Education and Research in Medical Education Network (ERimNN)
BSMS Nutrition Teaching and publications 2020-2021
Another busy year! Scroll down to find out more on the nutrition sessions we have developed for Brighton and Sussex Medical school as well as the publications ERimNN have authored over the 2020 to 2021 academic year:
Year 1
M101
Induction week: Multi-professional Team Working and Medicine (not nutrition specific but important to have a non-medic to contribute to this session)
- Case for and guidance around team working
- Multi-professional team working and learning opportunities at BSMS
- Doctor’s perspective on team working
Lecture x 1: Introduction to nutrition in the first 1000 days (Linked to prep for the family study)
By the end of this session you will have an awareness of:
- The impact of nutrition on growth and development in the first 1000 days (pregnancy to year 1)
- The impact of early year’s nutrition on long term health.
- Defining malnutrition, including undernutrition (low birth weight, stunting), overnutrition (obesity) and common nutrition deficiencies.
- Nutrition guidelines up to age 1- When to start solids/ macro and micronutrient requirements- milk/ breastfeeding.
- Intro to nutrition management- Including resources for patients and onward referral options.
- Key references on nutrition helpful for your project.
Afternoon workshop x 1: Nutrition, families and food inequality (This did not run 2021 due to COVID but hoping to reinstate 2021-22).
By the end of this session you should be able to
- List a variety of nutrition related problems from conception to year 1.
- Define social prescribing and the relevance for treatment plans.
- Critically engage with Nutrition public health guidelines to consider the application to individuals using case studies (Gestational diabetes, Breastfeeding problems, baby food refusal, food insecurity in pregnancy).
- Consider the role of a doctor and their role in addressing nutrition related health concerns and nutritional inequalities.
Student Assessment: Nutrition considerations to contribute to the family study assignment.
M103
Symposia: How can Health Professionals influence Behaviours?
By the end of this session students should be able to:
- Describe the main nutritional risks for UK adults in relation to CVD.
- Consider nutrition risks alongside other health behaviours and the relevance to clinical cases.
- Describe motivational interviewing techniques that doctors can use to motivate patients.
- Practice using the motivational interviewing techniques.
Diet Exercise and Arterial disease
- Understand the relationship between dietary intakes of fat and carbohydrate and their impact on lipid profile – Triacylglycerol, Cholesterol, LDL Cholesterol, HDL Cholesterol and VLDL cholesterol
- Understand how activity and exercise can impact on lipid profile
- Describe dietary patterns that can help to modify risk of NCD’s
SSC: The Great Food Debate
- Students will understand that providing definitive nutritional advice to patients about eating fat or carbohydrate foods to manage health is complex.
- They will have considered the evidence related to dietary intakes of fat and carbohydrates
- Students will recognise the limitations of the evidence and how they as doctors provide information and guidance to their patients.
- Students will feel comfortable in discussing a ‘balanced diet’
Students will recognize that as our knowledge about Fats and Carbohydrates increases the concept of a balanced diet may also shift.
Student Assessment:
- 4 x SBA questions on behaviour change
- 2 x SBA on the role of nutrition in cardiovascular disease
M104
Nutrition lectures X 4
- Malnutrition- preventable, important, detectable, treatable
- DEFINE MALNUTRITION AND RECOGNISE THIS CAN MEAN UNDER OR OVER NUTRITION
- RECOGNISE THE SIZE OF THE PROBLEM BOTH GLOBALLY AND NATIONALLY
- DESCRIBE THE EFFECT MALNUTRITION HAS ON THE POPULATION
- DESCRIBE THE IMPACT OF MALNUTRITION ON CLINICAL OUTCOMES
- IDENTIFY MOMENTS WHERE MALNUTRITION CAN BE RECOGNISED, PREVENTED OR STALLED (SCREENING AND NUTRITION PLAN)
- LEARN HOW TO SCREEN A PATIENT FOR MALNUTRITION
2 Macronutrients- Fat, carbohydrate and proteins
- Macronutrients and how they are digested and absorbed in the human body
- The role of macronutrients as part of a balanced dietary pattern
- Micronutrients- minerals and trace elements
3 Micronutrients and trace elements
- Recognise that eating a balanced diet is the best way to secure adequate amounts of micronutrients in the diet
- That micronutrients have a therapeutic range, insufficient or excessive intakes may not be beneficial
- Supplementation should be based on known deficiencies and are not a substitute for eating a balanced diet
- Requirements may be influenced by age and health status
- Name some micronutrients and mechanisms of absorption
- What all DRS should know about nutritionsupport
By the end of this lecture you will be able to:
- Describe the different available routes of nutrition support and their risks/benefits
- Choose a suitable form/route of nutritional support for different clinical scenarios
- Describe the Wernicke/Korsakoff syndrome and know how to treat/prevent it
- Describe the re-feeding syndrome and know how to avoid it
- Understand the ethical difficulties which surround feeding issues
Symposia X 2:
Obesity Symposium
By the end of the session you should be able to discuss
- The main pathways involved in appetite regulation including individual differences
- The main drivers of energy expenditure and metabolism
- The main drivers of energy intake
- How weight loss effects appetite and metabolism
- Evidence based nutrition interventions for weight loss treatment
- Weight Stigma and the effect on health
Renal Symposium
By the end of this session you should be able to answer:
- List the important biochemical, medical and social factors that may influence dietary advice for kidney patients.
