As a broad range of professionals in clinical and nonclinical settings requires some expertise in human nutrition, the university system must offer academic courses tailored to these different specific needs. In the Italian university system there is still uncertainty with regard to the learning objectives regarding human nutrition. In the ministerial decrees defining the criteria for establishing university courses, the indications about education in human nutrition are rather inconsistent, sometimes detailed, but often just mentioned or even only implied. Education in human nutrition requires both an appropriate duration (number of university credits included in the degree format for different disciplines) and course units that are designed in order to achieve specific expertise. The university system should appropriately design and distinguish the nutritional competencies of the different types of graduates. Physiology and biochemistry are the academic disciplines mostly involved in teaching fundamentals of human nutrition, while the discipline sciences of applied nutrition and dietetics more strictly focuses on applied nutrition and clinical nutrition. Other academic disciplines that may contribute to education in human nutrition, depending on the type of degree, are internal medicine (and its subspecialties), hygiene, endocrinology, food technologies, food chemistry, commodity science, and so forth.

Luca Scalfi

Furio Brighenti

Nino Carlo Battistini

Alessandra Bordoni

Alessandro Casini

Salvatore Ciappellano

Daniele Del Rio

Francesca Scazzina

Fabio Galvano

Nicol&#xf2; Merendino

University Education in Human Nutrition: The Italian Experience&#x2014;A Position Paper of the Italian Society of Human Nutrition

Evidence-based practice is the foundation of nutrition and dietetics. To effectively apply evidence-based practice, health professionals must understand the basis of research. Previous work has identified the lack of involvement of dietitians in research. As part of a curriculum redevelopment in undergraduate nutrition and dietetics courses, research skill teaching was enhanced. This study evaluated the effect of a new, year two level nutrition research methods unit on the perceived research skills of students. The unit consisted of two key components: a student-led class research project and a small group systematic literature review. Prior to commencement and on completion of the course, students completed a modified version of the Research Skills Questionnaire. Results demonstrated that self-perceived competence increased by a small degree in a set of specific research skills as well as in broader skills such as information gathering and handling, information evaluation, ability to work independently, and critical thinking. The new research unit was also evaluated highly on a student satisfaction survey. Despite these positive findings, students indicated that their general feelings towards research or a career in research were unchanged. In summary, this unit enhanced students&#x2019; perceived research skills. Further exploration of students&#x2019; attitude towards research is warranted.

Zoe E. Davidson

Claire Palermo

Developing Research Competence in Undergraduate Students through Hands on Learning

Despite the importance of healthful dietary choices in combating the childhood obesity epidemic, neither primary and secondary schools nor medical schools provide adequate nutrition education. In 2005, two medical students at the University of North Carolina started the Improving Meals and Physical Activity in Children and Teens (IMPACT) program, which utilized a peer-educator model to engage medical students and high school students in teaching 4th graders about healthy eating and physical activity. Over the years, medical student leaders of IMPACT continued the program, orienting the curriculum around the 5-2-1-0 Let&#x2019;s Go campaign, aligning the IMPACT curriculum with North Carolina state curricular objectives for 4th graders and engaging and training teams of health professional students to deliver the program. The IMPACT project demonstrates how medical and other health professional students can successfully promote nutrition and physical activity education for themselves and for children through community-based initiatives. Ongoing efforts are aimed at increasing family participation in the curriculum to maximize changes in eating and physical activity of IMPACT participants and ensuring sustainability of the organization by engaging health professional student participants in continuing to improve the program.

