Culinary Medicine Experiences for Medical Students and Residents in the U.S. and Canada: A Scoping Review

Abstract

Phenomenon

Despite the importance of diet in the prevention and management of many common chronic diseases, nutrition training in medicine is largely inadequate in medical school and residency. The emerging field of culinary medicine offers an experiential nutrition learning approach with the potential to address the need for improved nutrition training of physicians. Exploring this innovative nutrition training strategy, this scoping review describes the nature of culinary medicine experiences for medical students and resident physicians, their impact on the medical trainees, and barriers and facilitators to their implementation.

Approach

This scoping review used the Joanna Briggs Institute methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR) checklist as guides. Eligible publications described the nature, impact, facilitators, and/or barriers of nutrition and food preparation learning experiences for medical students and/or residents. Additional inclusion criteria were location (U.S. or Canada), allopathic or osteopathic, English, human subjects, and publication year (2002 or later). The search strategy included 4 electronic databases. Two reviewers independently screened titles/abstracts and a third reviewer resolved discrepancies. The full-text review consisted of 2 independent reviews with discrepancies resolved by a third reviewer or by consensus if needed, and the research team extracted data from the included articles based on the nature, impact, barriers, and facilitators of culinary medicine experiences for medical trainees.

Findings

The publication search resulted in 100 publications describing 116 experiences from 70 institutions. Thirty-seven publications described pilot experiences. Elective/extracurricular and medical student experiences were more common than required and resident experiences, respectively. Experiences varied in logistics, instruction, and curricula. Common themes of tailored culinary medicine experiences included community engagement/service-based learning, interprofessional education, attention to social determinants of health, trainee well-being, and cultural considerations. Program evaluations commonly reported the outcome of experiences on participant attitudes, knowledge, skills, confidence, and behaviors. Frequent barriers to implementation included time, faculty, cost/funding, kitchen space, and institutional support while common facilitators of experiences included funding/donations, collaboratives and partnerships, teaching kitchen access, faculty and institutional support, and trainee advocacy.

Insights

Culinary medicine is an innovative approach to address the need and increased demand for improved nutrition training in medicine. The findings from this review can guide medical education stakeholders interested in developing or modifying culinary medicine experiences. Despite barriers to implementation, culinary medicine experiences can be offered in a variety of ways during undergraduate and graduate medical education and can be creatively designed to fulfill some accreditation standards.

Keywords:

• Culinary medicine
• hands-on nutrition education
• experiential nutrition learning
• nutrition training in medicine
• residency nutrition training

SUSTAINABLE DEVELOPMENT GOALS:

• SDG 4: Quality education

Acknowledgements

We would like to express our gratitude to Jessica Alfonzo, MD, for her contribution to data extraction and UNC librarians Carrie Baldwin-SoRelle and Jennifer Bissram for their support with our project.

Positionality statement

We bring to this work backgrounds in nutrition, medicine, and medical education, and many of us are advocates for increasing nutrition training of physicians. Some of us have experience designing and teaching culinary medicine experiences. While many of us hold advanced degrees and some of us may come from privileged backgrounds, we strive to promote equity in our research.

Authors' contributions

CH – conceptualization, data curation, formal analysis, investigation, methodology, project administration, supervision, validation, visualization, writing – original draft, writing – review & editing; MP – investigation, methodology, validation, visualization, writing – original draft, writing – review & editing; AT – investigation, validation, writing – original draft, writing – review & editing; JL – investigation, validation, writing – review & editing; KL – investigation, visualization, writing – original draft; MC – preliminary analysis, investigation; AO – investigation, preliminary analysis, writing – original draft; CD – conceptualization, methodology, visualization, writing – original draft, writing – review & editing; KG – writing – review & editing; TH – writing – review & editing; AA – conceptualization, methodology, supervision, writing – review & editing

Disclosure statement

The authors have no disclosures to report.

Additional information

Funding

This research was partially supported by a National Research Service Award Pre-Doctoral/Post-Doctoral Traineeship from the Agency for Healthcare Research and Quality sponsored by The Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Grant No. T32-HS000032. This publication was partially funded by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award (cooperative agreement numbers: U48 DP006400) with 1% funded by CDC/HHS.