NEWS & EVENTS
Advancing Nutrition Training, and Research for Medical Students, Residents, Fellows, Attending Physicians and other Clinicians
September 7 - 8, 2017
Bethesda, MD
Description

In 1998-2005, the National Heart, Lung, and Blood Institute (NHLBI) and the National Institute for Digestive, Diabetes and Kidney Disease (NIDDK) introduced and funded the Nutrition Academic Award Program (NAA) among 21 medical schools to incorporate nutrition into their curricula. The NAA curricula objectives have been applied world-wide since that time, but there is a need to update and initiate novel objectives due to new nutrition knowledge and guidance since 2005. In addition, major changes in medical school curricula and new trends in medical education have altered the scope, approach, and content over these years, requiring further adjustments in the nutrition curricula. A 2012 NHLBI workshop recommended revision of the NAA curricula objectives and inclusion of new and emerging research topics to accompany the evolving curricula.

The purpose of this 2017 workshop was to convene an interdisciplinary team consisting of experts in nutrition, metabolism, medicine, and lifestyle to plan the process for updating the NAA objectives with the goal of supporting the work of medical educators, administrators, and researchers in teaching and training physicians and medical-care providers within the currently shifting models of medical education. The workshop is consistent with the NHLBI Strategic Vision Objectives, which include the need to develop, diversify, and sustain the scientific workforce and with the critical challenge “to develop curricula and resources for education of health-care workers in evidenced-based care”. The NIH Office of Dietary Supplements co-sponsored the workshop and many NIH staff served on the planning committee and participated in the workshop.

The workshop participants consisted of clinical and academic health professionals in a variety of fields such as pediatrics, family medicine, internal medicine, bioinformatics, nursing, dietetics and nutrition, and population health, as well as medical (allopathic and osteopathic) and dental school faculty, medical school deans and course directors, and directors of nutrition programs. In addition, there were representatives from various medical organizations, including those from the National Board of Medical Examiners (NBME®), the Accreditation Council for Graduate Medical Education (ACGME), the Licensing Committee of Medical Education (LCME), the American Society for Nutrition- Medical Nutrition Council, and the Academy of Nutrition and Dietetics.

Recap

Workshop Objectives

  1. To discuss, identify, and prioritize core nutrition competencies for use in updating the objectives of the NIH-funded Nutrition Academic Award (NAA) Curriculum Guide to include new knowledge in nutrition science and its clinical application, incorporate changes in response to contemporary models of learning and knowledge acquisition, and take advantage of technological advances that have profoundly influenced preclinical and clinical training.
  2. To identify and prioritize nutrition research needed to identify, validate and further investigate new research questions and directions generated by the revised NAA objectives.
  3. To challenge key workshop attendees/volunteers to update, revise, and reformulate the current NAA objectives based on identified competencies and workshop discussions, with the goal of incorporating relevant information and addressing specific approaches for including the concepts in the National Board Examinations.

Discussions

After brief introductions and charge, the workshop focused on four main discussion topics:

  1. What is the landscape of nutrition in medicine?
  2. What approaches are needed to develop a medical nutrition curriculum in medical schools and residency programs?
  3. What processes are needed in the development of competency-based nutrition curricula?
  4. What approaches should be emphasized in a patient-centered approach to nutrition, physical activity, and lifestyle behavior change across the continuum of care?

Various panelists provided their perspectives and recommendations on nutrition in the medical school curricula, inter-professional nutrition instruction (e.g., for nurses and dental students), as well as approaches to integrating nutrition into specialty programs for residents and fellows. Representatives from NBME®, LCME, and ACGME discussed their perspectives on incorporating nutrition in the United States Medical Licensing Examination ® (USMLE®) and clinical programs for residents and fellows, respectively. Breakout sessions focused on sustainability of nutrition programs in medical schools, resident and fellowship programs, and on research needed to enhance the training of medical students, residents, and fellows, using team-based clinical care delivery model.

Participants made recommendations for research, medical school curricula development and implementation, and sustainability of education programs. More details from this workshop and comprehensive recommendations for the future will be available in a publication that will follow.

