Skip to main content
Log in

Hands-on Cooking in Medical Schools: Diffusion of a Prevention Education Innovation

  • Original research
  • Published:
Medical Science Educator Aims and scope Submit manuscript

Abstract

Educating physicians early and often on how to have conversations with patients about diet to prevent and treat chronic disease is imperative, yet under realized. Some innovative medical schools have begun implementing hands-on cooking (HOC) programs to fill this gap, but how these programs are promoted is unknown. This study assessed the prevalence and innovation characteristics of HOC programs offered to medical students in the USA. Content analysis of webpages was conducted using a Diffusion of Innovation (e.g., relative advantage, compatibility, complexity, trialability, and observability) framework. Themes of relative advantage included increasing students’ confidence, improvements in medical and interprofessional education, and translating into a benefit to patients through improved care. Compatibility codes showed only a quarter of webpages referred to the program as “evidence-based.” Complexity codes showed most (86%) webpages clearly described the course. About half the webpages described the program as an elective, suggesting trialability of this innovation. Many (43%) of the programs referenced use of a standardized “culinary medicine” curriculum, contributing to the observability of this innovation. Within the sample of schools, 35% provided HOC programs for their students. These findings suggest HOC programs have a strong foothold in healthcare education and provide a framework from which future studies might examine what effects innovative, successful HOC programs have on curriculum development, student experience, and, ultimately, patient outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Sick room and convalescent cookery for medical students. J Br Med. 1893;(Jan 7):35.

  2. Kochanek KD, Murphy SL, Xu J, Arias E. National Vital Statistics Reports Volume 68, Number 9 June 24, 2019 deaths: final data for 2017.; 2019. Accessed July 21, 2019. https://www.cdc.gov/nchs/products/index.htm.

  3. CDC. About chronic disease | Chronic disease prevention and health promotion. Published 2018. https://www.cdc.gov/chronicdisease/about/index.htm

  4. Nutrition and Weight Status | Healthy People 2020. Accessed March 16, 2020. https://www.healthypeople.gov/2020/topics-objectives/topic/nutrition-and-weight-status.

  5. Kushner RF. Barriers to providing nutrition counseling by physicians: a survey of primary care practitioners. Prev Med (Baltim). 1995;24(6):546–52. https://doi.org/10.1006/PMED.1995.1087.

    Article  Google Scholar 

  6. Kolasa KM, Rickett K. Barriers to providing nutrition counseling cited by physicians: a survey of primary care practitioners. Nutr Clin Pract. 2010;25(5):502–9. https://doi.org/10.1177/0884533610380057.

    Article  Google Scholar 

  7. Lewis MA, Fitzgerald TM, Zulkiewicz B, Peinado S, Williams PA. Identifying synergies in multilevel interventions: the convergence strategy. Heal Educ Behav. 2017;44(2):236–44. https://doi.org/10.1177/1090198116673994.

    Article  Google Scholar 

  8. Sallis JF. Needs and challenges related to multilevel interventions: physical activity examples. Heal Educ Behav. 2018;45(5):661–7. https://doi.org/10.1177/1090198118796458.

    Article  Google Scholar 

  9. DiMaria-Ghalili RA, Mirtallo JM, Tobin BW, Hark L, Van Horn L, Palmer CA. Challenges and opportunities for nutrition education and training in the health care professions: intraprofessional and interprofessional call to action. Am J Clin Nutr. 2014;99(5). https://doi.org/10.3945/ajcn.113.073536.

  10. Adams KM, Butsch WS, Kohlmeier M. The state of nutrition education at US medical schools. J Biomed Educ. 2015;2015:1–7. https://doi.org/10.1155/2015/357627.

    Article  Google Scholar 

  11. Katz DL. How to improve clinical practice and medical education about nutrition. AMA J Ethics. 2018;20(10):994–1000. https://doi.org/10.1001/amajethics.2018.994.

    Article  Google Scholar 

  12. Barnard ND. Ignorance of nutrition is no longer defensible. JAMA Intern Med. Published online July. 2019;1:1021. https://doi.org/10.1001/jamainternmed.2019.2273.

    Article  Google Scholar 

  13. Abbasi J. Stephen Devries, MD: Training physicians about nutrition. JAMA - J Am Med Assoc. 2018;319(17):1751–2. https://doi.org/10.1001/jama.2018.1070.

