A realist review of educational interventions to improve the delivery of nutrition care by doctors and future doctors.

Victor Mogre,Mary Gemma Cherry,Albert Scherpbier,Tim Dornan,Paul Armah Aryee,Fred Stevens

doi:10.1186/2046-4053-3-148

Abstract

BackgroundDietary interventions are considered an important aspect of clinical practice, more so in the face of the rising prevalence of obesity, diabetes and cardiovascular diseases globally. Routinely, most doctors do not provide such intervention to their patients, and several barriers, present during both training and clinical practice, have been identified. Educational interventions to improve nutrition care competencies and delivery have been implemented but with variable success, probably, due to the complex nature of such interventions. Using traditional methods only to investigate whether interventions are effective or not could not provide appropriate lessons. It is therefore pertinent to conduct a realist review that investigates how the interventions work. This realist review aims at determining what sort of educational interventions work, how, for whom, and in what circumstances, to improve the delivery of nutrition care by doctors and future doctors.Methods/designThis realist review will be conducted according to Pawson’s five practical steps for conducting a realist review: (1) clarifying the scope of the review, (2) determining the search strategy, including adopting broad inclusion/exclusion criteria and purposive snowballing techniques, (3) ensuring proper article selection and study quality assessment using multiple methods, (4) extracting and organising data through the process of note taking, annotation and conceptualization and (5) synthesising the evidence and drawing conclusions through a process of reasoning. This realist review protocol has not been registered in any database before now.DiscussionFindings will be reported according to the publication criteria outlined by the realist and meta-narrative evidence synthesis (RAMESES) group.

Highlights

Dietary interventions are considered an important aspect of clinical practice, more so in the face of the rising prevalence of obesity, diabetes and cardiovascular diseases globally
Findings will be reported according to the publication criteria outlined by the realist and meta-narrative evidence synthesis (RAMESES) group
To the best of our knowledge, no review be it traditional or realist, has considered the effectiveness of educational interventions to improve the nutrition care competencies of future doctors only and/ or both doctors and future doctors. This is probably due to the complex nature of such interventions. As such there is paucity of data exploring how educational interventions might work most effectively, how, why and under what circumstances to improve the delivery of nutrition care by future doctors and doctors

Summary

Introduction

Dietary interventions are considered an important aspect of clinical practice, more so in the face of the rising prevalence of obesity, diabetes and cardiovascular diseases globally. This realist review aims at determining what sort of educational interventions work, how, for whom, and in what circumstances, to improve the delivery of nutrition care by doctors and future doctors Dietary interventions, such as discussing weight loss and providing dietary counselling to obese patients, are an important part of clinical practice. Doctors have generally positive views on the role of nutrition in clinical practice [1,2] and would give nutrition care (for example dietary counselling) to their patients if it were not for the various barriers outlined above [1] Those barriers are present during both training and practice. It is important to identify key components of effective educational interventions and which educational interventions and strategies should be used in which settings [10]

Objectives

Methods

Conclusion