MedEdPORTAL (Sep 2015)
Introduction to Nutrition Care in the Hospital Setting
Abstract
Abstract Introduction During the third year of medical school, students gather information, formulate differential diagnoses, and propose initial plans for the evaluation and management of patients. Medical students have limited exposure to nutrition during their first 2 years of training yet need to evaluate and manage malnutrition and other diet-related conditions. This resource introduces medical students to the nutrition assessment of hospitalized patients, the rationale for nutrition intervention with a hospitalized patient, the role of the registered dietitian nutritionist (RDN) in the care of hospitalized patients, the role of the physician in ordering diets and nutritional supplements for patients, the types of diets and nutritional supplements typically available in the hospital setting, and an understanding of malnutrition of the hospitalized patient. Methods The resource includes three PowerPoint presentations, an instructor's guide, and eight supporting handouts. Students view a student version of the PowerPoints in preparation for the session. Also included are sample formulary and diet cards, an algorithm of the route of nutrition administration, screening tools for food insecurity and eating disorders, and a course evaluation form. These tools can be used in a single 90-minute session or divided into a 30-minute orientation session and a 60-minute, follow-up, small-group case discussion. Results The orientation and case discussion have been presented in this format for 3 years in our program. Students typically evaluate this session with scores of 4-5 (on a 5-point scale) for instructor preparedness, instructor answering questions appropriately, and overall value of session. Many students remark that the session should be provided before their first inpatient experience. Others indicate that it is good to know what the RDN does in the hospital. A few have noted that the instructors assume students have more background knowledge about nutrition than they actually do. Discussion Time in the curriculum is the main limitation for implementing the resource. Availability of RDNs with appropriate skills, time, and willingness to teach can be a limitation. This educational activity should ideally be completed before a student finishes his/her first rotation on an inpatient service. Realistically, however, it can be placed on whatever service has a commitment to teaching nutrition to medical students.
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