Recommendations:

Potential Research Topics

  • Studies that examine student assessment methods used by schools for the nutrition curriculum, and the granularity and effectiveness of nutrition curriculum content and methods of curriculum delivery.
  • Studies that examine Graduate Medical Education (GME) program satisfaction on Post Graduate Year 1 (PGY-1) resident knowledge, skills, and attitudes regarding nutrition education (measure of Undergraduate Medical Education (UME) nutrition curriculum effectiveness and/or usefulness).
  • A longitudinal study of physicians who are trained in nutrition versus those with limited nutrition training. Measure physicians’ personal health (i.e., nutrition, exercise, avoiding burnout) and, if possible, the quantity and quality of their medical practice through patient outcomes.
  • Studies that include comparative effectiveness research testing the effectiveness of medical nutrition education by, for example, instruction by a physician alone versus by both a physician and registered dietitian nutritionist.

Clinical Applications and Practice

  • Studies that examine the effect of nutrition education of physicians and training of physicians in nutrition counseling focusing on the impact of comprehensive diet and lifestyle assessment and intervention on patient health outcomes (e.g. clinical warehouse data, audits).
  • Dissemination and implementation research to compare the effectiveness or personal health (as an intermediate indicator of efficacy) of physicians trained with and without nutrition in their curriculum
  • Randomized controlled trials that compare different approaches and assess both quantitative and qualitative outcomes to inform best practices for training. 
  • Studies that determine the most effective ways to present health apps data to providers and identify how providers use this information.  For example, assess what tools and resources are needed for patient assessment and counseling.
  • Studies that examine how to address uncomfortable topics with patients, how to use non-judgmental terminology, and how to effectively enable patients to change lifestyle behaviors.
  • Studies that integrate nutritional risk assessment into predictive models to determine levels of intensity of nutritional care post-discharge. For example: High-risk: intervention delivered by a dietitian; Medium-risk: intervention delivered by nurses or by non-certified nutrition graduates; or Low-risk: intervention delivered by a social worker or lay-health worker to address issues related to social determinants of health indicators and to link patients to community food and other resources.
  • Studies that identify and review programs instituted by hospitals to address nutrition needs post-discharge. Common elements: Program costs, cost savings, sustainability, and patient outcomes.
  • Research that develop ways to enhance the longitudinal/continuity of relationship between patient/provider and assess changes in patient self-efficacy.
  • Research-based tools for training and practice, such as interactive videos and web-based applications.

Medical School Curricula and Implementation

  • Consider integrating established learning objectives into the UME curriculum, either as a discreet course or as an integrated thread.
  • Consider integrating basic nutrition sciences and nutrition as a biological science discipline, as well as clinical medicine and practice in the continuum of medical education training, with more focus on sciences in the medical school and on practice in residency/fellowship.
  • Consider identifying nutrition champions and role models in medical schools and train interested faculty in teaching nutrition using train-the-trainer models (e.g., Physician Nutrition Scientist/Specialist). Partnerships with various organizations may be needed to provide funding support and sustain such scientists and specialists within medical schools.
  • Encourage training of medical students with immersion in the broader system of health care, and in population health management, inter-professional collaboration, health system improvement, and contextual factors (i.e., social determinants of health) in patient care.
  • In collaboration with other entities, develop a nutrition subspecialty (nutrition, metabolism, and lifestyles), particularly as a career path for pediatricians. Diet and nutrition issues are extremely common in the U.S. pediatric population and a gap exists in nutrition expertise in medicine.

Sustainability of Education in Graduate Programs

Participants made recommendations regarding strategies to use to strengthen and sustain nutrition programs including:

  • Increasing the appeal of the curricula at the undergraduate level so that the interest in nutrition can be sustained in the graduate programs
  • Enhancing innovative approaches to make education programs more interactive
  • Developing and reinforcing nutrition knowledge and counseling skills of trainees, holding them accountable by “board level” testing
  • Involving students in all years of medical school in both basic (biomedical) and applied nutrition education, along with graduate teaching to increase students’ confidence and comfort with nutrition counseling skills.

