The aims of this program were to develop medical students’ aptitude in meal preparation and basic nutrition in addition to increasing their education on social determinants of health and issues of food access. These aims were informed by the quality improvement survey that was conducted at LCOM in 2023. Cooking with the Curriculum, a pilot culinary medicine program was launched to address identified gaps in LCOM nutrition education. The course’s combination of didactic and active learning was used to enhance medical students’ knowledge and confidence in a fun, hands-on way. The post-program survey demonstrated encouraging results, with high levels of engagement, satisfaction and an increase in perceived nutrition knowledge.
Overall, participants reported increased confidence in taking a diet history and a better understanding of the relationship between diet and disease. Students indicated that they intended to use the information they learned in both clinical practice and their personal lives. Students found a strength of the course was highlighting social determinants of health while providing ways to alleviate those effects on patients. The positive feedback and high levels of student engagement throughout the course suggest this type of program could be a valuable addition to the standard curriculum. Our results extend the existing evidence by supporting culinary medicine as an effective method to teach nutrition education in undergraduate medical education as well as promote wellness among students.
It is important that physicians feel confident in their knowledge of nutrition and ability to make patient-specific recommendations on diet and lifestyle to engage effectively in fundamental dietary counseling. Research has shown that nutrition training in medical schools leads to increased self-confidence in counseling patients on nutritional interventions and higher rates of counseling engagement [2, 9, 16]. The integration of culinary medicine into medical schools can equip future physicians with the skills needed to provide comprehensive nutritional care.
Commonly cited barriers to the implementation of culinary medicine courses in medical schools include high costs, challenges in obtaining curriculum licensing, and difficulty accessing teaching kitchens [17,18,19]. Costs associated with starting a teaching kitchen can range from $10,000 to over $500,000, and licensing a new curriculum is estimated to be $1,200-$3,000 [17, 18]. Some culinary medicine programs have overcome these barriers through the creation of”pop-up”kitchens, virtual classes where students use their own home kitchens or community kitchens [20,21,22]. The LCOM program was unique in its integration of a”mobile kitchen”and a culinary medicine curriculum, which was developed and led by medical students, including a registered dietitian and a certified integrative health professional. This helped minimize costs and allowed for a greater number of students to join the elective. The course’s emphasis on small appliances, basic tools, and more affordable foods simulates a low-resource environment many patients may experience, addressing the challenge of cooking on a budget with limited resources. The program demonstrated the feasibility of a low-cost, accessible model of culinary medicine that other medical schools can replicate.
Additionally, this course sought to highlight social determinants of health as they relate to food access and chronic disease. As previously mentioned, underserved populations are disproportionately affected by chronic diseases and often grapple with social determinants of health, such as food insecurity, that impact nutritional status and increase disease risk. Many other culinary medicine courses have chosen to integrate social determinants of health into their curriculums, emphasizing issues of food access or food insecurity [19, 23,24,25]. This type of material has often been taught through lectures or by challenging students to prepare budget-friendly recipes [24, 26].
Like existing programs, the LCOM pilot program incorporated social considerations into its didactics. However, it placed additional emphasis on the importance of addressing social determinants of health when counseling patients. To support this aim, the program incorporated motivational interviewing, encouraging students to consider social determinants while practicing these skills in small group settings. Additionally, the program’s”mobile kitchen”reinforced the focus on social determinants of health by utilizing easily accessible, low-cost culinary materials and featuring simple recipes, simulating a low resource setting to actively demonstrate these principles to students. Specific community organizations and resources were discussed during class to inform students of the local options available to support patients facing food insecurity.
In 2022, the US House of Representatives passed a resolution that called for meaningful nutrition education for medical trainees. The resolution was prompted by the growing prevalence of nutrition-related diseases in the US. In response, a panel of 37 multidisciplinary medical education professionals compiled a consensus statement which was comprised of 36 nutrition competencies for medical professionals, 32 of which apply to undergraduate medical education. There is a significant overlap between the objectives of the LCOM pilot course and the proposed competencies (Table 2). Additionally, 92% of the panelists agreed that surveys of students should be used to assess their competency and confidence in this area, which LCOM participants completed at the end of the program. The article also reiterates that”there is mounting evidence that medical students and physician trainees who receive culinary medicine education change their own cooking and eating behaviors and demonstrate increased confidence in discussing food and nutrition with their patients [27]. These findings were reaffirmed in the LCOM pilot program.
Limitations
This study had several limitations. As there was no pre-course survey, the ability to determine changes in participants’confidence and knowledge after completion of the course was limited. Long-term retention of nutritional information and counseling skills was not assessed through follow up surveys, it is unknown if students in the program gained lasting knowledge. Variability was limited in this study as this course was provided at one institution and did not include the entire medical school class. Students elected to participate in the program, which introduced selection bias. Students who joined the program likely already had an interest in nutrition, which may have made them more likely to perceive the course as valuable. Not all students responded to the post-course survey, which may have introduced further selection bias, by overrepresenting the opinions of students who were more engaged. The course curriculum was created and taught for free by a registered dietitian and funded through micro-grants, limiting reproducibility at other institutions that lack similar resources. The course did not have faculty trained in culinary medicine contributing to course design and implementation, potentially limiting the depth and breadth of content.
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