Original Publication
Open Access

Nutrition in Critical Care: A Modified Team-Based Learning Exercise

Published: April 22, 2016 | 10.15766/mep_2374-8265.10386

All appendices are peer reviewed as integral parts of the Original Publication.

  • Nutrition GRAT Answer Sheet.docx
  • Nutrition Group Exercise Answer Sheet.docx
  • Nutrition Group Exercise Key.docx
  • Nutrition Group Exercise Presentation.pptx
  • Nutrition IRAT Explanations.docx
  • Nutrition IRAT Key.docx
  • Nutrition IRAT.docx
  • Nutrition Instructor's Guide.docx
  • Nutrition Module Evaluation Form.docx
  • Nutrition Student Instructions.docx
  • Nutrition Study Guide.docx

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Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.

Abstract

Introduction: This is a module for teaching medical students nutrition in critical care, utilizing a TBL format. This particular session is designed around a 2-hour time block in the classroom. Methods: Students are assigned reading to be completed prior to the classroom and are tested with an independent readiness assessment test upon arrival to class. The class then discusses the answers to the test before splitting into groups for a larger, discussion-based exercise. Teams are led through a presentation by a proctor and asked to answer questions relevant to the topic of nutrition in critical care. Aspects of caloric intake and the nuances of burn injury versus starvation on the body's fuel are covered in this module. Twenty-four preclinical second-year medical students participated in the Nutrition in Critical Care Minimester Module. At the conclusion of the 2-week course, the students were given the opportunity to evaluate this specific module. Results: Of the 24 students in the class, 17 completed the survey. The survey elicited responses in a five-tier grading system. The majority of the students found that the activity was "Valuable" (11/17), and the remainder found it "Extremely Valuable" (6/17). These results correspond to a 4/5 and the remainder of a 5/5 grade, respectively. In the comments section, students were allowed to write any suggestions for future iterations of this module. Several students noted that the study materials provided a substantial amount of information and wanted to have more time to prepare. Six out of 17 students thought that this module could be implemented in the future as is—without changes. Seven out of 17 indicated that the module could be implemented in the future with changes. Five of the seven students who indicated changes needed to be made to the curriculum wrote about needing more time to absorb the topics in the reading. Discussion: This is a module for teaching medical students utilizing a TBL format. Feedback from learners suggests that this module is effective at conveying information regarding nutrition in critical care.


Educational Objectives

By the end of this module, learners will be able to:

  1. Describe the biochemical changes that occur following trauma, sepsis, or burns and compare with normal physiology.
  2. Compare and contrast the metabolic differences between injury and starvation, given clinical information on a patient who has sustained major trauma or burn injuries.
  3. Compare and contrast nutritional requirements for critically ill patients and noninjured patients.
  4. Apply the basic methods of assessing a patient’s nutrition status to a simulated or real patient.
  5. Describe the different routes of nutrition, the risks associated with them, and when is the most appropriate use for them.
  6. Write basic nutrition orders, including orders for simple total parenteral nutrition.
  7. Discuss the consequences of poor nutrition on patient survival and outcomes.

Author Information

  • James Elder: University of Texas Medical Branch School of Medicine
  • Jennifer Perone, MD: University of Texas Medical Branch School of Medicine
  • Ludwik Branski, MD: University of Texas Medical Branch School of Medicine
  • Kimberly Brown, MD: University of Texas Medical Branch School of Medicine

Disclosures
None to report.

Funding/Support
None to report.


References

  1. Adams CA, Stephen A, Cioffi WG. Surgical critical care. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sibaston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. Philadelphia, PA: Elsevier Saunders; 2012:563-594.
  2. Fiser SM, The ABSITE Review. 4th ed. Philadelphia, PA: Lippicott Williams & Wilkins; 2014.
  3. Neal MD, Sperry JL. Nutritional support in the critically ill. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. Philadelphia, PA: Elsevier Saunders; 2014:1284-1289.
  4. Seres D. Nutrition support in critically ill patients: an overview. UpToDate Web site. http://www.uptodate.com/contents/nutrition-support-in-critically-ill-patients-an-overview. Accessed August 25, 2015.
  5. Seres D. Nutrition support in critically ill patients: enteral nutrition. UpToDate Web site. http://www.uptodate.com/contents/nutrition-support-in-critically-ill-patients-enteral-nutrition. Accessed August 25, 2015.
  6. Seres D. Nutrition support in critically ill patients: parenteral nutrition. UpToDate Web site. http://www.uptodate.com/contents/nutrition-support-in-critically-ill-patients-parenteral-nutrition. Accessed August 24, 2015.


Citation

Elder J, Perone J, Branski L, Brown K. Nutrition in critical care: a modified team-based learning exercise. MedEdPORTAL. 2016;12:10386. https://doi.org/10.15766/mep_2374-8265.10386