Meeting Participants

  • Rachel Ballard, MD, MPH, Senior Scientific Officer, Office of Disease Prevention

  • Bettina M. Beech, Dr PH, MPH, Dean, John D. Bower School of Population Health, Professor of Population Health Science, University of Mississippi Medical Center

  • Michael A. Barone, MD, MPH, Vice President, Licensure Programs, National Board of Medical Examiners

  • Patricia Carney, Ph.D, Professor of Family Medicine and of Public Health, OHSU Family Medicine

  • Janet De Jesus, MPH, RD, Center for Translational Research and Implementation Science

  • Rose Ann DiMaria-Ghalili, PhD, RN, CNSC, FASPEN, FAAN, Drexel University, College of Nursing and Health Professions
  • William H. Dietz, MD, PhD, Redstone Global Center for Prevention and Wellness, Milken Institute School of Public Health

  • Stephanie A. Dunbar, MPH, RD, American Society for Nutrition

  • Lawrence Fine, MD, DrPH, Branch Chief, DCVS/CAPB, National Heart, Lung, and Blood Institute, Division of Cardiovascular Sciences, Prevention and Population Sciences Program

  • Paul George, MD, Assistant Dean for Medical Education, Associate professor of family medicine, Warren Alpert Medical School, Brown University

  • David Goff, MD, PhD, Director, NHLBI/DCVS, National Heart, Lung and Blood Institute, Office of the Director

  • Timothy S. Harlan, MD, FACP, Tulane University School of Medicine, Associate Dean for Clinical Services, Associate Professor of Medicine, Executive Director of the Goldring Center for Culinary Medicine

  • Robert Hash, MD, LCME Assistant Secretary, American Medical Association

  • Emily Johnston, PhD Student, Penn State University

  • Martin Kohlmeier, MD, Research Professor, Department of Nutrition, University of North Carolina

  • Kathryn M Kolasa PhD, RD, LDN, Professor Emeritus and Affiliate Professor, Master Educator, Vidant Health Nutrition Consultant, Department of Family Medicine; of Pediatrics, Brody School of Medicine at East Carolina University

  • Nancy F. Krebs, MD, MS, Professor of Pediatrics, Head, Section of Nutrition, Vice Chair, Academic Affairs, Dept of Pediatrics, University of Colorado School of Medicine

  • Robert Kushner, MD, Professor of Medicine, Northwestern University Feinberg School of Medicine

  • Carine Lenders, MD, MS, ScD, Co-Chair, Associate Professor of Pediatrics, Boston University School of Medicine, Chief, Division of Pediatric Nutrition, Boston Medical Center

  • Zhaoping Li, MD, PhD, Professor of Medicine, Lynda and Stewart Resnick Endowed Chair in Human Nutrition, Director, Center for Human Nutrition, Chief, Division of Clinical Nutrition, David Geffen School of Medicine at UCLA

  • Mary Lieh-Lai, MD, FAAP, FCCP, ACGME Senior Vice President, Medical Accreditation, Accreditation Council for Graduate Medical Education

  • Janet E. Lindsley, PhD, Associate Professor of Biochemistry, Assistant Dean of Curriculum, Foundational Sciences, University of Utah School of Medicine, Department of Biochemistry

  • Christopher Lynch, PhD, National Institute of Diabetes and Digestive Kidney Diseases, Office of Nutrition Research

  • William C. McGaghie, PhD, Professor of Medical Education, Professor of Preventive Medicine, Northwestern University Feinberg School of Medicine, Department of Medical Education and Feinberg Academy of Medical Educators

  • Kathryn McMurry, MS, National Heart Lung and Blood Institute

  • Susan L. Meacham, Ph.D., R.D., Professor, Preventive Medicine, Edward Via Virginia College of Osteopathic Medicine

  • Holly Nicastro, PhD, MPH, National Institutes of Health, National Heart, Lung, and Blood Institute, Division of Cardiovascular Sciences, Prevention and Population Sciences Program

  • Emma Norland, PhD, CEO and Senior Science Advisor, Cedarlock Research LLC

  • Professor Caryl Nowson, PhD,  Chair of Nutrition and Ageing, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University

  • Voula Osganian, MD, ScD, MPH, Paediatric Clinical Obesity Program Director, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health

  • Carol Palmer, EdD, RD, Head of the Division of Nutrition & Oral Health Promotion, Tufts University School of Dental Medicine & Friedman school

  • Miguel Paniagua, MD, FACP, Medical Advisor, Test Materials Development, National Board of Medical Examiners