Avik Chatterjee

Thomas N. Rusher

Julia Nugent

Kenneth W. Herring

Lindsey M. Rose

Dean Nehama

Natalie D. Muth

Making an IMPACT: The Story of a Medical Student-Designed, Peer-Led Healthy Eating and Physical Activity Curriculum

Medical nutrition education in most US medical schools is lacking, despite an epidemic of lifestyle related chronic conditions and high rates of malnutrition in hospitals.  In a unique response to this deficit, students at Boston University School of Medicine have created a novel student interest group entitled Student Nutrition Awareness and Action Council (SNAAC).  This student group is unique in that it focuses on interprofessional collaboration and development of concrete practice skills and works to fill educational gaps. The goal of SNAAC is to increase medical student knowledge, attitude, and skills in medical nutrition through providing extracurricular activities and partnering with official medical school curriculum committees. To accomplish this, SNAAC has developed a multipartite group overseen by a mentoring team composed of a physician nutrition specialist, registered dietitian, and a mental health provider.  SNAAC provides nutrition oriented opportunities for members and the student body at large. Participation is high because it fills an educational gap, offers a unique focus on expanding nutrition awareness and education, and provides opportunities for student leadership and professional development.  We encourage other medical schools to use the SNAAC student involvement model to increase nutrition awareness and facilitate the incorporation of medical nutrition in their curriculum.

Cynthia L. Schoettler

Jennifer N. Lee

Kathy A. Ireland

Carine M. Lenders

A Novel Method of Increasing Medical Student Nutrition Awareness and Education

<i>Purpose</i>. Describe nutrition education at US colleges of osteopathic medicine; determine if it meets recommended levels. <i>Method</i>. We surveyed 30 US colleges of osteopathic medicine (US COM) with a four-year curriculum about the amount and form of required nutrition education during the 2012/13 academic year. The online survey asked about hours of required nutrition across all 4 years and also in what types of courses this instruction occurred. We performed descriptive statistics to analyze the data. <i>Results</i>. Twenty-six institutions (87&#x25; response rate) completed the survey. Most responding US COM (22/26, 85&#x25;) do not meet the recommended minimum 25 hours of nutrition education; 8 (31&#x25;) provide less than half as much. Required nutrition instruction is largely confined to preclinical courses, with an average of 15.7 hours. Only 7 of the 26 responding schools report teaching clinical nutrition practice, providing on average 4.1 hours. <i>Conclusions</i>. Most US COM are inadequately preparing osteopathic physicians for the challenges they will face in practice addressing the nutritional concerns of their patients. Doctors of osteopathy cannot be expected to properly treat patients or guide the prevention of cardiovascular disease, obesity, cancer, diabetes, and metabolic syndrome if they are not trained to identify and modify the contributing lifestyle factors.

Kathaleen Briggs Early

Kelly M. Adams

Martin Kohlmeier

Analysis of Nutrition Education in Osteopathic Medical Schools

Deficiencies in medical school nutrition education have been noted since the 1960s. Nutrition-related non-communicable diseases, including heart disease, stroke, cancer, diabetes, and obesity, are now the most common, costly, and preventable health problems in the US. Training medical students to assess diet and nutritional status and advise patients about a healthy diet, exercise, body weight, smoking, and alcohol consumption are critical to reducing chronic disease risk. Barriers to improving medical school nutrition content include lack of faculty preparation, limited curricular time, and the absence of funding. Several new LCME standards provide important impetus for incorporating nutrition into existing medical school curriculum as self-directed material. Fortunately, with advances in technology, electronic learning platforms, and web-based modules, nutrition can be integrated and assessed across all four years of medical school at minimal costs to medical schools. Medical educators have access to a self-study nutrition textbook, <i>Medical Nutrition and Disease, Nutrition in Medicine</i>&#xA9; online modules, and the NHLBI <i>Nutrition Curriculum Guide for Training Physicians</i>. This paper outlines how learner-directed nutrition content can be used to meet several US and Canadian LCME accreditation standards. The health of the nation depends upon future physicians&#x2019; ability to help their patients make diet and lifestyle changes.

