The Nutrition Academic Award (NAA) Charlotte Pratt, PhD, RD Program Director Prevention and Population Sciences Program Division of Cardiovascular Sciences National Heart, Lung, and Blood Institute National Institutes of Health PCRM Briefing, April 4, 2014
Background RFA HL-97-011 and RFA: HL-98-016 issued in 1997 and 1998, respectively. Inadequate nutrition education and practical application in US medical schools and residency programs; also established physicians Call by USPS, DHHS, AMA, and the scientific community (e.g., national surveys, evidence of little nutrition content in USMLE, etc.) Scientific evidence supports importance of nutrition in chronic disease prevention and treatment (e.g., Hypertension, Heart Disease, Type 2 diabetes, Cancer, Obesity) Clinicians play critical roles in disease prevention and treatment to reduce morbidity and enhance longevity
Goals of NAA Program Establish a network of US medical schools committed to nutrition education Develop nutrition curriculum guide for training physicians Identify key learning objectives Incorporate most current clinical practice guidelines Create a range of educational & clinical tools Evaluate curricula, materials, etc for effectiveness Establish a website to provide access to teaching modules and evaluation tools Collaborate with other organizations working on nutrition training Disseminate NAA programs & expertise through presentations, publications, panel participation & consultancies.
NAA Objectives Encourage the development or enhancement of medical school curricula to increase opportunities for students, house staff, faculty, and practicing physicians to learn nutrition principles and clinical practice skills with an emphasis on preventing cardiovascular diseases (CVD), obesity, diabetes, and other chronic diseases. Provide training modules for dissemination to other medical schools as well as other health care professional schools
21 NAA Medical Schools West: Midwest: University of Washington, Seattle, WA Northwestern University, Chicago, IL Stanford University, Stanford, CA University of Iowa, Iowa City, IA University of Nevada, Reno, NV University of Wisconsin, Madison, WI University of Colorado, Denver, CO South: University of Texas, Southwestern, Dallas, TX University of Texas, Houston, TX University of Alabama, Birmingham, AL University of Arkansas, Little Rock, AR Mercer University, Macon, GA East: Albert Einstein University, New York City, NY Columbia University, New York City, NY University of Rochester, Rochester, NY Brown University, Pawtucket, RI Tufts University, Boston, MA Harvard University, Boston, MA University of Pennsylvania, Philadelphia, PA University of Maryland, Baltimore, MD University of Vermont, Burlington, VT NHLBI funded with co-funding from NIDDK, 1998-2005
NAA Program Outcomes Nutrition Curriculum Guide http://www.nhlbi.nih.gov/funding/training/naa/curr_gd e/index.htm NAA products http://www.nhlbi.nih.gov/funding/training/naa/index.h tm Course materials on NHLBI Web page http://www.nhlbi.nih.gov/funding/training/naa/products.htm Instructional and practice tools-handbooks, course materials; patient education tools. Additionally, voluntarily, more than 25 non NAA schools provided evidence of nutrition in their curriculum http://www.nhlbi.nih.gov/funding/training/naa/faculty_c ourses.pdf
NAA Program Outcomes NAA and National Board of Medical Examiners- to include nutrition in the USMLE Step I and Step II Published a supplement in American Journal of Clinical Nutrition (AJCN) 2006 http://www.ajcn.org/content/83/4/936s.full.pdf+html Continued collaboration with and presentations at professional society and agency meetings (e.g., American Society for Nutrition (ASN), American Heart Association and the American Diabetes Association)
NAA Program Outcomes Development of Physician Nutrition Specialist (ASN support) Working Group on Future Directions for Implementing Nutrition Across the Continuum of Medical and Health Professions Education and Training, and Research, Sept 10-11, 2012. - http://www.nhlbi.nih.gov/meetings/workshops/nutrition.htm AJCN Supplement Online 2014 (ASN, NIH)
NAA Outcomes: Ratings of Adequacy of Nutrition Instruction by 4 th Year Medical Students Courtesy of Linda Van Horn, September 2012 NIH Workshop NAA # 1 NAA # 2
NAA Outcomes 21 NAA schools integrated required nutrition education across all 4 years Inventoried clinical tools and educational materials, collaborated on development and validation of new tools and materials Developed a standardized knowledge questionnaire and attitude survey Completed a survey of education deans Provided National Board of Medical examiners input on nutrition questions for Board exams Some schools added casebased, competency based, integrated, thematic & webbased teaching of assessment/intervention methods Schools selected NAA resources to suit their nutritional educational objectives Source: Linda Van Horn 2006
Examples of Achievements in NAA Schools: University of Texas, Houston
NAA Program Goals- Development of Tools
NAA Program Goals- Development of Tools (WAVE- Weight, Activity, Variety and Excess)
NAA Program Goals Establish a network of US medical schools committed to nutrition education Develop nutrition curriculum guide for training physicians Identify key learning objectives Incorporate most current clinical practice guidelines Create a range of educational & clinical tools Evaluate curricula, materials, etc for effectiveness Establish a website to provide access to teaching modules and evaluation tools Collaborate with other organizations working on nutrition training Disseminate NAA programs & expertise through presentations, publications, panel participation & consultancies.
Lessons Learned and Opportunities Lessons from Curricular Enhancement Reference: Hark, LA. AJCN 2006; 83(Suppl):968S-70S Curriculum Committee, Deans, and Offices of Educational Programs Team approach among faculty, physician role models, RDs and other health care professionals A Champion-Director of Medical Nutrition Education appointed by the Dean for oversight Longitudinal incorporation of nutrition competencies across the curriculum AAMC, LCME, ACGME and medical specialty boards regarding nutrition competencies Regular review of nutrition content on the USMLE Need for training of established physicians through CME certification
Moving Forward Inter-professional education and team based curriculum Broader professional role of physicians in collaboration with RDs, pharmacists, PAs and nurses for patient-centered nutrition care Coordinating Center- Coordination and Monitoring Functions GME and CME certification- ACGME Core Competencies Physician Nutrition Specialists and Nutrition Experts as champions in all 141 medical schools