scholarly journals Novel Longitudinal and Propensity Score Matched Analysis of Hands-On Cooking and Nutrition Education versus Traditional Clinical Education among 627 Medical Students

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Dominique J. Monlezun ◽  
Benjamin Leong ◽  
Esther Joo ◽  
Andrew G. Birkhead ◽  
Leah Sarris ◽  
...  
Keyword(s):  
Medical Students ◽  
Propensity Score ◽  
Medical School ◽  
Nutrition Education ◽  
Clinical Education ◽  
Meta Analysis ◽  
Traditional Education ◽  
Inverse Variance ◽  
Hands On ◽  
Disease Epidemics

Background. Physicians are inadequately equipped to respond to the global obesity and nutrition-associated chronic disease epidemics. We investigated superiority of simulation-based medical education with deliberate practice (SBME-DP) hands-on cooking and nutrition elective in a medical school-based teaching kitchen versus traditional clinical education for medical students.Materials and Methods. A 59-question panel survey was distributed to an entire medical school twice annually from September 2012 to May 2014. Student diet and attitudes and competencies (DACs) counseling patients on nutrition were compared using conditional multivariate logistic regression, propensity score-weighted, and longitudinal panel analyses. Inverse-variance weighted meta-analysis (IVWM) was used for planned subgroup analysis by year and treatment estimates across the three methods.Results. Of the available 954 students, 65.72% (n=627) unique students were followed to produce 963 responses. 11.32% (n=109) of responses were from 84 subjects who participated in the elective. SBME-DP versus traditional education significantly improved fruit and vegetable diet (OR = 1.38, 95% CI: 1.07–1.79,p=0.013) and attitudes (OR = 1.81, 95% CI: 1.40–2.35,p<0.001) and competencies (OR = 1.72, 95% CI: 1.54–1.92,p<0.001).Conclusions. This study reports for the first time superiority longitudinally for SBME-DP style nutrition education for medical students which has since expanded to 13 schools.

scholarly journals Machine Learning-Augmented Propensity Score-Adjusted Multilevel Mixed Effects Panel Analysis of Hands-On Cooking and Nutrition Education versus Traditional Curriculum for Medical Students as Preventive Cardiology: Multisite Cohort Study of 3,248 Trainees over 5 Years

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Dominique J. Monlezun ◽  
Lyn Dart ◽  
Anne Vanbeber ◽  
Peggy Smith-Barbaro ◽  
Vanessa Costilla ◽  
...  
Keyword(s):  
Machine Learning ◽  
Cohort Study ◽  
Medical Students ◽  
Propensity Score ◽  
Causal Inference ◽  
Nutrition Education ◽  
Mixed Effects ◽  
Panel Analysis ◽  
Traditional Curriculum ◽  
Hands On

Background. Cardiovascular disease (CVD) annually claims more lives and costs more dollars than any other disease globally amid widening health disparities, despite the known significant reductions in this burden by low cost dietary changes. The world’s first medical school-based teaching kitchen therefore launched CHOP-Medical Students as the largest known multisite cohort study of hands-on cooking and nutrition education versus traditional curriculum for medical students. Methods. This analysis provides a novel integration of artificial intelligence-based machine learning (ML) with causal inference statistics. 43 ML automated algorithms were tested, with the top performer compared to triply robust propensity score-adjusted multilevel mixed effects regression panel analysis of longitudinal data. Inverse-variance weighted fixed effects meta-analysis pooled the individual estimates for competencies. Results. 3,248 unique medical trainees met study criteria from 20 medical schools nationally from August 1, 2012, to June 26, 2017, generating 4,026 completed validated surveys. ML analysis produced similar results to the causal inference statistics based on root mean squared error and accuracy. Hands-on cooking and nutrition education compared to traditional medical school curriculum significantly improved student competencies (OR 2.14, 95% CI 2.00–2.28, p<0.001) and MedDiet adherence (OR 1.40, 95% CI 1.07–1.84, p=0.015), while reducing trainees’ soft drink consumption (OR 0.56, 95% CI 0.37–0.85, p=0.007). Overall improved competencies were demonstrated from the initial study site through the scale-up of the intervention to 10 sites nationally (p<0.001). Discussion. This study provides the first machine learning-augmented causal inference analysis of a multisite cohort showing hands-on cooking and nutrition education for medical trainees improves their competencies counseling patients on nutrition, while improving students’ own diets. This study suggests that the public health and medical sectors can unite population health management and precision medicine for a sustainable model of next-generation health systems providing effective, equitable, accessible care beginning with reversing the CVD epidemic.