Lisa A. Hark

Darwin D. Deen

Gail Morrison

Learner-Directed Nutrition Content for Medical Schools to Meet LCME Standards

Good nutrition is the foundation for good health. While basic nutritional assessment is part of many medical consultations, it remains underutilized despite becoming increasingly recognized as important for chronic disease prevention and management. Many studies identify shortfalls in physicians&#x2019; knowledge and attitudes toward nutrition as a result of inadequate emphasis in medical school. Additional teaching about nutrition and nutritional assessment procedures was integrated within a first year module of a MBBS program. Blended learning techniques were employed to facilitate student engagement and sessions were evaluated via student response system technology (clickers) or minute paper feedback. The initial survey to all medical students <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-2.18977pt" id="M1" height="11.4781pt" version="1.1" viewBox="-0.0498162 -9.28833 56.8659 11.4781" width="56.8659pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g50-41" d="M309 -142C211 -61 151 99 151 271S210 601 309 683L288 710C141 611 75 451 75 272V271C75 90 141 -72 288 -169L309 -142Z"/></g><g transform="matrix(.013,0,0,-0.013,4.654,0)"><path id="g50-111" d="M504 89L488 119C453 85 428 69 416 69C408 69 405 75 412 102L462 304C492 438 460 451 436 451S388 441 356 423C311 397 229 336 170 256H168L189 340C208 418 200 451 177 451C144 451 82 413 24 352L40 322C65 345 98 369 108 369C114 369 119 363 112 335L28 -3L36 -12C54 -3 83 4 112 10C125 73 138 122 153 174C205 258 328 382 376 382C395 382 399 369 384 305L330 93C312 25 323 -12 351 -12C378 -12 439 21 504 89Z"/></g><g transform="matrix(.013,0,0,-0.013,14.986,0)"><path id="g54-34" d="M556 331V384H55V331H556ZM556 140V193H55V140H556Z"/></g><g transform="matrix(.013,0,0,-0.013,26.604,0)"><path id="g50-50" d="M389 0V32C297 38 291 46 291 118V635C234 613 175 595 109 583V556L161 554C203 552 207 547 207 497V118C207 46 201 38 110 32V0H389Z"/></g><g transform="matrix(.013,0,0,-0.013,32.935,0)"><path id="g50-49" d="M245 635C92 635 37 457 37 312C37 149 91 -12 244 -12C395 -12 449 166 449 312C449 469 395 635 245 635ZM243 598C332 598 358 454 358 312C358 173 334 26 245 26C158 26 128 174 128 313S152 598 243 598Z"/></g><g transform="matrix(.013,0,0,-0.013,39.266,0)"><path id="g50-52" d="M290 377C321 398 342 415 358 430C378 450 389 473 389 502C389 578 329 635 238 635H237C184 635 137 610 109 578L64 515L88 493C112 529 154 573 208 573S303 542 303 482C303 409 233 370 141 341L149 308C165 313 190 319 215 319C272 319 341 283 341 193C342 98 292 43 222 43C163 43 122 72 96 94C88 101 79 100 70 94C61 87 47 73 46 60C44 47 48 37 62 23C76 10 118 -12 165 -12C238 -12 430 62 430 223C430 297 379 359 290 375V377Z"/></g><g transform="matrix(.013,0,0,-0.013,45.597,0)"><path id="g50-56" d="M453 623H65C60 580 56 530 46 472H80C103 538 110 548 175 548H389C310 380 195 168 90 0L98 -12L175 -2C273 206 366 408 462 610L453 623Z"/></g><g transform="matrix(.013,0,0,-0.013,51.93,0)"><path id="g50-42" d="M283 271C283 451 220 610 70 710L48 683C146 603 207 443 207 271S149 -59 48 -142L70 -169C220 -67 283 90 283 271Z"/></g></svg> documented that less than half (45&#x25;) felt they could discuss nutrition with patients. The majority <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-2.18977pt" id="M2" height="11.4781pt" version="1.1" viewBox="-0.0498162 -9.28833 50.5112 11.4781" width="50.5112pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g50-41"/></g><g transform="matrix(.013,0,0,-0.013,4.654,0)"><use xlink:href="#g50-111"/></g><g transform="matrix(.013,0,0,-0.013,14.986,0)"><use xlink:href="#g54-34"/></g><g transform="matrix(.013,0,0,-0.013,26.604,0)"><path id="g50-55" d="M141 347C171 480 264 541 327 570C364 587 403 599 436 605L429 641C389 634 339 622 300 609C191 570 37 458 37 239C37 86 126 -12 245 -12C367 -12 454 89 454 210C454 314 380 397 272 397C252 397 230 390 208 380L141 347ZM231 338C323 338 366 257 366 174C366 108 340 27 263 27C180 27 129 123 129 244C129 268 130 292 135 310C158 323 193 338 231 338Z"/></g><g transform="matrix(.013,0,0,-0.013,32.935,0)"><use xlink:href="#g50-49"/></g><g transform="matrix(.013,0,0,-0.013,39.266,0)"><use xlink:href="#g50-55"/></g><g transform="matrix(.013,0,0,-0.013,45.597,0)"><use xlink:href="#g50-42"/></g></svg> regularly consulted the internet for nutrition information, while only 163 utilised peer-reviewed journals. With the first year cohort <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-2.18977pt" id="M3" height="11.4781pt" version="1.1" viewBox="-0.0498162 -9.28833 50.5112 11.4781" width="50.5112pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g50-41"/></g><g transform="matrix(.013,0,0,-0.013,4.654,0)"><use xlink:href="#g50-111"/></g><g transform="matrix(.013,0,0,-0.013,14.986,0)"><use xlink:href="#g54-34"/></g><g transform="matrix(.013,0,0,-0.013,26.604,0)"><path id="g50-51" d="M414 144C384 79 371 75 317 75H135L276 221C367 316 408 376 408 465C408 570 327 635 237 635C179 635 131 609 100 575L42 494L67 471C94 510 138 565 205 565C277 565 321 517 321 435C321 348 258 270 195 195C146 137 88 81 33 26V0H411C423 44 433 88 446 135L414 144Z"/></g><g transform="matrix(.013,0,0,-0.013,32.935,0)"><path id="g50-58" d="M247 635C116 635 39 518 39 421C39 315 113 237 221 237C239 237 258 241 281 253L349 289C315 140 204 42 60 19L66 -15C90 -15 153 -5 207 16C344 70 447 199 447 385C447 521 373 635 247 635ZM231 598C329 598 356 478 356 390C356 371 355 347 352 325C330 309 297 297 262 297C179 297 127 369 127 456C127 515 156 598 231 598Z"/></g><g transform="matrix(.013,0,0,-0.013,39.267,0)"><use xlink:href="#g50-56"/></g><g transform="matrix(.013,0,0,-0.013,45.6,0)"><use xlink:href="#g50-42"/></g></svg> &#x201c;clickers&#x201d; revealed that 91&#x25; felt nutrition important to health care and 82&#x25; felt it important in general practice. 71&#x25; found using clickers an interesting enhancement, whilst 70&#x25; noted the nutrition content informative. Early nutrition teaching was well received by students. Long-term increases in nutritional information dissemination, particularly by influential health care workers, might benefit not only economies but also the health of society as a whole.

