| The importance of nutrition education in medicine has been established in scientific literature. However, physicians have not been consistently trained to apply nutrition knowledge in practice. This study was undertaken to develop a method for measuring affective and cognitive aspects of nutrition competence among prospective physicians. The purpose was to construct a theoretically driven, valid and reliable instrument for assessing prospective physicians' self-efficacy, attitude, and knowledge of diabetes medical nutrition therapy (D-MNT). The survey involved three phases: (I) administration of a traditional self-administered questionnaire, (II) administration of a computer self-administered questionnaire (C-SAQ), and (III) data collection and analysis. Data were collected from 66 (56.4%) first- and 67 (57.2%) fourth-year medical students who comprised a sample (N = 234) that was self-selected from the University of Florida College of Medicine.;A valid instrument was developed for assessing prospective physicians' competence to provide D-MNT. This was accomplished by providing evidence that supports six major aspects of validity. Classic test theory (e.g., factor analysis, t-test, and correlations), and item response theory (e.g., rating scale analysis) were used to evaluate utility of the instrument. Most of the findings suggested that the instrument measured characteristics it was interpreted to assess. However, not every hypothesis that supports convergence, the external aspect of validity, was found. Reasons for this are described.;Results from this study could be used to assess nutrition competence among physicians and compel medical educators and policymakers toward remedial action. However, questions remain about the potential impact that nutrition in medical education may have on the health of the public. Thus, future evaluation studies are recommended and goals for nutrition education are suggested.;The study also provides an overview of contextual factors that influence nutrition literacy among physicians and explores relative levels of nutrition competence among prospective physicians at one college of medicine. On the basis of the results, it is recommended that teaching and evaluation of nutrition in medical schools as it relates to MNT must be strengthened. Findings may be generalized to similar U.S. accredited colleges of medicine and should prove useful in future evaluations of other populations with similar curriculum characteristics. |