Meta-analysis and machine learning-augmented mixed effects cohort analysis of improved diets among 5,847 medical trainees, providers, and patients

2021 ◽  
pp. 1-27
Author(s):  
Dominique J. Monlezun ◽  
Christopher Carr ◽  
Tianhua Niu ◽  
Francesco Nordio ◽  
Nicole DeValle ◽  
...  
Keyword(s):  
Machine Learning ◽  
Cohort Study ◽  
Nutrition Education ◽  
Meta Analysis ◽  
Cohort Analysis ◽  
Cost Effective ◽  
Number Needed To Treat ◽  
Nutrition Counseling ◽  
Medical Trainees ◽  
Hands On

Abstract Objective: We sought to produce the first meta-analysis (of medical trainee competency improvement in nutrition counseling) informing the first cohort study of patient diet improvement through medical trainees and providers counseling patients on nutrition. Design: (Part A) A systematic review and meta-analysis informing (Part B) the intervention analyzed in the world’s largest prospective multi-center cohort study on hands-on cooking and nutrition education for medical trainees, providers, and patients. Settings: (A) Medical educational institutions. (B) Teaching kitchens. Participants: (A) Medical trainees. (B) Trainees, providers, and patients. Results: (A) Of the 212 citations identified (N=1,698 trainees), 11 studies met inclusion criteria. The overall effect size was 9.80 (95%CI 7.15-12.456.87-13.85; p<0.001), comparable to the machine learning (ML)-augmented results. The number needed to treat for the top performing high quality study was 12. (B) The hands-on cooking and nutrition education curriculum from the top performing study was applied for medical trainees and providers who subsequently taught patients in the same curriculum (N=5,847). The intervention compared to standard medical care and education alone significantly increased the odds of superior diets (high/medium versus low Mediterranean diet adherence) for residents/fellows most (OR 10.79, 95%CI 4.94-23.58; p<0.001) followed by students (OR 9.62, 95%CI 5.92-15.63; p<0.001), providers (OR 5.19, 95%CI 3.23-8.32, p<0.001), and patients (OR 2.48, 95%CI 1.38-4.45; p=0.002), results consistent with those from ML. Conclusions: This study suggests that medical trainees and providers can improve patients’ diets with nutrition counseling in a manner that is clinically and cost effective and may simultaneously advance societal equity.

Medical students’ perceptions of nutrition education in Canadian universities

2010 ◽  
Vol 35 (3) ◽  
pp. 336-343 ◽  
Author(s):  
Leah M. Gramlich ◽  
Dana Lee Olstad ◽  
Roseanne Nasser ◽  
Laki Goonewardene ◽  
Maitreyi Raman ◽  
...  
Keyword(s):  
Medical Students ◽  
Medical School ◽  
Student Satisfaction ◽  
Nutrition Education ◽  
Nutrient Requirements ◽  
Undergraduate Medical Students ◽  
Canadian Universities ◽  
Survey Response Rate ◽  
Nutrition Instruction

Patients routinely seek physicians’ guidance about diet and the relation between nutrition and the prevention and treatment of disease. However, the adequacy of nutrition instruction in undergraduate medical education is questionable. The purpose of this study was to investigate Canadian medical students’ perceptions of and satisfaction with their education in nutrition. At 9 universities across Canada, a 23-item survey questionnaire was distributed in English and French to undergraduate medical students after at least 8 months of medical school. Overall, 9 of 17 universities participated in the survey, and 933 of the 3267 medical students approached completed the survey (response rate, 28.6%). Mean satisfaction with nutrition instruction received during medical school was 4.7 (±0.06) on a scale of 1–10, where 1 is very dissatisfied and 10 is very satisfied, and there were significant differences among schools (p < 0.0001). Students were comfortable in their ability to counsel patients regarding basic nutrition concepts and the role of nutrition in prevention of disease, but were much less comfortable discussing the role of nutrition in the treatment of disease and nutrient requirements across the lifecycle, and in identifying credible sources of nutrition information. Of the 933 respondents, 87.2% believe that their undergraduate program should dedicate more time to nutrition education. The amount of nutrition instruction correlated with student satisfaction (p < 0.0001), but varied among schools. A significant number of students are dissatisfied with the nutrition education they receive and their ability to provide relevant and appropriate nutrition counselling. This study paves the way for further discussions and development of strategies to improve nutrition education in medical schools in Canada.