- The main dietary interventions that may be necessary for people with chronic kidney disease.
- A doctor’s role in the nutrition assessment, treatment and monitoring of patients with kidney disease (within the multi-professional team).
- A dietitians role in the nutrition management of kidney disease and when to refer on.
Self-Selected Components (SSC) X 3:
Adverse reactions to food – allergy and food intolerance
By the end of this SSC students will be able to:
- define the terms food allergy and food intolerance;
- describe the underlying physiological mechanisms;
- discuss the issues involved in diagnosis of food allergy and intolerance;
- demonstrate an awareness of the symptoms that might indicate food allergy/intolerance;
- discuss the relationship between food allergy/intolerance and inflammatory bowel disease and irritable bowel syndrome; demonstrate an awareness of the concept of an elimination diet and how this is managed in practice.
Diet, cancer and cachexia
By the end of this SSC students will be able to:
- Discuss the relationship between diet and some cancers, and how the links between diet and cancer are researched drawing on contemporary literature.
- Demonstrate an awareness of The NHS Cancer Strategy
- Discuss the concept of a healthy diet.
- Recognise that encouraging a healthier diet is an important public health measure.
Medical Nutrition Online – Changing future online resources for medical students
Learning outcomes
- To explore opportunities for integrated nutrition online learning for UK medical students.
- Drawing on student experiences of learning from home to discuss the role of online education in medical school
Student Assessment:
- 4 x SBA questions Obesity.
- X x SBA questions from the nutrition lectures
Year 2
M203
Symposia x 1:
Living with Type 2 Diabetes
Overall Learning Outcomes for symposium:
- To appreciate the impact of diabetes on an individual (inc. psychosocial impact & how diabetes mellitus can affect employment, insurance & driving).
- To understand the patient partnership in Diabetes Mellitus care
- To understand the concept of the multidisciplinary team in Diabetes Mellitus care.
Themes:
- Patient empowerment/self-management
- Psychosocial aspects of DM
- Employment/Driving/travel/insurance
- Costs to the patient of good glycaemic control – hypos, barriers to self-management
- Roles of primary care & MDCT.
Nutrition in the prevention and treatment of diabetes:
We will explore the role of nutrition in:
- Diabetes prevention
- Glycaemic management
- Macrovascular/ microvascular complications
- Signposting and onward referral
M204
Symposia X 1:
Bone Health
Kathy to add
Student Assessment
- 2 x SBA Qs on Type 2 diabetes.
- X x SBA Qs on Bone Health
Year 3
Lifestyle Medicine workshop
In this session we discuss how you can apply nutrition knowledge to assist with
- Nutrition assessment
- Deciding nutrition priorities
- Incorporating nutrition into your management plan
Student Clinical placements(Both consider MDT nutrition inputs)
- Nutrition support team MDT ward rounds.
