New curriculum to boost nutrition education, addressing need found in recent study

Dec 11, 2017

A recent study by researchers from the Ohio University Heritage College of Osteopathic Medicine and OHIO’s College of Health Sciences and Professions suggests that many first- and second-year osteopathic medical students don’t know as much about nutrition as they think they do. And most medical schools, it notes, aren’t providing their students with as many hours of nutrition education as the National Academy of Science recommends.

Now for the good news. The Heritage College’s Pathways to Health and Wellness Curriculum, which will launch next August, places an increased emphasis on the role of diet and wellness in health.

“We are doing it through patient cases,” Elizabeth Beverly, Ph.D., assistant professor of family medicine, said of the plan for nutrition education. “Students will be expected to create nutrition plans for patients based on current recommendations as well as counsel patients on physical activity guidelines, stress management and sleep.”

Beverly is the senior author of a paper published in the October edition of the Journal of the American Osteopathic Association. Her co-authors are Darlene Berryman, Ph.D., R.D., L.D., executive director of the Diabetes Institute and interim associate dean of research and innovation at the Heritage College; Emily Hargrove, M.S., R.D., L.D., a former nutrition graduate student in CHSP’s School of Applied Health Sciences & Wellness; and Jennifer Yoder, M.S., R.D., L.D., a lecturer in the same school. The study, titled “Assessment of Nutrition Knowledge and Attitudes in Preclinical Osteopathic Medical Students,” is based on a survey of 257 first- and second-year Heritage College students.

The students filled out a questionnaire assessing their attitudes toward nutrition counseling and took a quiz testing how much they knew about nutrition. Questionnaire results showed that students appreciated the importance of nutrition to health and that most believed they could counsel future patients on nutrition. Their performance on the quiz, however, suggested they lacked the knowledge to do so effectively, especially in the areas of Dietary Reference Intakes and medical nutrition therapy. DRIs offer physicians an important guide to the different nutrition requirements for people of different ages, genders and life stages.

Beverly noted that the quiz tested for fairly specialized knowledge of nutrition, so members of the general public – and even some health professionals – might not do well on it. She also pointed out that while over half of the students would have failed the quiz if it were given in a Heritage College course using the school’s standard pass/fail criterion, overall the students averaged close to 70 percent correct answers without having studied for it (the quiz was part of an online survey study). In addition, Beverly said, the same test given to third- and fourth-year students probably would have shown better performance, reflecting the teaching on nutrition they would have received by that time.

Still, the findings of the study are noteworthy because of the disparity between the students’ confidence in their knowledge of nutrition and their quiz performance. In a news release from JAOA about the study, Beverly cited this “disconnect” as a reason for concern.

“Nutrition is understood to be integral to overall health, but it is not given serious attention in physician education," she said. “The lack of knowledge about Dietary Reference Intakes, which tell physicians what kind of nutrient and energy intake their patients need, is concerning because the guidelines vary dramatically by age, sex and other factors, like pregnancy and lactation.”

The National Academy of Science recommends 25 hours of nutrition education for physicians. However, a number of previous studies have found that most medical schools fall well short of that goal. It’s difficult to precisely quantify the hours the Heritage College currently devotes to the topic, Beverly said, because nutrition-related material is included in some lectures where it may not be the central topic.

The paper’s authors recommend developing nutrition-related competencies and including nutrition questions on board certification examinations to help push schools to provide the minimum NAS-recommended number of hours of nutrition education.

Including questions about nutrition on board exams is crucial, Beverly said. “I think that’s the key,” she said. “If you test for it, that will send the message that it’s important.”