Perceived Effectiveness of Nutrition Education among Gastroenterology Fellows in the United States

Abstract

Purpose: the American Gastroenterological Association (AGA), the Accreditation Council for Graduate Medical Education (ACGME) and the Residency Review Committee (RRC) have mandated that all gastroenterology (GI) fellowship programs should provide the requisite training opportunities in nutrition. Despite the establishment of these guidelines, questions have been raised about the effectiveness of current curriculum used in GI fellowships. the aim of this study was to determine the perceived effectiveness of nutrition education among GI fellows. Methods: A survey was created to collect demographic data and perceived nutritional knowledge on components of nutrition specific to GI fellows, including: nutrition assessment, nutrition support, micro/macronutrient requirements, nutrition in GI diseases and obesity. A list of all 162 U.S. accredited fellowship programs and the contact information for all their fellowship coordinators was obtained from the AGA website. All fellowship coordinators were sent an email asking them to forward an internet link to SurveyMonkeyTM website, where fellows could anonymously complete the survey. Results were tallied using SurveyMonkeyTM. Results: Of the approximately 1,400 GI fellows in the U.S., 137 fellows attempted the survey (66.4% males, 33.6% females). Postgraduate year of training was distributed equally among first, second and third year fellows (49, 49 and 39 fellows, respectively). Of the fellows surveyed, 83.9% reported receiving no formal education in nutrition before fellowship. During fellowship, 34.3% reported receiving no formal education, 51.1% reported some nutritional education, and 14.6% reported completion of a formal rotation or training in nutrition. The majority of fellows (86.6%) reported that they would like to have more nutrition-focused education. Only 5.1% fellows reported that they planned on specializing in nutrition and incorporating it into their practice. Fellows perceived themselves as having the least knowledge in micro/macronutrients and providing nutritional support to patients. Included in analysis, only 45.5% of GI fellows reported a good understanding of nutrition as it relates to obesity. Fellows perceived themselves as having the strongest knowledge in technical skills to manage nutritional issues. Conclusion: Current nutritional curriculum used in most GI fellowships is limited. GI fellows believe their knowledge of nutrition is sub-optimal, and would like more nutrition education to be incorporated into their fellowship curriculum. Most concerning is the lack of understanding in the topic of obesity among fellows. Formal nutrition education should be developed in the context of GI fellowship education.