Nutrition content of summative examinations within an Australian 4-year graduate entry medical course: 2013–2016

Abstract

BackgroundPoor nutrition is a major contributor to chronic disease, but the level of nutrition education in medical training is limited. Deakin University Medical School has been working to embed more nutrition into the curriculum since 2009.AimTo assess the nutrition content of all summative examinations in the Bachelor of Medicine, Bachelor of Surgery over a 4-year period.MethodsThe type, amount and scope of nutrition-related questions were assessed in all summative examinations delivered to all 4-year levels from 2013 to 2016. These were assessed independently and analysed for nutrition content. The amount of nutrition was quantified, and the nutrition topic areas and nutrition competencies addressed were documented.ResultsLess than 10% of summative examination questions contained any nutrition content. For first-year and second-year students, these examinations included an average yearly total of 433 multiple choice questions (MCQs) (range 337–530) and 47 short answer questions (SAQs) (range 33–62). Third-year and fourth-year students had 150 MCQs on average per year and no SAQs. The percentage of nutrition-related questions across all 4 years ranged from 6% in 2013 to 10% in 2016. The proportion of SAQs with nutrition content ranged from 12% in 2013 to 19% in 2016. Basic nutritional sciences, accounted for 60% of nutrition content and, 25% addressed dietary strategies for prevention and treatment of disease, and skills-based nutrition competencies represented approximately 10% of all questions.Summary and conclusionsMinimal nutrition was included in the summative examinations. There did not appear to be any consistent increase in the nutrition content of MCQs over the 4-year period but there was some indication of an increase in nutrition content in SAQs. Longer term evaluation is required to confirm this trend. Only a small number of nutrition questions were skills based, most focused on basic nutritional science. Examinations included few skills-based nutrition questions, and consideration of setting a minimum level of nutrition in examinations could assist in ensuring the development of appropriate nutrition competencies in medical graduates.

Nutrition Coverage in Medical Licensing Examinations in Germany: An Analysis of Six Nationwide Exams

“…In this context, the overall number of identified nutrition-related questions appears to be very low in our sample. Our findings are essentially in line with previous studies from the United States of America and Australia, although the number of total questions in our analysis seems to be slightly lower [21,22]. Perlstein et al assessed the nutrition content of the Bachelor of Medicine/Bachelor of Surgery curriculum at Deakin University Medical School in Australia between 2013 and 2016 [22].…”

“…Our findings are essentially in line with previous studies from the United States of America and Australia, although the number of total questions in our analysis seems to be slightly lower [21,22]. Perlstein et al assessed the nutrition content of the Bachelor of Medicine/Bachelor of Surgery curriculum at Deakin University Medical School in Australia between 2013 and 2016 [22]. The authors reported that approximately 10% of the exam questions in the investigated medical course were nutrition-related.…”

“…One approach to identifying the potentially mediating factors is to look beyond medical school curriculums. Very few studies have assessed the nutritional knowledge required in students' final-year exams [21,22]. Hark et al investigated the extent of nutrition coverage in the US Medical Licensing Examinations (USMLE) Steps 1 and 2 in 1986 and 1993.…”

“…More recent studies are scarce and often limited to specific (local) programs rather than examining national medical licensing examinations. One example is the analysis by Perlstein et al, which assessed the nutrition content of the Bachelor of Medicine/Bachelor of Surgery curriculum at Deakin University Medical School in Australia [22]. The authors found that 10% of the exam questions in the investigated medical course were nutrition-related, yet they were mostly short-answer questions and were asked in the preclinical years of the course.…”

Practice recommendations and referrals, perceptions of efficacy and risk, and self-rated knowledge regarding complementary medicine: a survey of Australian psychologists

“…The current study highlights that psychology professional associations may need to provide further CM relevant training for psychologists, given both a high level of psychologist engagement with CM and that 87% of surveyed psychologists perceive psychology as a field should provide more training on CM. Our findings relating to these specific issues have some similarities to the findings from studies of student doctors in Australia, where it was highlighted that nutrition education, for example, may not be sufficient to support nutrition related competencies in medical training and subsequently in their clinical practice [ 25 , 41 ]. Findings reported in previous literature, as well as those identified from the current study, highlights that psychologists perceive gaps in their knowledge about a number of CM approaches, including nutrition, and how to integrate them into practice [ 8 , 13 , 38 ].…”