    Article  Google Scholar 

  14. Aspry KE, Linda Van Horn C, Carson JA, et al. Medical nutrition education, training, and competencies to advance guideline-based diet counseling by physicians. Circulation. 2018;137(1):821–41. https://doi.org/10.1161/CIR.0000000000000563.

    Article  Google Scholar 

  15. Polak R, Phillips EM, Nordgren J, la Puma J, la Barba J, Cucuzzella M, et al. Health-related culinary education: a summary of representative emerging programs for health professionals and patients. Glob Adv Heal Med. 2016;5(1):61–8. https://doi.org/10.7453/gahmj.2015.128.

    Article  Google Scholar 

  16. Monlezun DJ, Kasprowicz E, Tosh KW, Nix J, Urday P, Tice D, et al. Medical school-based teaching kitchen improves HbA1c, blood pressure, and cholesterol for patients with type 2 diabetes: results from a novel randomized controlled trial. Diabetes Res Clin Pract. 2015;109(2):420–6. https://doi.org/10.1016/j.diabres.2015.05.007.

    Article  Google Scholar 

  17. Arman D, Monlezun DJ, Peters B, Urday P, Cutler H, Pellicore D, et al. CHOP-International: an open access nutrition education tool for physicians, resident doctors, and medical and public health students. J Med Person. 2015;13(2):118–24. https://doi.org/10.1007/s12682-014-0202-5.

    Article  Google Scholar 

  18. Leong B, Ren D, Monlezun D, Ly D, Sarris L, Harlan TS. Teaching third and fourth year medical students how to cook: an innovative approach to training students in lifestyle modification for chronic disease management. Int Assoc Med Sci Educ. Published online 2014. https://doi.org/10.1007/s40670-014-0014-5.

  19. La Puma J. What is culinary medicine and what does it do? Popul Health Manag. 2016;19(1):1–3. https://doi.org/10.1089/pop.2015.0003.

    Article  Google Scholar 

  20. La Puma J, Marx RP. ChefMD’s big book of culinary medicine : a food lover’s road map to losing weight, preventing disease, and getting really healthy. New York: Three Rivers Press; 2009.

  21. Hart J. Lifestyle as medicine: institute of lifestyle medicine. Harvard Medical School. Altern Complement Ther. 2017;23(2):72–5. https://doi.org/10.1089/act.2017.29104.pro.

    Article  Google Scholar 

  22. IPEC. Core competencies for interprofessional collaborative practice : 2016 update. Interprofessional Educ Collab. Published online 2016. doi:https://doi.org/10.1097/ACM.0b013e3182308e39

  23. WHO. Framework for Action on Interprofessional Education & Collaborative Practice Health Professions Networks Nursing & Midwifery Human Resources for Health. Published 2010. Accessed July 30, 2019. http://www.who.int/hrh/nursing_midwifery/en/

  24. Rogers EM. Diffusion of innovations. Free Press; 2003.

  25. Fernandez MA, Desroches S, Turcotte M, Marquis M, Dufour J, Provencher V. Factors influencing the adoption of a healthy eating campaign by federal cross-sector partners: a qualitative study. BMC Public Health. 2016;16(1):904. https://doi.org/10.1186/s12889-016-3523-x.

    Article  Google Scholar 

  26. Zhang X, Yu P, Yan J, Ton AM, Spil I. Using diffusion of innovation theory to understand the factors impacting patient acceptance and use of consumer e-health innovations: a case study in a primary care clinic. BMC Health Serv Res. 2015;15(1):71. https://doi.org/10.1186/s12913-015-0726-2.

    Article  Google Scholar 

  27. McGarry D, Cashin A, Fowler C. “Coming ready or not” high fidelity human patient simulation in child and adolescent psychiatric nursing education: diffusion of innovation. Nurse Educ Today. Published online 2011. doi:https://doi.org/10.1016/j.nedt.2011.01.002

  28. Mohammadi MM, Poursaberi R, Salahshoor MR. Evaluating the adoption of evidence-based practice using Rogers’s diffusion of innovation theory: a model testing study. Heal Promot Perspect. 2018;8(1):25–32. https://doi.org/10.15171/hpp.2018.03.

    Article  Google Scholar 

  29. LCME. Accredited U.S. Programs | LCME. Published 2019. Accessed February 3, 2019. http://lcme.org/directory/accredited-u-s-programs/.

  30. AAMC. Data and analysis - AAMC. Published 2019. Accessed April 22, 2019. https://www.aamc.org/data.

  31. Andermann A. Taking action on the social determinants of health in clinical practice: a framework for health professionals. CMAJ. 2016;188(17-18):E474–83. https://doi.org/10.1503/cmaj.160177.