  • Magda Pasarica MD, PhD, Associate Professor of Medicine, Family Medicine Chair for Education, Family Medicine Interest Group Faculty Advisor, KNIGHTS Clinic Faculty Advisor, University of Central Florida College of Medicine

  • Edward M. Phillips, MD, Director, Institute of Lifestyle Medicine, Assistant Professor of Physical Medicine and Rehabilitation, Harvard Medical School, Chief, Physical Medicine and Rehabilitation Services, VA Boston Healthcare System

  • Charlotte A. Pratt, PhD, RD, FAHA, Program Director, National Institutes of Health, National Heart, Lung, and Blood Institute, Division of Cardiovascular Sciences, Prevention and Population Sciences Program

  • Sumantra Ray, MD, NNEdPro Founding Chair and Wolfson Governing Body Fellow at the University of Cambridge, MRC Senior Clinician Scientist in Nutrition & Vascular Studies and Lead Clinician for the National Diet & Nutrition Survey, Honorary Professorships – Imperial College London (Visiting), Ulster University (Visiting) and University of Waterloo (Adjunct)

  • Nicole Redmond MD, PhD, MPH, Medical Officer, DCVS/NHLBI

  • Suzanne Rose, M.D., MSEd., Senior Vice Dean for Medical Education, Perelman School of Medicine, University of Pennsylvania

  • Marcel Salive, MD, National Institute on Aging, Division of Geriatrics & Clinical Gerontology

  • Marsha Schofield, MS, RD, LD, FAND, Senior Director, Governance and Nutrition Services Coverage, Academy of Nutrition and Dietetics

  • Kathryn Thompson, PhD, RD, Department of Biomedical Sciences, College of Osteopathic Medicine

  • Jennifer L. Trilk, PhD, Clinical Assistant Professor, Dept. of Biomedical Sciences, University of South Carolina School of Medicine Greenville

  • Gwen Twillman, Vice President, Education & Development, American Society for Nutrition

  • Ashley Vargas, PhD, Health Scientist Administrator, NIH Office of Disease Prevention

  • Linda Van Horn, PhD, RD, Co-Chair, Professor of Preventive Medicine, Associate Dean for Faculty Development, Department of Preventive Medicine, Northwestern University

  • Gina S. Wei, MD, MPH, Associate Director, DCVS/NHLBI, Director, PPSP, Prevention and Population Sciences Program, Division of Cardiovascular Sciences, NHLBI, NIH

  • Jeffrey D. White, MD, Director, Office of Cancer Complementary and Alternative Medicine, Division of Cancer Treatment and Diagnosis, National Cancer Institute, NIH

Chairs

  • Carine Lenders. MD, MS, ScD, Boston University School of Medicine

  • Linda Van Horn, PhD, RD, Northwestern University
     

NIH Staff

NHLBI

  • Janet de Jesus, MS, RD, Center for Translational Research and I

  • Kathryn McMurry, MS, Office of Science Policy, Engagement, Education, and Communications

  • Holly Nicastro, PhD, MPH, Division of Cardiovascular Sciences

  • Charlotte A. Pratt, PhD, RD, FAHA, Division of Cardiovascular Sciences

  • Nicole Redmond MD, PhD, MPH, Division of Cardiovascular Sciences

NIA

  • Marcel Salive, MD, Division of Geriatrics & Clinical Gerontology

  • Giovanna Zappala, PhD, MPH, Division of Geriatrics and Clinical Gerontology

NCI

  • Jeffrey D. White, MD, Office of Cancer Complementary and Alternative Medicine

NIDDK

  • Christopher Lynch, PhD, Office of Nutrition Research

  • Voula Osganian, MD, ScD, MPH, Division of Digestive Diseases and Nutrition

NIH OD

  • Rachel Ballard, MD, MPH, Office of Disease Prevention

  • Ashley Vargas, PhD, MPH, RD, Office of Disease Prevention

  • Abby Ershow, Sc.D., R.D., Office of Dietary Supplements

  • Johanna T. Dwyer, D.Sc., R.D, Office of Dietary Supplements
     

Next Steps

Workshop participants, in collaboration with the American Society for Nutrition and other partners (e.g., LCME, ACGME and NBME), will develop a plan to update the comprehensive list of curricula objectives to include the survey results from the American Society for Nutrition. The co-chairs will lead the development of a peer-reviewed manuscript that describes the workshop discussions and curriculum development framework.

