Evaluation of undergraduate medical education “Culinary medicine in primary care” course innovation

Problem

There is a growing body of evidence that medical students globally recognise the value of nutrition and dietary intervention in clinical care, and that there is currently an unmet need for teaching in this area in the majority of medical schools (Schoendorfer et al, 2017; Kahan et al, 2017). Culinary medicine is particularly relevant to patient care in the primary healthcare setting in enabling dialogue with patients about lifestyle impact on chronic disease management and promoting and supporting healthy eating for well-being, disease prevention and surgical preparation. Evidence estimates that increasing fruit intake by one portion a day could reduce cardiovascular mortality risk by 8%, 1.6 million deaths per annum globally (Mozaffarian et al, 2011). Another study has identified dietary factors as the most important risk factor for disability and premature death (Murray et al, 2013). A learning needs assessment was conducted (Xie et al, in press) to inform the development of a Culinary medicine course situated within a General Practice rotation. The new course combines practical kitchen experience with motivational interviewing, case-based discussion and presentation of the relevant, emerging evidence-base in this field. In particular, the course focuses on enabling engagement of patients across different socioeconomic and cultural contexts. Our study aims to evaluate student learning including meeting students’ unmet nutritional knowledge needs; providing them with the skills to perform a basic nutritional assessment and to adapt their advice to individual patients’ socioeconomic and cultural needs in the primary care setting.

Approach

Two online questionnaires evaluating students’ pre- and post-course knowledge were carried out throughout the academic year’s placements. A variety of Likert-type, multiple choice and free text questions were used. Quantitative analysis of Likert-type and multiple choice questions was carried out and qualitative thematic analysis was used to analyse free text and identify themes for improvements.

Findings

First we present quantitative data demonstrating improvement in medical students’ familiarity with and ability to take a diet history, discuss dietary changes and give advice appropriate to individual patients’ demographics after the course, compared to before the course. Second, we present qualitative data and their implementation in recommendations for course development within undergraduate primary care medical education.

Consequences

Our findings show the efficacy and acceptability of a hands-on “Culinary medicine in primary care” medical education course in meeting students’ nutritional education needs. We share reflections from students and the organising team about hopes for future improvement in the quality of dietary interventions and potential impact on chronic disease and complex multi-morbidity patient experience.