Niikee Schoendorfer

Jennifer Schafer

Enabling Valuation of Nutrition Integration into MBBS Program

Nutrition knowledge, attitudes, and confidence were assessed in General Practice Registrars (GPRs) throughout Australia.  Of approximately 6,000 GPRs invited to complete a nutrition survey, 93 respondents (2&#x25;) completed the online survey, with 89 (20 males, 69 females) providing demographic and educational information. Fifty-one percent had graduated from medical school within the last two years.  From a list of 11 dietary strategies to reduce cardiovascular risk, respondents selected weight loss (84&#x25;), reducing saturated fats (90&#x25;), a maximum of two alcoholic drinks/day (82&#x25;), and increasing vegetables (83&#x25;) as &#x201c;highly appropriate&#x201d; strategies, with only 51&#x25; indicating that salt reduction was &#x201c;highly appropriate.&#x201d;  Two-thirds of registrars felt &#x201c;moderately&#x201d; (51&#x25;) or &#x201c;very&#x201d; confident (16&#x25;) providing nutrition advice.  Most of them (84&#x25;) recalled receiving information during training, but only 34&#x25; recalled having to demonstrate nutritional knowledge. The results indicate that this group of Australian GPRs understood most of the key dietary recommendations for reducing cardiovascular risk but lacked consensus regarding the recommendation to reduce salt intake and expressed mixed levels of confidence in providing nutritional advice.  Appropriate nutrition education before and after graduation is recommended for GPRs to ensure the development of skills and confidence to support patients to make healthy dietary choices and help prevent chronic diseases.

