Presented By: Sonia Lobo, Geisinger Commonwealth School of Medicine
Co-Authors: Karla Feeley, Geisinger Commonwealth School of Medicine
Francis Gesel, Geisinger Commonwealth School of Medicine
Matthew Hamers, Geisinger Commonwealth School of Medicine
Sireesha Mamillapalli, Geisinger Commonwealth School of Medicine
Alexis Notarianni, Geisinger Commonwealth School of Medicine
Mahdi Taye, Geisinger Commonwealth School of Medicine
Gabi Waite, Geisinger Commonwealth School of Medicine

Purpose 
Nutrition education content in Geisinger Commonwealth School of Medicine's Total Health Curriculum falls short of national recommendations with 14 hours of instruction predominating in the preclinical phase and centered on the basic sciences. Additionally, the nutrition content fails to emphasize chronic disease prevention and lacks continuity between formal preclinical and clinical instruction. We performed a qualitative assessment to determine perceived gaps, beliefs, and competencies in nutrition education from stakeholders and solicit their suggestions for intervention and improvement. 

Methods 
We conducted semi-structured focus groups and one-on-one interviews with stakeholders throughout Geisinger to clarify gaps and barriers to nutrition instruction improvement. Purposive sampling was used to identify study participants, which included students, faculty, residents, physicians, and other healthcare professionals. Qualitative thematic analysis was completed using a grounded theory approach and inductive coding process. Semi-structured interviews and focus groups were recorded, transcribed, and thematically analyzed. 

Results 
To date, 20 participants were interviewed, representing diverse stakeholder groups. Participants' views on nutrition varied based on their roles as students, teachers, clinicians, or community stakeholders. Collectively, participants acknowledged the inadequacy of current nutrition education and the challenges in recognizing nutrition as a clinical tool in medicine; further, they noted the importance of a having a comprehensive foundation in clinical nutrition independent of medical specialty. Suggestions for improving nutrition education included qualified nutrition instructors, honing of motivational interviewing skills, and better integration throughout medical training. Quantitative analyses are underway to construct a conceptual framework explaining the longitudinal gaps in nutrition education.

Conclusion 
Our initial findings underscore the need for innovative initiatives to incorporate nutrition content throughout Geisinger's medical education curriculum, while recognizing the challenges of doing without emphasis of nutrition on national medical licensure examinations. Identifying a tangible framework to enhance nutrition education at Geisinger is underway.