RD Trainees Teaching MD Trainees: Nutrition Assessment Training in Medical Education
Authors: Wickman Brooke E. , Ratner Edward R. 
Published: April 2020

Importance of nutrition’s role in health is well established. However, less than one‐quarter of medical schools meet the US National Academy of Sciences recommendation to provide a minimum of 25 hours of nutrition education. Though the clinicians most qualified to provide medical nutrition therapy are registered dietitians (RDs), medical doctors (MDs) are expected to incorporate nutrition into clinical care. An evidence‐practice gap persists as medical trainees report inadequate nutrition education, dissatisfaction with nutrition education, and unpreparedness to counsel patients about nutrition. To provide practical nutrition training to medical students, a dietetic intern at the Minneapolis VA Health Care System developed and taught nutrition curriculum to groups of 2–5 medical students in 30‐minute sessions. Nutrition professionals and trainees were surveyed to assess physician nutrition knowledge deficits observed in clinical practice. The survey guided curriculum development and therefore included an overview of RD training, the difference between RDs and nutritionists, areas of nutrition specialization, the role of RDs in various care settings, physician attitudes towards ancillary health care professionals affecting patient attitudes, and an overview of nutrition assessments. Interactive activities in the training included a diet history practice and discussion and malnutrition assessment nutrition‐focused physical exam training. Medical students provided feedback on what was learned, what could be applied in future practice, and comments about the training. Fifty‐two first‐year medical students from the University of Minnesota each attended one of twelve nutrition assessment trainings at the Minneapolis VA Medical Center between April‐June 2019. Session duration ranged 30–60 minutes based on questions and discussions. Medical student feedback of the training was overwhelmingly positive. Students reported improved awareness of nutrition considerations and RDs in clinical practice, intention to work with RDs, and intention to incorporate strategies and techniques for diet histories and nutrition‐focused physical exams into future assessments. Students were grateful and appreciative of receiving nutrition training from a dietetics trainee and requested more time for comprehensive nutrition training. This program does not yet address the sustainability of nutrition curriculum in medical education, but continuation and expansion of this program will enable further evaluation of efficacy and sustainability. Obstacles to incorporating nutrition content into medical education include financial constraints and determining how to teach and who should teach nutrition. Often in proximity, RD trainees are in position to teach MD trainees nutrition and can promote interdisciplinary professionalism and partnerships. Efforts to provide future physicians the knowledge, skills, and confidence to incorporate nutrition education into practice while simultaneously influencing collaborations with RDs has the potential to positively impact the healthcare system and patient health.

Support or Funding Information

Support was provided by the Minneapolis VA Health Care System Dietetic Internship Program and Geriatric Research, Education, and Clinical Center