Caryl A. Nowson

Stella L. O&#x2019;Connell

Nutrition Knowledge, Attitudes, and Confidence of Australian General Practice Registrars

The organization of medical curricula with a clear distinction between basic and clinical subjects makes it difficult for teachers to collaborate and teach students in an integrated way. We designed a new subject, <i>Integrated Medicine</i>, to overcome such limitations. Here, we describe the evaluation of the first three years of running the experience, as well as the opinion of the first group of students in their sixth year. Three cohorts of first-year medical students <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-2.18977pt" id="M1" height="11.4781pt" version="1.1" viewBox="-0.0498162 -9.28833 50.5112 11.4781" width="50.5112pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g50-41" d="M309 -142C211 -61 151 99 151 271S210 601 309 683L288 710C141 611 75 451 75 272V271C75 90 141 -72 288 -169L309 -142Z"/></g><g transform="matrix(.013,0,0,-0.013,4.654,0)"><path id="g50-111" d="M504 89L488 119C453 85 428 69 416 69C408 69 405 75 412 102L462 304C492 438 460 451 436 451S388 441 356 423C311 397 229 336 170 256H168L189 340C208 418 200 451 177 451C144 451 82 413 24 352L40 322C65 345 98 369 108 369C114 369 119 363 112 335L28 -3L36 -12C54 -3 83 4 112 10C125 73 138 122 153 174C205 258 328 382 376 382C395 382 399 369 384 305L330 93C312 25 323 -12 351 -12C378 -12 439 21 504 89Z"/></g><g transform="matrix(.013,0,0,-0.013,14.986,0)"><path id="g54-34" d="M556 331V384H55V331H556ZM556 140V193H55V140H556Z"/></g><g transform="matrix(.013,0,0,-0.013,26.604,0)"><path id="g50-50" d="M389 0V32C297 38 291 46 291 118V635C234 613 175 595 109 583V556L161 554C203 552 207 547 207 497V118C207 46 201 38 110 32V0H389Z"/></g><g transform="matrix(.013,0,0,-0.013,32.935,0)"><path id="g50-54" d="M158 548H390L417 615L410 623H122L83 318C105 326 143 337 185 337C296 337 350 275 350 188C350 116 308 42 225 42C164 42 122 74 100 93C90 101 82 99 72 92C60 82 51 68 50 59C48 46 52 38 66 24C82 9 125 -12 172 -12C225 -11 292 15 346 59C408 108 437 166 437 226C437 309 371 397 242 397C214 397 170 382 133 369L158 548Z"/></g><g transform="matrix(.013,0,0,-0.013,39.266,0)"><path id="g50-57" d="M253 635C142 635 71 555 71 471C71 401 113 353 178 316C144 294 106 267 91 252C70 231 46 202 46 157C46 51 132 -12 241 -12C328 -12 442 52 442 168C442 257 379 305 311 343C354 373 380 398 388 407C406 428 417 458 417 487C417 568 348 635 253 635ZM240 600C288 600 340 563 340 481C340 423 313 387 279 360C207 394 148 427 148 499C148 549 182 600 240 600ZM252 23C188 23 129 73 129 163C129 217 162 266 211 298C289 260 360 217 360 144C360 69 312 23 252 23Z"/></g><g transform="matrix(.013,0,0,-0.013,45.597,0)"><path id="g50-42" d="M283 271C283 451 220 610 70 710L48 683C146 603 207 443 207 271S149 -59 48 -142L70 -169C220 -67 283 90 283 271Z"/></g></svg> and eight teachers, as well as a group of students of sixth year <svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-2.18977pt" id="M2" height="11.4781pt" version="1.1" viewBox="-0.0498162 -9.28833 44.1564 11.4781" width="44.1564pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g50-41"/></g><g transform="matrix(.013,0,0,-0.013,4.654,0)"><use xlink:href="#g50-111"/></g><g transform="matrix(.013,0,0,-0.013,14.986,0)"><use xlink:href="#g54-34"/></g><g transform="matrix(.013,0,0,-0.013,26.604,0)"><path id="g50-53" d="M462 177V227H365V632H320C217 496 116 350 21 208V177H284V109C284 43 280 38 190 31V0H451V31C369 38 365 43 365 108V177H462ZM284 227H88C155 336 218 430 282 519H284V227Z"/></g><g transform="matrix(.013,0,0,-0.013,32.935,0)"><use xlink:href="#g50-50"/></g><g transform="matrix(.013,0,0,-0.013,39.266,0)"><use xlink:href="#g50-42"/></g></svg>, participated in the experiment. Students worked following the problem-based learning approach. Their satisfaction, their subjective improvement of content knowledge in basic and clinical fields, and their belief about the accomplishment of educational objectives were evaluated. The results showed a high level of satisfaction, increased content knowledge, and improvement in solving problems, searching for relevant information, team working, and oral and written communication skills. Students of sixth year agreed that the subject helped them to better understand the clinical manifestations of disease, the diagnosis process, and therapeutic approaches. In conclusion, experiences such as <i>Integrated Medicine</i> may enhance the integration of knowledge by the joint work of basic and clinical teachers.

