A Randomized Controlled Trial of a Culinary Medicine Intervention in a Virtual Teaching Kitchen for Primary Care Residents

Abstract

Background: For decades, physicians have received inadequate nutrition education. “Culinary medicine,” an emerging pedagogy in medical education, seeks to address this by integrating hands-on cooking to enhance nutrition training. While cohort and cross-sectional studies have demonstrated culinary medicine’s efficacy, no randomized controlled trials to date have been conducted among medical trainees. Objective: To evaluate the efficacy of a hands-on culinary medicine curriculum compared to didactics-only nutrition education. Design: Two versions of a nutrition education curriculum were developed: a culinary medicine curriculum (intervention) and a didactics-only curriculum (control). The curricula were assessed using a non-inferiority randomized controlled trial design. Participants: All active Yale Primary Care residents were randomized to receive either the intervention curriculum or the control curriculum. Main Measures: Residents completed surveys at baseline, immediately post-session, and 8 weeks post-session assessing nutrition knowledge, attitudes regarding providing dietary counseling, and behavior in providing nutrition resources to patients. Key Results: Nutrition knowledge increased from baseline to immediately post-session in both groups (control (mean percent correct 54% to 94%, P = 0.001), intervention (60% to 92%, P = 0.001)). Compared to the control group, the intervention group gained more confidence in counseling patients on a plant-forward diet (F = 5.44, P = 0.03). Residents in the intervention group reported providing nutrition resources to their patients significantly more frequently at 8 weeks post-session than at baseline (mean frequency per week 0.1 to 0.9, P = 0.002), a change that was not demonstrated among control group participants (0.1 to 0.5, P = 0.35). Conclusions: Both culinary medicine and didactics-only pedagogies can be effective approaches to teaching nutrition. Culinary medicine was found in this trial to be non-inferior to a didactics-only approach and may be superior in improving participants’ confidence in providing dietary counseling to patients.