Selected References

  1. Adams KM, Butsch WS, Kohlmeier M. The State of Nutrition Education at US Medical School. Journal of Biomedical Education 2015: 1-8. http://dx.doi.org/10.1155/2015/357627
  2. Adams, KM, Kohlmeier M, Zeisel SH. Nutrition Education in U.S. Medical Schools: Latest Update of a National Survey. Academic Medicine. 2010;85(9): 1537-1542.
  3. American Medical Association (AMA) wire https://wire.ama-assn.org/education/whats-stake-nutrition-education-during-med-school
  4. Bradley D, Dietz W. Provider Competencies for the Prevention and Management of Obesity. The Robert Woodson Foundation 2017; (1)(1): 1-12. https://cdn.bipartisanpolicy.org/wp-content/uploads/2017/07/Provider-Competencies-for-the-Prevention-and-Management-of-Obesity.pdf
  5. Burch E, Crowley J, Laur C, Ray S, Ball L. Dietitians' Perspectives on Teaching Nutrition to Medical Students. J Am Coll Nutr. 2017 Jun 19:1-7. doi: 10.1080/07315724.2017.1318316.. https://www.ncbi.nlm.nih.gov/pubmed/28628368
  6. Castillo M, Feinstein R, Tsang J, Fisher M. Basic nutrition knowledge of recent medical graduates entering a pediatric residency program. International Journal of Adolescent Medicine and Health 2016; (28)4: 357-361 https://www.ncbi.nlm.nih.gov/pubmed/26234947
  7. Committee on Nutrition in Medical Education FaNB, Commission on Life Sciences, and National Research Council, Nutrition Education in U.S. Medical Schools, The National Academies Press, Washington, DC, USA, 1985.
  8. Core Entrustable Professional Activities for Entering Residency. A curriculum development guide. American Medical Association:Gastroenterology EPAS and links to toolbox and OWN.https://gi.org/fellows-in-training/entrustable-professional-activities-epas-for-gi-fellowship-training/. Pediatrics EPAS (links to EPAS in general pediatrics and subspecialties and to milestones. https://www.abp.org/entrustable-professional-activities-epas
  9. Daley BJ, Cherry-Bukowiec J, Van Way CW, Collier B, Gramlich L, McMahon MM, McClave SA; A.S.P.E.N. Task Force on Postgraduate Medical Education. Current Status of Nutrition Training in Graduate Medical Education From a Survey of Residency Program Directors: A Formal Nutrition Education Course Is Necessary. JPEN J Parenter Enteral Nutr. 2016 Jan;40(1):95-9. doi: 10.1177/0148607115571155. https://www.ncbi.nlm.nih.gov/pubmed/25672985
  10. Devries S, Agatston A, Aggarwal M, Aspry KE, Esselstyn CB, Kris-Etherton P, Miller M, O'Keefe JH, Ros E, Rzeszut AK, White BA, Williams KA, Freeman AM. A Deficiency of Nutrition Education and Practice in Cardiology. Am J Med. 2017 May 24. pii: S0002-9343(17)30527-2. doi: 10.1016/j.amjmed.2017.04.043. https://www.ncbi.nlm.nih.gov/pubmed/28551044
  11. Dimaria-Ghalili RA, Edwards M, Friedman G, Jaferi A, Kohlmeier M, Kris-Etherton P, Lenders C, Palmer C, Wylie-Rosett J. Capacity building in nutrition science: revisiting the curricula for medical professionals. Ann N Y Acad Sci. 2013 Dec;1306:21-40. doi: 10.1111/nyas.12334. Review. https://www.ncbi.nlm.nih.gov/pubmed/24329516
