Presented By: Matthew Yee, Columbia University
Co-Authors: Cecilia Brassett, University of Cambridge
Jane Dutton, King's College
Mandeep Gill Sagoo, King's College
Sean McWatt, Western University Schulich School of Medicine and Dentistry
Geoffroy Noel, University of California at San Diego School of Medicine
Takeshi Sakurai, Kyoto University
Dana Stearns, Harvard Medical School
Anette Wu, Columbia University

Purpose
Nutrition affects overall health, yet comprehensive nutrition education is persistently lacking in medical schools. Even when taught, nutrition courses rarely include global cultural perspectives. Physicians are thus insufficiently equipped to support diverse patient populations with nutrition-related guidance. Our objective was to develop a novel online, international, and interactive elective course for senior medical students to learn and review fundamental nutrition topics in a cross-cultural context.

Methods
This course was based on formats from the International Collaboration and Exchange Program (ICEP) at Columbia University. From March to April 2023, students participated via videoconferences in didactic lectures and small group discussions. Discussion topics included nutrition-related cultural perspectives and practices. To investigate course outcomes, we administered pre- and post-course surveys to explore student perspectives on nutrition knowledge, cultural competency and health equity, and to direct feedback on the course itself. We included validated Likert scale questions from a Cross-Cultural Care Survey (CCCS). Inductive thematic analysis was conducted for short-response course feedback questions, in which student responses were semantically coded.

Results
Students (n=40) were successfully recruited from past ICEP participants on four continents (North America, Asia, Europe, and Africa). Compared to the pre-course baseline, post-course survey evidence demonstrated students’ improvement in perceived nutrition content knowledge and ability to provide patients with advice on diet and healthy eating. CCCS Likert-type scales demonstrated that students gained an improved appreciation for cultural competency practices and health equity promotion. Thematic analysis demonstrated that students also gained an interest in interprofessional education and dietary culture exposure in their medical training.

Conclusions
Teaching nutrition in a synergistically cross-cultural context promotes practices essential for equitable healthcare delivery. We propose that global student small group learning should be further investigated to support cultural competency training. Our novel course format introduces students to multiple dimensions of medicine that are crucial for holistic patient care but are rarely included in traditional curricula.