Medical school teaching in nutrition – the Barts and The London experience

Part 1: Nutrition education at Medical school

It has been widely reported that undergraduate medical teaching in nutrition is lacking both nationally and internationally. In the Barts and the London medical school curriculum, there has been the opportunity to expand the nutrition curriculum for third year students by way of three different mechanisms-an online learning module, a half-day of training in nutritional assessment and a half day learning about healthy eating and home cooking in the context of poverty.

These teaching activities were designed using a combination of educationalists from the gastroenterology, primary care, dietetics and the charity sector organisation Bags of Taste. All activities were delivered as core curriculum (as opposed to an optional ‘SSC’ component). Activities were designed to appeal a wide range of learning styles by variation in style of delivery. Feedback was gathered by evaluation forms and knowledge was assessed by way of end of year assessment. Over the academic year, over 300 students experienced each activity.

Students reported high rates of satisfaction in all three activities. They most highly rated the activities which directly transferred to assessment (eg practice osce stations in taking dietary histories and performing nutritional assessments).

Students were also asked to write a brief reflection about their half day cooking activity with Bags of Taste.  They identified barriers to healthy eating (eg cost, skill, food access and time) aswell as some students learning new cooking skills and making the link between mental and physical health.

It is hoped by providing these educational resources to medical students that they will be able to integrate these essential knowledge and clinical skills in nutrition into their practice.

Part 2: Nutrition education during COVID-19:

Like all UK medical schools, the current covid crisis and lockdown has led to the swift switch to emergency remote teaching in order that medical students may continue their education. In our recent Year 3 “Community Diagnosis” teaching week, there was opportunity to discuss nutrition in the context of covid via an online webinar with 50 of our students.

Previous teaching had introduced our students to broader concepts of nutrition in terms of barriers to healthy eating. A local charity had given a lecture signposting students that barriers to healthy eating which are both multifactorial-cost, skill, time and equipment-and overlapping in nature.

In terms of the impact of the current covid crisis on nutrition, positives identified by the student body present at the webinar included recognising that lockdown has given more time to cook at home, to eat together as a family, to shop locally and to grow vegetables.

Challenges in regards to nutrition during lockdown include access to food (recalling the initial panic buying in the U.K. and the ongoing issues getting online deliveries for those at a distance to shops, clinically vulnerable or without transport), a more sedentary lifestyle meaning dietary changes were required to prevent weight gain, and one student commenting in the chat that “lockdown=Netflix=snacks”- I couldn’t have put it better myself! 

The overlap with nutrition and other social systems was also briefly explored-only today in the newspapers the government are asking those furloughed in the UK to consider soft fruit picking to avoid a mass spoil of the harvest. I recalled the vegetable box delivered to my house last week explained about the “hunger gap” approaching, the time of the year when we in the UK rely more heavily on imports, but for a combination of reasons this year, citing both extreme weather last year and current transit issues, that “the gap may be longer and more costly than usual”.

Finally, we reviewed a recently published survey about changes in food behaviours during covid (found at ). Some real positives here-and I can only hope that in the challenging times ahead of us adapting to the “new normal” that we manage to hold on to some of these positive changes made on both personal and society levels. I also look forward to the time I can meet with our students in person again to discuss the issues further!

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