By ELLEN GOLDBAUM
Published January 21, 2022
Eat healthy and exercise: This is the most common New Year’s resolution people make and often fail to achieve. But this year, UB students learned new skills that they are putting into practice in local clinics with the goal of motivating their patients — and themselves — to make better life choices.
In partnership with the Buffalo Niagara Medical Campus, 170 third-year students from the Jacobs School of Medicine and Biomedical Sciences and 30 dietetics students from the School of Public Health and Health Professions participated earlier this month in a two-day intersession weeks with a “Food as medicine”.
Marla Guarino, Associate Director of Health and Wellness at BNMC, kicked off the event by discussing the national Food As Medicine movement and BNMC’s conference on the subject last fall. Beth Machnica, Director of Health and Wellness, joined on the final day of the session to outline how Jacobs School students can participate in the Food as Medicine research study that BNMC launched with its recent Blue Fund award.
Food as Medicine Subsidy
“In 2022, BNMC will conduct a HighMark Blue Cross Blue Shield supported food-as-medicine research study that aims to contribute to the existing body of research while continuing to foster clinical-community partnerships – including with the Jacobs School,” Guarino said. . “The UB/Jacobs School/BNMC partnership will help ensure that future healthcare professionals gain an in-depth understanding of the connection between diet and health to use across their continuum of care.”
The benefits of this interprofessional session will prove far more than academic, according to faculty organizers at the Jacobs School. This semester, armed with their newfound “food as medicine” knowledge and skills, Jacobs School students will integrate into third-year placements and clinical rotations in the community new ways to motivate patients to eat healthier. .
“Our students are not just vessels to be filled with knowledge,” noted Daniel Sheehan, associate director of the medical program and professor of pediatrics who has led the annual intersessional for third-year students for the past seven years. “They are of great value to our health care system and they can be co-agents of change with us.
“That’s the whole point of an academic medical center,” Sheehan continued. “In a world where physicians and medical residents are busier than ever, our students provide such value. »
Appreciation of the care team
The Jan. 7 “Food as Medicine Friday” intersession was designed as an interprofessional activity to bring aspiring physicians and dietitians at UB to appreciate how the healthcare team of the future is better equipped to meet the needs of patients. and customers.
The two weeks ended with a final day dedicated to discussing the findings of scientific papers that demonstrated, for example, how dietary interventions in diabetic patients can lead to better outcomes than pharmacological interventions.
“Organizing an event where medical and dietetic students come together to share their knowledge can help learners develop an attitude of appreciation for other healthcare professionals and reinforce the need to seek interdisciplinary solutions to the problems of their patients,” said Alison Vargovich, assistant professor of medicine in the Jacobs School’s Division of Behavioral Medicine.
“Interprofessional opportunities aren’t typically built into traditional health sciences curricula, so these sessions are extremely valuable,” added Jill Tirabassi, clinical assistant professor of family medicine.
“The earlier students see the integration between different facets of the healthcare team and understand what their colleagues do, the better they can use their expertise when entering their profession,” she explained. . “Our education systems weren’t designed to do this naturally, so being able to do this now is wonderful and will foster future collaboration.”
The challenges of supermarkets
Under the direction of Nicole Klem, Director of the MS/Dietetic Clinical Nutrition Practicum at the School of Public Health and Health Professions, second-year dietetics students developed a presentation for medical students on the specific pathways of the supermarket that pose unique challenges to consumers.
Medical students have learned that contrary to what some people have heard, low-fat dairy products do not necessarily have a higher sugar content. They discussed dairy milk alternatives centered on soy, oats, almond, peas and other non-dairy milks; it has been noted that while cow’s milk contains about 8 grams of protein, soy and pea milk may be comparable, but almond and oat milk provide less protein per serving.
Cereals, known for their high sugar content, were also discussed, and patients were advised to choose cereals with 5 grams of sugar or less. Canned goods have been touted as convenient and affordable, but they can contain excessive amounts of sodium, which can often be significantly reduced simply by rinsing the contents before cooking.
After a heated discussion about tips for healthy eating, the medical students began tackling the much harder question of how to motivate patients to make healthier lifestyle choices. It’s a problem, the faculty point out, that’s at the very essence of the practice of medicine.
Make patients “take off”
“I postulate to each of you that no matter what medical house you enter, 90% of the job is to convince your patients to peel back a little, to step out of the fence, to take new steps to improve their health,” said Sourav Sengupta, assistant professor of psychiatry and pediatrics, who sees patients through UBMD Psychiatry.
Sengupta noted that Jacobs School students have been hearing about behavior change in medicine since their first year of training, and that a key skill is the technique called motivational interviewing, or MI.
“Motivational interviewing is a way to focus on where the patient is, how they may be stuck, and how we can help them take the next step,” he said.
It’s a technique that has been described less as a way to get someone to do something than as a way to cultivate the conditions where change is more likely.
“Motivational interviewing is a style of communication that should feel like ‘dancing’ rather than ‘struggling’ with a patient,” Vargovich explained. “This creates a patient-centered approach, giving the patient autonomy over their healthcare choices and fostering the doctor-patient relationship. The goal is never to force change, but it makes it easier to understand a patient’s perspective and concerns, plant seeds related to important health changes, and provide education when needed.
Beginning January 10, Jacobs School third graders returned to local clinics to begin sharing what they had learned. “Our students gained a great understanding of food as medicine,” Sheehan said. “They will go out into the community as messengers to talk to patients and other health care providers about healthy diets and discuss how to improve nutrition when patients live in ‘food deserts’.
“With training like this, we empower them to help us transform health care in Buffalo.”
Other professors involved in the intersession include Michael Morales, research associate professor of physiology and biophysics; A. John Ryan, clinical associate professor of medicine; Helen Cappuccino, clinical assistant professor of surgery at UB and assistant professor of oncology at Roswell Park Comprehensive Cancer Center; and Gary Giovino, SUNY Emeritus Professor Emeritus in the School of Public Health and Health Professions.
Funding for the four-module “What Every Clinician Needs to Know” online nutrition course (from the Gaples Institute, a physician-led nonprofit educational organization) that was taken by all third-year medical students was was provided by the Gerald Friedman, MD ’57 and Roberta Friedman Medical School Curriculum Research and Education Fund.