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Launching a revolutionary new program in culinary medicine [debrief and future plans]

Allow me to start by extending my heartfelt gratitude for the overwhelming support the dietitian community extended after my first Practice Blog post. I feel so incredibly proud to be part of a profession that prides itself in collaboration and innovation. Your encouraging messages and support in spreading the word about The Physician in the Kitchen program has no doubt contributed to its success.
 
The inspiration for Physician in the Kitchen
 
These two quotes recap the motivation for developing this program well:
 
Early evidence is emerging that “cooking demonstrations and participatory hands-on cooking workshops, combined with more traditional didactic, nutrition-related presentations, would result in positive changes in behaviour among participants’ personal habits and their perceived ability to advise" (p.471).1

"Other than being a primary care practitioner, practicing a healthful behavior oneself was the most consistent and powerful predictor of physicians counselling patients about related prevention issues" (p.637).2

Recapping the program’s objectives:
 

  • Improve health care providers’ nutrition related self-behavior
  • Improve health care providers’ ability to discuss culinary skills (shopping, food storage, meal prep) and nutritional knowledge with patients
  • Boost  health care providers’ attitudes about the importance of their patients’ nutrition and culinary behaviours
  • Provide practical tools for patients to help them improve their nutritional and culinary behaviours (e.g. patient handouts)

 
Facing challenges
 
We faced many challenges when developing this program.
 
It was hard to find an affordable teaching venue and identify chefs with compatible attitudes regarding evidence-based nutrition practice. We also had to figure out how to effectively teach the program considering the likelihood of participants coming from different disciplines and having varied nutritional knowledge and culinary skills.  Developing an evaluation strategy was another hurdle.   
 
However, the most difficult hurdle was getting the program accredited by the College of Family Physicians of Canada, including the BC Chapter.
 
An anonymous reviewer’s initial comments: “The Mainpro system is designed to accredit education that benefits one’s profession vs education that benefits one's self; for example, teaching about the health benefits of yoga can be accredited, doing yoga cannot. As such the cooking time cannot be included as educational time.”
 
Therefore, for the pilot sessions, the program was accredited for up to 2.25 Mainpro-M1 credits, instead of 3.0.

Overcoming accreditation challenges
 
Our subsequent argument to accredit the hands-on cooking time was this:

Firstly, circulating training chefs supervise and coach the attendees during the hands-on cooking time. It is therefore an educational activity. The attendees are learning new skills and are not simply executing previously well-established cooking techniques that they have already mastered.

Secondly, although it’s clear the hands-on cooking time is associated with a personal benefit, we believe strongly it also benefits one’s profession.
 
As Frank2 has emphasized, a physician who practices a healthful behaviour (such as cooking and eating in a healthful manner) is a powerful predictor of the physician who counsels patients about these same behaviours (p. 637).
 
Further, there is emerging evidence that those physicians who are knowledgeable and skilled in the kitchen will be better able to effectively communicate such principles to their patients, thereby benefitting their professional practice.
 
Thirdly, the physicians are cooking in pairs and in close proximity with other physicians in the working kitchens. The collegial discussions that emerge related to cooking and nutrition in these small groups are powerful learning interactions. 
 
Fourthly, the annual Healthy Kitchens, Healthy Lives conference sponsored by the Harvard School of Public Health integrates hands-on teaching workshops into its program. We have confirmed with the conference that these sessions are deemed eligible as AMA PRA Category 1 credits™
 
After submitting this argument, the program was accredited by the College of Family Physicians of Canada and the BC Chapter for up to 3.0 Mainpro-M1 credits!
 
How did the pilot workshops go and who attended?
 
In November 2015, we launched our first two Introduction to Culinary Medicine workshops!  We had a great turnout of a mixed audience in both sessions. We almost reached maximum capacity of 32 people per session!
 
The audience was predominantly physicians working in family practice (which is what we anticipated), but we also attracted a few dietitians, allied health professionals, students, and residents.
 
To our surprise, there were also couples in attendance. It turns out that our program was perceived as not only an educational evening, but also a fun and creative one. This led to spouses (usually not in the health care field) to attend as well.
 
Evaluating our efforts
 
With this impressive mix of participants coming from varied educational and professional backgrounds, we weren’t quite sure what their response would be. After the completion of the evening program, each attendant was encouraged to fill out a formal evaluation.
 
Here is a snapshot of the results:
 

  • Overall rating: 4.42 (1=unsatisfactory, 3=satisfactory, 5=exceptional)
  • Will you be recommending this workshop? Of those that responded to this question (17), 100% said yes!
  • How would you rate your degree of proficiency in the kitchen BEFORE attending this workshop? Average: 5.53 (1-lowest 10-highest)
  • How would you rate your degree of proficiency in the kitchen AFTER attending this workshop? Average: 7.06
  • How would you rate your degree of nutritional knowledge BEFORE attending this workshop? Average: 6.24
  • How would you rate your degree of nutritional knowledge AFTER attending this workshop? Average: 7.12
 
We are very encouraged by the improvement in scores in both kitchen and nutritional knowledge proficiency and the overall rating of the program! I strongly believe that it was the intentional and creative collaboration within our team (physician, dietitian, chef) that led to these results.
 
Future plans
 
We have two more introductory workshops scheduled for April 2 and May 21. We are excited to continue offering more health care professionals and students a taste of culinary medicine. Thereafter, our plan is to create speciality workshops for specific health conditions and launch them later this year!

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Editor’s note: Angel’s argument to get the hands-on cooking time accredited had me saying, “Yes, yes, yes!” Great points. It is so important to teach behaviours and skills, in addition to nutrition knowledge. Way to go Angel and team!

Please leave your comments or questions for Angel below. 

 
References
  1. Eisenberg, D.M., Myrdal, M.A., McManus, K., Burgess, J., & Bernstein, A.M. (2013). Enhancing medical education to address obesity: “See one. Taste one. Cook one. Teach one.” Journal of the American Medical Association, 73, 470-472. 
  2. Frank, E. (2004). Physician health and patient care. Journal of the American Medical Association,291(5), 637.
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