  12. Driessen EW, Van Tartwijk J, Overeem K, Vermunt JD, Van Der Vleuten CSPN.  Conditions for successful reflective use of portfolios in undergraduate medical education.  Medical Education, 2005; 39(12);1230–1235.
  13. Entrustable Professional Activity. Carraccio C, et al. Shifting paradigms: from Flexner to competencies. Acad Med. 2002;77(5):361-7).
  14. Hark LA, Deen D. Position of the Academy of Nutrition and Dietetics: Interprofessional Education in Nutrition as an Essential Component of Medical Education. J Acad Nutr Diet. 2017 Jul;117(7):1104-1113. doi:10.1016/j.jand.2017.04.019. https://www.ncbi.nlm.nih.gov/pubmed/28648264
  15. Hu J, Raman M, Gramlich L. Current Status of and Recommendations for Nutrition Education in Gastroenterology Fellowship Training in Canada. Nutr Clin Pract. 2017 Apr 1:884533617700852. doi: 10.1177/0884533617700852.  https://www.ncbi.nlm.nih.gov/pubmed/28426396
  16. Kahan S, Kushner RF. Nutrition in Clinical Medicine: A Core Competency for Healthcare Providers. Med Clin North Am. 2016 Nov;100(6):xvii-xx. doi: 10.1016/j.mcna.2016.09.001. https://www.ncbi.nlm.nih.gov/pubmed/27745600
  17. Kris-Etherton PM, Akabas SR, Douglas P, Kohlmeier M, Laur C, Lenders CM, Levy MD, Nowson C, Ray S, Pratt CA, Seidner DL, Saltzman E. Nutrition competencies in health professionals' education and training: a new paradigm. Adv Nutr. 2015 Jan 15;6(1):83-7. doi: 10.3945/an.114.006734. https://www.ncbi.nlm.nih.gov/pubmed/25593146.
  18. Kushner RF, Van Horn L, Rock CL, Edwards MS, Bales CW, Kohlmeier M, Akabas SR. Nutrition education in medical school: a time of opportunity. Am J Clin Nutr. 2014 May;99(5 Suppl):1167S-73S. doi: 10.3945/ajcn.113.073510. Epub 2014 Mar 19. https://www.ncbi.nlm.nih.gov/pubmed/24646826
  19. Lenders C, Gorman K, Milch H, Decker A, Harvey N, Stanfield L, Lim-Miller A, Salge-Blake J, Judd L, Levine S. A novel nutrition medicine education model: the Boston University experience. Adv Nutr. 2013 Jan 1;4(1):1-7. doi:10.3945/an.112.002766. Review. https://www.ncbi.nlm.nih.gov/pubmed/23319117
  20. Lenders CM, Deen DD, Bistrian B, Edwards MS, Seidner DL, McMahon MM, Kohlmeier M, Krebs NF. Residency and specialties training in nutrition: a call for action. Am J Clin Nutr. 2014 May;99(5 Suppl):1174S-83S. doi: 10.3945/ajcn.113.073528.
  21. Lindsley JE, Ercikan Abali E, T. Bikman B, et al. What Nutrition-Related Knowledge, Skills, and Attitudes Should Medical Students Develop? Medical Science Educator with a DOI: 10.1007/s40670-017-0476-3 2017.
  22. Poulsen, G.M., et al., Randomized trial of the effects of individual nutritional counseling in cancer patients. Clin Nutr, 2014. 33(5): p. 749-53.
  23. Ravasco, P., et al., Impact of nutrition on outcome: a prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy. Head Neck, 2005. 27(8): p. 659-68.
  24. Rose S, Fix OK, Shah BJ, Jones TN. Entrustable Professional Activities for Gastroenterology Fellowship Training. Gastroenterology, 2014; (147) 1: 233-242.
  25. Teaching Doctors-in-Training About Nutrition: Where Are We Going in 2016? https://www.ncbi.nlm.nih.gov/pubmed/26929967
Agenda

