Community-based Review, Implementation, andEvaluation of Nutrition Lesson Plan in theDoctorate of Medicine and Baccalaureate ofNursing by Nutritional Need Assessment: AQualitative Study of students’ views onShortcomings and Strategies

Introduction: Historically, less attention has been paid tonutrition sciences in curriculums of many medical schools.Community based review of nutrition lesson plan may supportand facilitate more robust medical and nursing nutrition educationand training. On the other hand, to be more successful in medicaleducation and detect the strengths and weaknesses of thecurriculum in this field, assessment of the students' views isessential. The overall goal of this study was to identify thestrengths and weaknesses of community-based reviewed lessonplan of nutrition in the doctorate of medicine and baccalaureateof nursing from the students' views. This study was conducted inthe form of a strategic development, objective, and missionorientedpackage from the Medical Education Development Planof the Iran Ministry of Health and Medical Education.Methods: This qualitative study was conducted on thecommunication of Abadan, Khorramshahr, and Shadegan, inKhuzestan province, Iran, in ۲۰۱۷-۲۰۱۹. The study was designedin four phases: ۱) training needs assessment, ۲) review ofnutrition lesson plan, ۳) implementation of reviewed nutritionlesson plan, and ۴) evaluation by students. In the first phase, byapplying the "needs assessment technique based on a survey", theparticipants including ۱۳ nutrition experts declared five prioritiesof nutrition-related health problems in the communication. Then,the nominal group technique (NGT) was applied to determine thecauses of each problem and categorize into “behavioral” and“non- behavioral” types. In the second phase, "General Principlesof Nutrition" lesson plan in the medical doctorate and the"Nutrition and Nutrition Therapy" lesson plan in the bachelor ofnursing was reviewed and changed up to ۲۰%. In the third phase,the reviewed lesson plan was presented to the medical (n=۱۲۴)and nursing (n=۱۲۸) students in two consecutive semesters (۱stand ۲nd semester of academic year ۲۰۱۸-۲۰۱۹). In the fourthphase, evaluation of implemented lesson plans was carried out atthe end of each semester by a researcher-made written form andprovided to the students who trained with revised lesson plans.The form included two open questions: ۱) “how was the qualityof educational content?”; ۲) “did the educational headings meetyour educational needs as a physician / nurse who will work inthis community in the future?”. Method for the subjectiveinterpretation of the qualitative data content through a coding andsystematic categorizing process was used to analyze the date. Thefinal codes after coding treatment were ۲۷ for answers to thequestion ۱ (۱۸ for medical and ۹ for nursing student) and ۳۱ foranswers to the question ۲ (۲۰ for medical and ۱۱ for nursingstudents). Then, according to the quality of communicationbetween the codes, the researcher was able to primary categorizethe codes by combining, grouping, and organizing of them ascontext based. By secondary categorization, the overall concept(themes) that was the resulting sum of these categories wasobtained. Three main themes were perfect educational content,shortcomings, and strategies to improve the quality of nutritioneducation.Results: Among the medical students answering the question ۱,۲۲ (۵۲.۹%)considered the educational content as perfect and practical, ۳۰(۵۰%) stated that their educational needs as a physician who willbe working in the community in the future have been fully met.Among the nursing students answering the question ۱, ۵ (۱۰.۹%)considered the educational content as perfect and practical, ۷(۱۵.۲%) was considered the educational content incomplete andin need of modification, ۷ (۱۵.۲%) found the educational contentexcessive for the nursing student's educational needs. Also,among nursing students,۱۷ (۶۰.۷%) stated that their trainingneeds as a nurse who will be working in the community in thefuture have been fully met. As students' view, many factorscontribute to shortcomings in medical nutrition education andtraining. Among these are incomplete and out of the charteducational content for future physician duties, compactnesseducational content and inconsistency with the numbers of lessonunits, lack of sustainability of educational content in mind, timeconstraints for student study, and educational system problems.Besides that, factors contributed to shortcoming in nursingnutrition education were excessive educational content fornursing students and the lack of sustainability of educationalcontent in mind. However, the strategies to improve the qualityof medical and nursing nutrition education were focused on themore practical and clinical educational contents.Conclusion: The evaluation of trained medical/nursing students'view can be identified their education needs in the field ofnutrition as future employees, the shortcomings, and strategies toreinforce the reviewed lesson plan.