Mariano Sent&#xed;

Ramon Miralles

Joan Bigorra

Meritxell Girvent

Joan Minguella

Enric Sams&#xf3;

Jos&#xe9;-F. Solsona

Josep-E. Ba&#xf1;os

A Collaborative Project to Bridging the Gap between Basic and Clinical Teachers: The Opinion of Medical Students

Malnutrition results in increased duration of patient stay and increases hospital costs. 
However, few studies address this issue in the Indian context. A recent UK study showed that
intensive nutrition training was effective in increasing awareness of health professionals. In
order to inform such educational interventions in India, a needs assessment was conducted in
Kolkata by measuring doctors&#x2019; and dietitians&#x2019; attitudes and confidence regarding nutrition
care, advocacy, and leadership. A total of 123 doctors (including general medicine,
endocrinology, and critical care) and 56 dietitians completed a questionnaire. Doctors displayed moderate confidence in providing nutrition care but
were less confident in their skills relating to advocacy and leadership. Dietitians displayed
greater confidence than doctors in providing nutrition care but similarly lacked confidence in
skills relating to advocacy and leadership. Overall, doctors and dietitians displayed equally
positive attitudes towards nutrition in patient care. The greater confidence of dietitians
compared to doctors in providing nutrition care may be the result of specialised training. 
Despite the limitations of this study, this paper provides a first glance at the gaps in
nutritional practice within the doctors and dietitians community of Kolkata such that targeted
future studies can now be planned.

Sumantra Ray

Minha Rajput-Ray

Lauren Ball

Jennifer Crowley

Celia Laur

Suchismita Roy

Shweta Agarwal

Sabyasachi Ray

Confidence and Attitudes of Doctors and Dietitians towards Nutrition Care and Nutrition Advocacy for Hospital Patients in Kolkata, India

About this journal

Journal profile

Meet the editorial board

Editor spotlight

Submit your proposal

Do you think there is an emerging area of research that really needs to be highlighted? Or an existing research area that has been overlooked or would benefit from deeper investigation? Raise the profile of a research area by leading a Special Issue.

Journal of Biomedical Education