Nutritional education in medical curricula and clinical practice: A scoping review on the knowledge deficit amongst medical students and doctors.

Introduction: Non-communicable diseases (NCDs), accounting for 74% of deaths worldwide (World Health Organization 2024), are a major health concern and are often the result of poor dietary habits. To reduce the prevalence of chronic diseases healthcare professionals must encourage healthy eating, and therefore require the appropriate nutritional knowledge and skills. This scoping review critically synthesises the literature on nutrition education to understand why there is a gap in nutrition knowledge and skills among medical students and doctors (MSAD) in English-speaking countries, and the solutions which have been proposed in the literature to close this gap.

Methods: This scoping review adhered to PRISMA Scr guidelines outlined by Tricco et al. (2018) and used four online databases: PubMed; WebOfScience; Embase and ERIC as well as grey literature sources: Google; Bing and Perplexity AI, published within the last 10 years, from 2014 to 2024. Studies investigating medical students/doctors nutrition education/knowledge were included. Data analysis was guided by Braun and Clarke's (2012) six-step thematic analysis approach and the Delve qualitative coding software analysis tool was used to identify the two principal themes and the 20 sub-themes. The PICO tool was also used for question analysis.

Results: From the 674 records identified, 28 papers met the inclusion criteria for full data extraction, analysis and synthesis. The results identified four reasons for the gap in nutrition knowledge, including insufficient curriculum time dedicated to nutrition education, perceptions and confidence, stigmas and health habits, and challenges in clinical practice. The review also identified four potential solutions to minimise this gap, including curriculum changes, enforcement of standardised nutrition education guidelines, integration of nutrition in clinical practice and promotion of a multidisciplinary approach to nutrition education.

Conclusion: This scoping review shows that there are multiple complex reasons for the gap in nutrition knowledge and understanding. This is due to education institutional reasons; perceptions and confidence on nutrition; stigmas related to nutrition and being able to talk about nutrition; personal health habits; and challenges in clinical practice. Solutions to reduce the gap were identified and it is recommended that there are curricular innovations to incorporate nutrition education throughout medical training; standardisation and implementation of national competency standards; integration of nutrition into clinical practice; enhancement of postgraduate education pathways in nutrition; and the development of a multidisciplinary approach in medical education involving dietitians and other healthcare professionals. By enacting and supporting the recommendations and solutions would then improve patient care and likely contribute to better eating habits worldwide, thereby reducing the burden of NCDs to both patients and healthcare professionals.