8:30-8:40 am
-
Welcome Remarks

David Goff, MD, PhD, Director, DCVS/NHLBI

Charlotte Pratt, PhD, RD

8:40-8:50 am
-
Introductions

Linda Van Horn, PhD, RD, and Carine Lenders, MD, MS, ScD

8:50-9:05 am
-
Background, Goals, Charge/Expectations

Linda Van Horn, PhD, RD

9:05-10:40 am
-
What is the Landscape of Nutrition in Medicine?

9:05-9:25 am

The Shifting Model of Medical Education: Definitions, Lessons Learned and Need for an Outcome-based Patient-Centered Outcomes Approach.

Carine Lenders, MD, MS, ScD

 

Questions

9:25-9:45 am

Recent survey in US medical schools conducted by the International Association of Medical Science Educators

Janet E. Lindsley, PhD and Kathryn Thompson, PhD, RD

 

9:45-9:55 am

Survey results by a collaborative effort with the American Society for Nutrition

Carine Lenders, MD, MS, SCD.

 

Questions

 

9:55 -10:05 am

Medical Nutrition Education Efforts by the American Heart Association                                                  

Linda Van Horn, PhD, RD

 

Questions

 

10:05-10:20 am

Overview of Nutrition in Medicine Survey, 2000-present

Martin Kohlmeier, MD, PhD  

 

10:20-10:40 am

GROUP DISCUSSION

Moderator: Linda Van Horn, PhD, RD

10:40-10:50 am
-
BREAK

10:50-1:05 pm
-
What Do We Need to Develop a Medical Nutrition Curriculum in Medical Schools and Resident Programs?

10:50-11:15 am

Competencies Needed in A Nutrition Curriculum: Obesity Competencies as a Model

William H. Dietz, MD, PhD.

 

11:15-11:55 pm

Panel Perspectives on Nutrition in the Medical School Curricula

(Each speaker may have 3-5 slides followed by discussions)

Nancy Krebs, MD; Kathryn Kolasa, PhD; Bettina M. Beech, DrPH, MPH.

Panel Discussions:

  • What should be the role of nutrition education in the medical school curriculum?
  • How has the topic evolved to modern status as an evidence-based topic in patient care?
  • How has your medical school addressed these changes or might be planning to do so?
  • What could a group like this contribute towards facilitating that effort?
  • What would you like to see in a revised curriculum?

Moderator: Linda Van Horn, PhD, RD

                                                           

11:55-12:15 am

Role and Implementation of Entrustable Professional Activities

Suzanne Rose, MD, MSEd

 

12:15-12:35 pm          WORKING LUNCH BREAK- Room 3087

 

12:35-1:05 pm            Panel Perspectives on Nutrition for Residents and Fellows

(Each speaker may have 3-5 slides followed by discussions)

Suzanne Rose, MD, MSEd; Paul George, MD; Sumantra Ray, MD (NNEdPro Global Centre for Nutrition and Health, Cambridge, UK).

Panel Discussions                             

  • What are some valued nutrition competencies that should be addressed in residency/fellowship training and that should be included the curricular? 
  • Are there approaches your program has developed or utilized to facilitate nutrition skill related training?
  • Are there areas you would like to see expanded or enhanced that might help achieve the desired outcomes?
  • Are Residents/Fellows able to model these patient care skills for medical students in their clerkships?

Moderator: Carine Lenders, MD, MS, ScD

 

1:05-2:15 pm
-
What Processes are Needed in the Development of Competency-Based Nutrition Curricular?

1:05- 1:25 pm

Development of Competency-Based Nutrition Curriculum -  Example 1

Caryl Nowson, PhD (Deakin Univ., Aus.)

Questions

 

1:25-1:45 pm

Development of Competency-Based Nutrition Curriculum –

Example 2

Robert Kushner, MD, MS.

Questions       

 

1:45-2:00 pm

DISCUSSION  

Moderator: Nicole Redmond, MD, PhD, MPH

 

2:00-2:15 am

BREAK

 

2:15-4:45 pm
-
Nutrition in USMLE: Perspectives from Licensing and Board Members

2:15-3:15 pm

Panel Discussion: Members from LCME, ACGME, NBME

(Each speaker may have 3-5 slides followed by discussions)

Robert Hash, MD (LCME); Mary Lieh-Lai, MD, FAAP, FCCP (ACGME); Miguel Paniagua, MD, MSEd (NBME)

  • What are the current number and content of items that relate to nutrition in the board exams? Does the USMLE perceive a need to increase the number and content of items that address nutrition?
  • What drives inclusion of nutrition questions and how are they designed and monitored in terms of student response?
  • What evidence is needed to incorporate modern topics of medical interest that are especially relevant to nutrition?
  • What is the possibility of identifying nutrition (and obesity) as a select committee to quickly populate the examination with evidence based nutrition (obesity) items?
  • How can we assure that nutrition and its application are well represented in the board examinations? How can we assure that nutrition competencies are in included in accreditation requirements?

