Assessment of Clinical Nutrition Knowledge Amongst Newly Qualified Medical Doctors
David Mullins, John O'Grady, Orla Crosbie
Department of Gastroenterology, Cork University Hospital
Malnutrition refers to a deficiency, excess or imbalance of a wide range of nutrients, affecting body composition and function. Recognition and appropriate management leads to improved patient outcomes, regardless of presenting complaint. Clinical nutrition is a key part of overall disease prevention and management. While many patients and physicians often realise this intuitively, in clinical practice it is often inadequately addressed (1). Less than fifteen percent of American physicians, for example, feel capable of providing nutritional counselling to patients (2, 3).
We conducted an audit to assess clinical nutrition knowledge of newly qualified doctors in our hospitals to determine the level of understanding of nutritional practices relevant to physicians.
First year qualified doctors were asked to complete a 21 question questionnaire assessing knowledge on nutrition at organised teaching sessions across multiple sites. 11 clinical and 10 theoretical questions were devised. All completed questionnaires were corrected and assessed for inclusion.
32 questionnaires were suitable for analysis. The average age was 26 (range 23- 32). The average score was 10.16/21 (48.36%) (range 5- 15). There was a wide variation in individual answers. For example, 31/32 knew BMI units, while nobody answered correctly for initial NG tube placement assessment. Clinical question average was 4.53/11 (41%) and theoretical question average 5.63/10 (56%) (p=0.005).
An understanding of clinical nutrition has an important impact on management of chronic conditions such as cancer, diabetes and obstructive airway disease. It influences effective prevention of malnourished states. Suboptimal training may account for physician’s lack of confidence and competence in providing necessary nutritional support (1). Our audit suggests newly qualified doctors knowledge of nutrition, as well as application of its clinical uses, is suboptimal. This may reflect under resourced or undervalued teaching time, in keeping with known research (1, 3, 4), but further study is required to elucidate this. There is a clear need for dedicated education on malnutrition prevention and management at medical schools and healthcare facilities. Optimising nutrition improves clinical outcomes for both acute and chronic conditions (3), as well as reducing length of hospital stay and warrants more focused education for and from physicians.