A Medical Science Educator Article Review From Dr. Alice Fornari

This month the IAMSE Publications Committee review is taken from the article titled “Improving Nutrition Education with Second Year Medical Students: From Take-Home Assignments to Large Group Application Exercise, MSE (2021) 31, pages 1287–1290 (2021), by Julia Bisschops, Sabyasachi Moulik & Gregory W. Schneider.

Gap: medical schools lack curriculum focus on nutrition-related topics and therefore overall to include nutrition in management and treatment plans is minimal to none for practicing physicians.

With the current focus on Social Determinants of Health (SDOH) as an important component of clinical care and food access and insecurity as an SDOH domain, the case-based intervention described includes learning objectives for both nutrition education and SDOH framed in a case of a patient with Type II diabetes mellitus. In addition, evidence-based literature searching was incorporated into the learning activity as well. To substantiate the importance of this curriculum content for the faculty and students the activity supported EPA 7. How to implement the activity content was compared over a two-year period: a take-home module vs a large group in-class session.

Level of student and course context: MS2 and endocrinology in a case-based problem-solving interactive session. Due to limited faculty resources, the session was offered as a large group didactic session (N=112) and followed by student-led small group discussions of cases. The results of the session, as reported by the students, were very positive in three areas: literature searching skills, nutrition recommendations in DM Type II, and how SDOH affects patient care and health outcomes. Therefore, all three learning objectives as outlined were met and the lecture didactic format followed by small group was rated higher than the self-study module alone activity. Using a large group didactic and student-led small groups did not tax faculty resources.

This model can be replicated with other common clinical cases and illness scripts/cases where nutrition is part of management and treatment and SDOH interplays on the clinical outcomes. The authors recommend longer interventions (i.e., more than one session) and summative assessment (end of course exams) to enhance the learning and reinforce the acquisition of knowledge.

Alice Fornari, EdD FAMEE RDN
Vice President Faculty Development 
Northwell Health 
Office of Academic Affairs 
Associate Dean
ZSOM at Hofstra Northwell
Science Education Dept
Member IAMSE Publications Committee