Morning in refugee health: an introduction for medical students

2015 ◽  
Vol 11 (2) ◽  
pp. 86-94 ◽  
Author(s):  
Pauline S. Duke ◽  
Fern Brunger ◽  
Elizabeth Ohle
Keyword(s):  
Health Care ◽  
Medical Students ◽  
Medical School ◽  
Clinical Education ◽  
Clinical Skills ◽  
Refugee Health ◽  
Community Context ◽  
Successful Implementation ◽  
Health Providers ◽  
Content Type

Purpose – Migration is increasing worldwide. health care practitioners must provide care to migrants in a culturally competent manner that is sensitive to cultural, political and economic contexts shaping health and illness. Many studies have provided strong evidence that health providers benefit from training in cross-cultural care. Cultural competence education of medical students during their early learning can begin to address attitudes and responsiveness toward refugees. At Memorial University in Canada, the authors designed “Morning in Refugee Health”, an innovative program in cultural competency training for first year medical students in the Clinical Skills and Ethics course. The purpose of this paper is to discuss these issues. Design/methodology/approach – Here the authors introduce the curriculum and provide the rationale for the specific pedagogical techniques employed, emphasizing the consideration of culture in its relation to political and economic contexts. The authors describe the innovation of training standardized patients (SPs) who are themselves immigrants or refugees. The authors explain how and why the collaboration of community agencies and medical school administration is key to the successful implementation of such a curriculum. Findings – Medical students benefit from early pre-clinical education in refugee health. Specific attention to community context, SP training, small group format, linkages between clinical skills and medical ethics, medical school administrative and community agency support are essential to development and delivery of this curriculum. As a result of the Morning in Refugee Health, students initiated a community medical outreach project for newly arriving refugees. Originality/value – The approach is unique in three ways: integration of training in clinical skills and ethics; training of SPs who are themselves immigrants or refugees; and reflection on the political, economic and cultural contexts shaping health and health care.

scholarly journals How Effective is a Dental Workshop at Improving the Knowledge and Confidence of Medical Students in the Management of Dental Emergencies?

2016 ◽  
Vol 3 ◽  
pp. JMECD.S39992
Author(s):  
George R. Deeb ◽  
Amber Johnson ◽  
Mikhail Bondarew ◽  
Caroline Carrico ◽  
Daniel Laskin ◽  
...  
Keyword(s):  
Medical Students ◽  
Medical School ◽  
Medical Training ◽  
Dental Education ◽  
P Value ◽  
Hands On ◽  
Questionnaire Surveys ◽  
Interactive Workshop

The purpose of this study was to evaluate the effect of a three-hour hands-on workshop for medical students and residents on their pre- and postcourse knowledge and confidence in managing dental emergencies. A 1-hour lecture followed by four 20-minute “hands-on” skill stations on dental mannequins was administered to a group of 30 medical students and residents. Pre- and postworkshop questionnaire surveys were conducted. There was a significant increase in the percent of attendees who responded correctly to three of the four knowledge questions following the workshop ( P-value < 0.005). Confidence, as expressed in various statements, about treating dental emergencies was significantly improved after the lecture for eight of the nine statements. These findings indicate that dental knowledge is generally not provided during medical training. Our interactive workshop appeared to be effective in increasing this knowledge and self-reported confidence in handling dental emergencies. These findings clearly indicate the need for additional dental education during medical school. The use of a hands-on workshop may be one model for achieving this goal.

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.

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