Moderator: Linda Van Horn, PhD, RD

 

3:15 -4:00 pm

BREAKOUT DISCUSSION ON MODELS OF EFFECTIVE SUSTAINABILITY

ROUNDTABLE DISCUSSION – Rooms 3091 and 3087

  • What makes it possible for Medical Schools that already offer a strong nutrition curriculum/integrative program to sustain this? And how can those who have not had strong programs incorporate nutrition in their curriculum and sustain it? (Marcel Salive, MD; Room 3091)
  • What barriers exist to enhancing nutrition education across all medical schools and resident programs. How can these problems be addressed? (Kathryn McMurry, MS; Room 3091)
  • What role should NIH/ASN/AAMC/ Other organizations play in implementing and sustaining a strong nutrition curriculum? (Ashley Vargas, PhD, MPH,  RD; Room 3087)
  • How do we develop nutrition mentors for continuing medical education? (Janet De Jesus, MPH, RD; Room 3087)

 

4:00- 4:30 pm

Report Back from Table Reporters

Moderator: Carine Lenders, MD, MS, ScD

4:30-4:45 pm
-
Closing Remarks: Review of Tomorrow’s Expectations

Charlotte A. Pratt, PhD, RD

8:45 -9:00 am
-
Recap DAY 1

Linda Van Horn, PhD, RD, Carine Lenders, MD, MS, ScD

9:00-9:10 am
-
Welcoming Remarks

Gina Wei, MD, Associate Director, DCVS/NHLBI

9:10 am- 2:30 pm
-
Emphasizing a Patient-Centered Approach: Nutrition and Physical Activity Across the Continuum of Care

9:10 -9:30 am

Developing Behavioral Science Competencies to address Nutrition in Medicine:  The Science of Learning

Patty Carney, PhD

 

9:30-10:00 am

Physical Activity Competencies: A Lifestyle Approach to Medicine

Jennifer Trilk, PhD; Edward Phillips, PhD

 

10:00-10:30 am

Innovative Educational Approaches                     

William McGaghie, PhD; Tim Harlan, MD.

 

10:30 -10:40 am

DISCUSSION

Moderator: Carine Lenders, MD, MS, ScD

 

10:40-10:50 am

BREAK

 

10:50-11:30 am

Competencies in Team-Based Care: Inter-Professional Approach (Team care: Physicians collaborating with registered dietitians, physician assistants, nurse practitioners, dentists, pharmacists, social workers.)

(Each speaker may have 5 -8slides followed by discussions)              

Marsha Schofield, MS RD; Carole Palmer, EdD, RD, LDN; Rose DiMaria-Ghalili, PhD, RN

 

11:30-11:45 am

DISCUSSION

Moderator: Carine Lenders, MD, MS, ScD

 

11:45- 12:05 pm

The Delphi Process- An Approach to Gather Input from the Medical Community on Revised Curricular Objectives

Gwen Tillman, MS

                                   

12:05 -12:15 pm

Questions

 

12:15 am-12:30 pm

Research Needs in Nutrition in Medicine: A Portfolio analysis of NIH funding

Charlotte Pratt, PhD, RD and Holly Nicastro, PhD, MPH

                                   

12:30 am-1:30 pm

WORKING LUNCH - Room 3087

 

ROUNDTABLE DISCUSSIONS ON RESEARCH NEEDS TO ACCOMPANY CURRICULUM REVISIONS.

NIH Volunteers: Marcel Salive MD, Kathryn McMurry, MS, Ashley Vargas, PhD, Janet De Jesus, MPH, RD

 

1:30-2:00pm

Report back

Moderator: Linda Van Horn, PhD, RD

 

2:00-2:30 pm

Revising the NAA Objectives: Writing Group Expectations and Process

Linda Van Horn, PhD, RD, and Carine Lenders, MD, MS, ScD

 

2:30- 2:45 pm
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Next Steps

Charlotte Pratt, PhD

2:45 pm
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Closing Remarks

Lawrence Fine, MD, DrPH. Branch Chief, DCVS/CAPB