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Controlled trial of effect of computer-based nutrition course on knowledge and practice of general practitioner trainees^1,2,3,4

¹ From the Department of General Practice (HJSM and JWVR), the Skillslab Department (J-JER), and the Department of Educational Development and Research (LWTS), Maastricht University, Maastricht, the Netherlands; and the Department of Gastroenterology, University of Amsterdam (LMHM-V).

Background: Nutrition education is not an integral part of either undergraduate or postgraduate medical education. Computer-based instruction on nutrition might be an attractive and appropriate tool to fill this gap.

Objective: The study objective was to assess the degree to which computer-based instruction on nutrition improves factual knowledge and practice behavior of general practitioner (GP) trainees.

Design: We carried out a controlled experimental study, using a 79-item knowledge test and 3 incognito standardized patients’ visits in a pre- and posttest design with 49 first-year GP trainees. The experimental group (n = 25) received an average of 6 h of a newly developed computer-based instruction on nutrition. The control subjects (n = 24) took the standard vocational training program.

Results: The percentage of correct answers on the knowledge test increased from 30% at pretest to 42% at posttest in the experimental group, and from 36% to 37% in the control group. Analysis of covariance, with the pretest scores as covariate, showed a significant experimental versus control group difference at posttest: 9.2% (P = 0.002). The mean percentage of correctly performed items during the 3 standardized patients’ visits (assessed by checklists) showed an increase in the experimental group from 20% at pretest to 36% at posttest, whereas the control group changed from 20% to 22%. Analysis of covariance, with the pretest scores as covariate, revealed a significant group difference at posttest: 13.7% (P < 0.001).

Conclusion: The computer-based instruction proved its effectiveness, both by increasing factual knowledge and by substantially enhancing GP trainees’ practice behavior on the subject of nutrition.

Key Words: General practice • GP trainee • computer-based instruction • nutrition guidance • standardized patients • knowledge test

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