Academic journal article American Journal of Pharmaceutical Education

A Clinical Nutrition Course to Improve Pharmacy Students' Skills and Confidence in Counseling Patients

Academic journal article American Journal of Pharmaceutical Education

A Clinical Nutrition Course to Improve Pharmacy Students' Skills and Confidence in Counseling Patients

Article excerpt

Objective. To create, implement, and evaluate a PharmD course on primary care nutrition.

Design. A 2-credit hour elective course was offered to second- and third-year pharmacy students. It was informed by the Socratic method using a minimum number of formal lecture presentations and featured problem-based learning exercises, case-based scenarios, and scientific literature to fuel informed debate. A single group posttest design with a retrospective pretest was used to assess students' self-efficacy.

Assessment. There was a significant overall improvement in students' self-efficacy in their ability to practice primary care nutrition.

Conclusion. Completion of a nutrition course improved students' confidence in providing primary care nutrition and empowered them to speak more comfortably about the role of nutrition in the prevention of chronic diseases.

Keywords: nutrition, curriculum, problem-based learning, Socratic method

INTRODUCTION

Healthy People 2010 (HP2010) identified overweight and obesity as 1 of 10 leading health indicators. (1) The overarching goal of this national health agenda is to promote health and reduce chronic diseases associated with overweight and obesity as a result of poor nutrition and physical inactivity. In the United States, there has been a documented increase in overweight and obesity in all population segments. (2) Poor nutrition combined with physical inactivity is believed to have contributed to over 400,000 USdeaths in 2000. (2,3) Researchers have predicted that if the current trend of poor diet and physical inactivity continues, these will surpass tobacco as the number one causes of preventable death in the United States. (3) Another study forecasted a substantial negative impact on the life expectancy of obese young people, estimating up to a 20-year reduction for those who are severely obese. (4) If effective population-level interventions aimed at reducing obesity are not implemented, the trend of increased chronic disease and greater reduction in life expectancy will become more established.

Comprehensive lifestyle modification and pharmacological interventions are the cornerstone of primary and secondary prevention of obesity-related health conditions such as cardiovascular diseases and diabetes. Increasing compelling clinical evidence in nutrition science has demonstrated the effectiveness of a well-balanced diet and exercise in health maintenance and disease prevention and treatment. This process is recognized as medical nutrition therapy (MNT). (5) A number of disease management guidelines include MNT as an important component of their therapeutic plans for disease prevention and management. (6-10)

As members of one of the largest, most accessible, and trusted health care professions, pharmacists can play an even more significant role in disease prevention and health promotion by using MNT when educating patients at the point of care, in both clinical and retail settings. However, to do so they have to be equipped with necessary knowledge and skills. Although there is a pharmacy fellowship pathway in nutritional support research, primary care nutrition and MNT focused courses are missing in current pharmacy professional education. (11) An American College of Clinical Pharmacy (ACCP) white paper identified opportunities and voiced a call to action for pharmacists to become integral interdisciplinary health care team members helping to facilitate and accomplish Healthy People 2010 objectives including those for reducing prevalence rates of overweight and obesity in part through better nutrition. (12) Absent from this ACCP call to action was an acknowledgment that a gap exists in pharmacy education focusing on MNT at point of care.

This paper describes the creation and subsequent evaluation of a PharmD course on primary care nutrition that was created to address the gap we have identified in professional pharmacy practice and education. …

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