A consensus panel of medical education experts identified 36 nutrition competencies recommended for inclusion in undergraduate and graduate medical education curricula in the U.S.
The competencies were included if a 70% consensus was reached. They aim to address the gap in nutrition education and cover six major themes: foundational nutrition knowledge, assessment and diagnosis, communication skills, public health, collaborative support for specific conditions, and indications for referral.
Other competencies included providing evidence-based, culturally sensitive nutrition and food recommendations for disease prevention and treatment; screening for food insecurity and making appropriate referrals; assessing nutritional status through diet history, anthropometric measurements, and laboratory tests; demonstrating knowledge of nutrient functions, food sources, and national nutrition guidelines; and communicating nutrition information based on patients' health literacy levels.
Some of the recommendations garnered almost unanimous support as 97% of the panelists recommended evaluating nutrition competencies through licensing and board certification examinations, 95% agreed institutions should report on their nutrition-related teaching, and 92% supported using student surveys to assess competency and confidence in nutrition. Additionally, 73% recommend including a competency on the environmental impact of food choices.
Nineteen of the 22 nutrition subject matter experts supported incorporating experiential learning strategies, such as using teaching kitchens in medical education.
The panel used a modified Delphi process to achieve consensus among 37 experts, including 22 nutrition subject matter experts and 15 residency program directors. They reviewed 520 articles and 7 websites. After 4 rounds of voting, the panel recommended 30 competencies for both undergraduate and graduate levels, 2 for undergraduate level only, and 4 for graduate level only.
The panel also reached a consensus on six methods for evaluating trainee competence and two methods for monitoring institutional implementation of competencies.
In 2020, 42% of U.S. adults and nearly 20% of U.S. children had obesity, with more than 10% of U.S. adults having diabetes, and 38% having prediabetes. It is estimated that 60% of U.S. children will develop obesity before the age of 35 years. Approximately 12.8% of U.S. households reported food insecurity. The U.S. currently spends $4.3 trillion on health care annually, with 90% of spending attributed to chronic disease care.
Conflict of interest statements can be found in the article published in JAMA.
