NUTRITION EDUCATION FOR PEDIATRIC RESIDENTS: A SURVEY OF CANADIAN TRAINING PROGRAMS

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1 NUTRITION EDUCATION FOR PEDIATRIC RESIDENTS: A SURVEY OF CANADIAN TRAINING PROGRAMS Jason Silverman, MD FRCPC University of Calgary September 27, 2013

2 I do not have an affiliation (financial or otherwise) with a pharmaceutical, medical device or communications organization. Je n ai aucune affiliation (financière ou autre) avec une entreprise pharmaceutique, un fabricant d appareils médicaux ou un cabinet de communication. Jason Silverman MD FRCPC September 27, 2013

Je n ai aucune affiliation (financière ou autre) avec une entreprise

3 Nutrition in medical practice Nutrition central to health and disease Nutrition key to optimal health and growth of children Patients and parents seek physician advice on nutrition

4 Nutrition in undergraduate medicine Very limited! Nutrition education in US medical schools NAS recommends 25 hours of nutrition instruction during curriculum 40% 60% 25 hours < 25 hours Adams et al The American journal of clinical nutrition. May 2006;83(4):941S-944S.

of nutrition instruction during curriculum 40% 60% 25 hours < 25

5 Nutrition in undergraduate medicine 933 Canadian medical students surveyed Satisfaction rating: 4.7/10 Duration of Nutrition Instruction 13% 87% More needed Sufficient Gramlich LM, et al. Appl Physiol Nutr Metab 2010;35(3):

7/10 Duration of Nutrition Instruction 13% 87% More

6 Nutrition in postgraduate medicine 61 internal medicine residents surveyed 77% agreed nutrition assessment should be part of routine visits 94% agreed they should discuss nutrition with patients 14% felt physicians adequately trained to to counsel patients Vetter ML, et al. J Am Coll Nutr 2008;27(2):

they should discuss nutrition with patients 14% felt physicians adequately

7 Goal To assess formal nutrition instruction in Canadian pediatric residency training programs

8 Methods Online survey All Canadian pediatric residency program directors Able to be completed in less than 15 minutes

9 Survey content Nutrition instruction Who, when and for how long? RC objectives in nutrition Which ones, and how? Changes in program Why, and why not?

10 Results Response rate 71% Survey response 29% 71% Responded Did not respond

11 Results Response rate 71% Program Structure Program structure 50% 50% Two-year cycle Three-year cycle

12 Results Response rate 71% Teacher profession Program structure 25% Who does the teaching? 75% MDs and RDs RDs Only

13 Hours Nutrition instruction per year 5.6 hours during AHD Range hours outside AHD Range AHD Setting Outside AHD

14 Coverage of RC nutrition objectives Most programs felt all objectives covered during training 2 programs identified objectives not addressed at all AHD content varied significantly between programs

programs identified objectives not addressed at

15 Coverage of RC nutrition objectives Covered in AHD Covered through clinical exposure Recommended nutrient requirements Nutritional assessment Breastfeeding/infant feeding Parenteral/enteral nutrition Failure to thrive Health implications of diet Managing parenteral/enteral nutrition Counselling for healthy active living Obesity

Breastfeeding/infant feeding Parenteral/enteral nutrition Failure to thrive Health

16 Changes in nutrition coverage 58% had increased hours of nutrition instruction in past 5 years Barriers Insufficient time in AHD curriculum Lower priority/competing demands Lack of interested faculty

17 Conclusions Formal nutrition instruction for pediatric residents is limited 7.5 hours per year Despite increases in 58% of programs RC objectives covered in most programs Limited time in AHD biggest barrier to more nutrition coverage

18 Next steps Online learning may help overcome barriers to increasing nutrition education Thesis project will compare in-person to online learning in nutrition for pediatric residents Stay tuned

19 Acknowledgements Thesis Committee Dr. Maitreyi Raman Dr. Sylvain Coderre Dr. Decker Butzner Dr. Dana Boctor Dr. Kevin McLaughlin Help and support: Dr. Kathy Tobler Research arm of CPPG

20 Help us improve. Your input matters. Download the ICRE App, Visit the evaluation area in the North Building, Upper Level, near registration, or Go to: icreevaluations to complete the session evaluation. Aidons-nous à nous améliorer. Votre opinion compte. Téléchargez l application de la CIFR Visitez la zone d évaluation, au bâtiment nord, niveau supérieur, près du kiosque d inscription, ou Visitez le afin de remplir une évaluation de la séance. You could be entered to win 1 of 3 $100 gift cards. Vous courrez la chance de gagner l un des trois chèques-cadeaux d une valeur de 100 $.

Téléchargez l application de la CIFR Visitez la zone d évaluation, au bâtiment nord, niveau supérieur, près du kiosque d inscription, ou Visitez le

Developing EPAs (Entrustable Professional Activities) for Family Medicine

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