title: Enhancing self-efficacy and patient care with cardiovascular nutrition education.
abstract: BACKGROUND
  Provision of medical education that develops nutrition knowledge and self-efficacy is critical if physicians are to incorporate nutrition in preventive care. We studied the impact of a cardiovascular nutrition module on the knowledge, attitudes, and self-efficacy of fourth-year medical students and the relationship of these attributes to patient care practices.
  
  
  METHODS
  Based on national practice guidelines and learner needs, an educational intervention consisting of two web-based cases, pocket reference cards, and classroom discussion was developed and implemented. Knowledge, attitudes, and self-efficacy were measured at the beginning and end of the 4-week ambulatory care rotation for 40 control and 156 experimental students. Performance in patient care was approximated using a self-report; chart audits were performed for a subset of students.
  
  
  CONCLUSIONS
  Knowledge scores of experimental students increased significantly from a mean of 10.3 to 14.4 (p<0.001), while the change for control students from 9.2 to 9.8 was not significant (p=0.20). The increase in self-efficacy scores from 26.2 to 35.7 in the experimental group (p<0.001) was twice that of the increase from 25.8 to 29.9 in the control group (p=0.001). Small but significant increases in attitude scores were similar for both groups. Limited data on student performance revealed that students with greater cardiovascular nutrition self-efficacy were more likely to address nutrition with cardiovascular patients.
  
  
  CONCLUSIONS
  Incorporation of cardiovascular nutrition concepts in an ambulatory care rotation including use of computer-based cases improved student knowledge and self-efficacy, which may translate to increased frequency of future physicians addressing nutrition with patients.
authors.affiliation: Department of Clinical Nutrition, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75390, USA. Joann.Carson@utsouthwestern.edu
authors.forename: Jo Ann S
authors.initials: JA
authors.lastname: Carson
authors.forename: M Beth
authors.initials: MB
authors.lastname: Gillham
authors.forename: Lynne M
authors.initials: LM
authors.lastname: Kirk
authors.forename: Shalini T
authors.initials: ST
authors.lastname: Reddy
authors.forename: James B
authors.initials: JB
authors.lastname: Battles
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003194:Computer-Assisted Instruction; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016014:Linear Models; D008297:Male; D052756:Nutritional Sciences / Q000193:education*; D020377:Self Efficacy