- Antenatal diabetes MDT clinic. This was changed to online clinics this year but I hope we can offer this again 2021-22
Lost Teaching as a result of BSMS restructuring
- 1 x lecture- Nutrition in hospital placements (this was placed in the extended learning teaching afternoon)
- Diabetes afternoon teaching
- Clinical Skills- Clinical nutrition assessment treatment and monitoring for safe practice
Student Assessment
- All students complete A MUST nutrition assessment within their logbooks in M306
- A nutrition assessment OSCE has been developed but not used
Year 4
Nutrition lectures X2:
Nutrition in Primary Care
By the end of this session we will consider nutrition assessment, diagnosis and management for the following examples:
- Case 1- Food insecurity, rehabilitation, prevention of readmission.
- Case 2- Multi-morbidity related malnutrition.
- Case 3- Prevention and metabolic health.
Nutrition in Global Health
A global emergency of malnutrition and climate change. Sustainable nutrition for human and planetary health.
By the end of the session we will consider
- The role of nutrition in climate change
- The evidence for nutrition in human and planetary health
- Meeting the nutrition needs of a growing global population
- Reducing the environmental impact of our food
Nutrition Simulated Surgery
- Nutrition scenario to discuss the role of nutrition and activity in reducing the risk of CVD in a high risk individual.
IRP students
Can a plant-based diet help to slow progression & Treat Individuals with Chronic kidney disease (CKD)?
What are the barriers and facilitators for adults in low SES communities to sustain a healthy change in their diet?
Kathy students X 4
Student MedSoc Support
- Evening presentations
- Nutritank
- GPSoc
- The Green Society x 1
- An Apple A day x 2
- Mentorship
- An Apple A Day curriculum review
- Nutritank mentorship
Student scholarship and Academic support
2 x student publications for this academic year
- Food & mood: a review of supplementary prebiotic and probiotic interventions in the treatment of anxiety and depression in adults
https://nutrition.bmj.com/content/3/2/351
- Miah N, Copeland E, Mlevrije Z, Macaninch E. A systematic review on dietary interventions to reduce postoperative ileus: coffee and chewing gum. Clinical Nutrition ESPEN. 2020 Feb 1;35:223.
https://clinicalnutritionespen.com/article/S2405-4577(19)30538-8/fulltext#%20
https://medcraveonline.com/IJCAM/IJCAM-14-00535.pdf
3 x students poster presentation at national conference
- Nutrition in the enhanced care pathway for lower bowel surgery – Hadis
- An Apple a Day
- Nutritank BSMS
- 1 x paper in progress. Supporting a BSMS student to prepare her thesis for publication
Other publications Sept 2020-21
- Macaninch E, Martyn K, do Vale ML. Exploring the implications of COVID-19 on widening health inequalities and the emergence of nutrition insecurity through the lens of organisations involved with the emergency food response. BMJ nutrition, prevention & health. 2020 Dec;3(2):374.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7841810/
- Accelerating Nutrition Capacity Building for UK Doctors and Health Professionals
- Dietitians & their Role in Medical Education
- Food Is More Than Medicine BMJ letter
https://www.bmj.com/content/369/bmj.m2482/rr-0
- A Position Statement from the COVID-19 Taskforce of the NNEdPro Global Centre for Nutrition and Health, on Vitamin D and high-risk groups in the COVID-19 pandemic https://nutrition.bmj.com/content/3/1/106.responses#a-position-statement-from-the-covid-19-taskforce-of-the-nnedpro-global-centre-for-nutrition-and-health-on-vitamin-d-and-high-risk-groups-in-the-covid-19-pandemic
- Child malnutrition and COVID-19 in the UK
https://www.nnedpro.org.uk/post/child-malnutrition-covid-19-in-the-uk
- Response to the UK Government Obesity Strategy https://www.nnedpro.org.uk/post/nnedpro-global-centre-response-to-the-uk-government-obesity-strategy
National nutrition Education advocacy work 2020-21
- Member of the inter-professional working group designing a nutrition curriculum for UK Undergraduate Medical Education. This has now been completed and will be launched 2021-22
- Member of the NNEdPro Global Centre for Nutrition and Health
- Member of the Nutrition Implementation Coalition
- Member of the NNEdPro COVID-19 Taskforce
- Nutrition and COVID19 You Tube https://www.youtube.com/watch?v=C2Y9hyPaTrA
- Medical education and diet You Tube https://www.youtube.com/watch?v=9XZtAWkL-Qo
