Hidden Curriculum ◽  
Medical Training ◽  
Online Discussion ◽  
Discussion Groups ◽  
Discussion Forums ◽  
Formal Curriculum ◽  
Online Discussion Forums ◽  
Student Discussion ◽  
Insight Into

ObjectiveThe development of cynicism in medicine, defined as a decline in empathy and emotional neutralisation during medical training, is a significant concern for medical educators. We sought to use online medical student discussion groups to provide insight into how cynicism in medicine is perceived, the consequences of cynicism on medical trainee development and potential links between the hidden curriculum and cynicism.SettingOnline analysis of discussion topics in Premed101 (Canadian) and Student Doctor Network (American) forums.Participants511 posts from seven discussion topics were analysed using NVivo 11. Participants in the forums included medical students, residents and practising physicians.MethodsInductive content analysis was used to develop a data-driven coding scheme that evolved throughout the analysis. Measures were taken to ensure the trustworthiness of findings, including duplicate independent coding of a sub-sample of posts and the maintenance of an audit trail.ResultsMedical students, residents and practising physicians participating in the discussion forums engaged in discourse about cynicism and highlighted themes of the hidden curriculum resulting in cynicism. These included the progression of cynicism over the course of medical training as a coping mechanism; the development of challenging work environments due to factors such as limited support, hierarchical demands and long work hours; and the challenge of initiating change due to the tolerance of unprofessionalism and the highly stressful nature of medicine.ConclusionOur unique study of North American medical discussion posts demonstrates that cynicism develops progressively and is compounded by conflicts between the hidden and formal curriculum. Online discussion groups are a novel resource to provide insight into the culture of medical training.

The impact of patient narratives on medical students’ perceptions of shared decision making: A randomized controlled trial

2020 ◽  
Author(s):  
Martina Bientzle ◽  
Marie Eggeling ◽  
Simone Korger ◽  
Joachim Kimmerle
Keyword(s):  
Decision Making ◽  
Medical Students ◽  
Shared Decision Making ◽  
Medical Training ◽  
Controlled Trial ◽  
Future Research ◽  
Shared Decision ◽  
Randomized Controlled ◽  
Information Text ◽  
The Impact

BACKGROUND: Successful shared decision making (SDM) in clinical practice requires that future clinicians learn to appreciate the value of patient participation as early as in their medical training. Narratives, such as patient testimonials, have been successfully used to support patients’ decision-making process. Previous research suggests that narratives may also be used for increasing clinicians’ empathy and responsiveness in medical consultations. However, so far, no studies have investigated the benefits of narratives for conveying the relevance of SDM to medical students.METHODS: In this randomized controlled experiment, N = 167 medical students were put into a scenario where they prepared for medical consultation with a patient having Parkinson disease. After receiving general information, participants read either a narrative patient testimonial or a fact-based information text. We measured their perceptions of SDM, their control preferences (i.e., their priorities as to who should make the decision), and the time they intended to spend for the consultation.RESULTS: Participants in the narrative patient testimonial condition referred more strongly to the patient as the one who should make decisions than participants who read the information text. Participants who read the patient narrative also considered SDM in situations with more than one treatment option to be more important than participants in the information text condition. There were no group differences regarding their control preferences. Participants who read the patient testimonial indicated that they would schedule more time for the consultation.CONCLUSIONS: These findings show that narratives can potentially be useful for imparting the relevance of SDM and patient-centered values to medical students. We discuss possible causes of this effect and implications for training and future research.

scholarly journals Face, Content, and Construct Validity of a Virtual Reality Otoscopy Simulator and Applicability to Medical Training

2021 ◽  
pp. 019459982110328
Author(s):  
Tobias Albrecht ◽  
Christoph Nikendei ◽  
Mark Praetorius
Keyword(s):  
Virtual Reality ◽  
Medical Students ◽  
Construct Validity ◽  
Content Validity ◽  
Medical Training ◽  
Controlled Trial ◽  
Correct Diagnosis ◽  
Age Groups ◽  
Tertiary Referral Center ◽  
The Face

Objective Otologic diseases are common in all age groups and can significantly impair the function of this important sensory organ. To make a correct diagnosis, the correct handling of the otoscope and a correctly performed examination are essential. A virtual reality simulator could make it easier to teach this difficult-to-teach skill. The aim of this study was to assess the face, content, and construct validity of the novel virtual reality otoscopy simulator and the applicability to otologic training. Study Design Face and content validity was assessed with a questionnaire. Construct validity was assessed in a prospectively designed controlled trial. Setting Training for medical students at a tertiary referral center. Method The questionnaire used a 6-point Likert scale. The otoscopy was rated with a modified Objective Structured Assessment of Technical Skills. Time to complete the task and the percentage of the assessed eardrum surface were recorded. Results The realism of the simulator and the applicability to medical training were assessed across several items. The ratings suggested good face and content validity as well as usefulness and functionality of the simulator. The otolaryngologists significantly outperformed the student group in all categories measured (P < .0001), suggesting construct validity of the simulator. Conclusion In this study, we could demonstrate face, content, and construct validity for a novel high-fidelity virtual reality otoscopy simulator. The results encourage the use of the otoscopy simulator as a complementary tool to traditional teaching methods in a curriculum for medical students.

scholarly journals The Effectiveness of a Foundation Year 1 Doctor Preparation Course for Final Year Medical Students

2021 ◽  
Vol 8 ◽  
pp. 238212052098418
Author(s):  
William Beedham ◽  
Kasun Wanigasooriya ◽  
Georgia R Layton ◽  
Ley Taing Chan ◽  
Adnan Darr ◽  
...  
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Core Curriculum ◽  
Junior Doctor ◽  
Hidden Curriculum ◽  
Medical Curriculum ◽  
Primary Objective ◽  
Rank Test ◽  
Significant Difference ◽  
Curriculum Topics

Background: Starting work as a junior doctor can be daunting for any medical student. There are numerous aspects of the hidden curriculum which many students fail to acquire during their training. Objectives: To evaluate the effectiveness of a novel foundation year one (FY1) doctor preparation course focusing on certain core topics, practical tips and components of the hidden curriculum. The primary objective was to improve the confidence level and knowledge of final year medical students transitioning to FY1 doctors. Method: A 2-day, practical course titled ‘Preparation 2 Practice’ delivering hands-on, small-group and lecture-based teaching, covering core medical student undergraduate curriculum topics in medicine and surgery. The course content spanned therapeutics, documentation skills and managing acute clinical tasks encountered by FY1 doctors during an on-call shift. A pre- and post-course survey and knowledge assessment were carried out to assess the effectiveness of the course. The assessment was MCQ-based, derived from topics covered within our course. The 20-question test and a short survey were administered electronically. Results: Twenty students from a single UK medical school attended the course. 100% participation was observed in the pre- and post-course test and survey. The median post-course test result was 22 (IQR 20.25-23.75) which was higher than the median pre-course test score of 18.75 (IQR 17-21.75). A Wilcoxon sign rank test revealed a statistically significant difference between the pre- and post-course test results ( P = .0003). The self-reported confidence score of delegates on starting work as a junior doctor was also significantly higher following the course ( P = .004). Conclusion: The results show a significant improvement in perceived confidence and knowledge on core curriculum topics amongst final year medical students having attended our FY1 doctor preparation course. We conclude that there is scope for similar supplementary courses as an adjunct to the undergraduate medical curriculum.

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