    Article  Google Scholar 

  32. CulinaryMedicine.org. Partner sites using health meets food courseware – CulinaryMedicine.org. Published 2019. Accessed April 22, 2019. https://culinarymedicine.org/about-us/partner-schools/.

  33. McHugh ML. Interrater reliability: the kappa statistic. Biochem Medica. 2012;22(3):276–82. https://doi.org/10.11613/bm.2012.031.

    Article  Google Scholar 

  34. U.S. Department of Health & Human Services. Human subject regulations decision charts | HHS.gov. Published 2016. Accessed December 14, 2019. https://www.hhs.gov/ohrp/regulations-and-policy/decision-charts/index.html#c1.

  35. Khandelwal S, Zemore SE, Hemmerling A. Nutrition education in internal medicine residency programs and predictors of residents’ dietary counseling practices. J Med Educ Curric Dev. 2018;5:238212051876336. https://doi.org/10.1177/2382120518763360.

    Article  Google Scholar 

  36. Mogre V, Stevens FCJ, Aryee PA, Amalba A, Scherpbier AJJA. Why nutrition education is inadequate in the medical curriculum: a qualitative study of students’ perspectives on barriers and strategies. BMC Med Educ. 2018;18(1):26. https://doi.org/10.1186/s12909-018-1130-5.

    Article  Google Scholar 

  37. Eisenberg DM, Myrdal Miller A, McManus K, Burgess J, Bernstein AM. Enhancing medical education to address obesity: “See one. Taste one. Cook one. Teach one.” JAMA Intern Med. Published online 2013. doi:https://doi.org/10.1001/jamainternmed.2013.2517

  38. Eisenberg DM, Myrdal Miller A, McManus K, Burgess J, Bernstein AM. Enhancing medical education to address obesity: “See One. Taste One. Cook One. Teach One”. JAMA Intern Med. 2013;173(6):470. https://doi.org/10.1001/jamainternmed.2013.2517.

    Article  Google Scholar 

  39. Birkhead AG, Foote S, Monlezun DJ, et al. Medical student-led community cooking classes: a novel preventive medicine model that’s easy to swallow. Am J Prev Med. 2014;46(3). https://doi.org/10.1016/j.amepre.2013.11.006.

  40. Lawrence JC, Knol LL, Clem J, De La OR, Henson, Suzanne C, et al. Integration of interprofessional education (IPE) core competencies into health care education: IPE meets culinary medicine. J Nutr Educ Behav. 2019;51:510–2. https://doi.org/10.1016/j.jneb.2019.01.013.

    Article  Google Scholar 

  41. LA Hark RD, Deen DM. FROM THE ACADEMY Position Paper Position of the Academy of Nutrition and Dietetics: Interprofessional Education in Nutrition as an Essential Component of Medical Education POSITION STATEMENT. Published online. 2017;117:1104–13. https://doi.org/10.1016/j.jand.2017.04.019.

    Article  Google Scholar 

  42. Health Professions Accreditors Collaborative. Guidance on developing quality interprofessional education for the health professions. Published 2019. Accessed July 30, 2019. https://healthprofessionsaccreditors.org/wp-content/uploads/2019/02/HPACGuidance02-01-19.pdf.

  43. Dreibelbis TD, George DR. “Low-hanging fruit”: enhancing culinary medicine curricula by building intuitive community partnerships. Med Sci Educ. 2018;28(4):813–4. https://doi.org/10.1007/s40670-018-0618-2.

    Article  Google Scholar 

  44. Bleich SN, Bennett WL, Gudzune KA, Cooper LA. National survey of US primary care physicians’ perspectives about causes of obesity and solutions to improve care. BMJ Open. 2012;2:1790. https://doi.org/10.1136/bmjopen-2012.

    Article  Google Scholar 

Download references

Acknowledgments

The authors would like to express appreciation to the Association of Medical Colleges and Liaison Committee on Medical Education for data used to identify and present descriptive statistics for the study. The authors wish to thank Maria D. Thomson and Megan Edmonds for their feedback on the study design.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to April Williams.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(DOCX 382 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Williams, A., Diffenderfer, A. & Carlyle, K. Hands-on Cooking in Medical Schools: Diffusion of a Prevention Education Innovation. Med.Sci.Educ. 30, 1591–1598 (2020). https://doi.org/10.1007/s40670-020-01109-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40670-020-01109-6

Keywords

Navigation