By Jennifer J. Salopek
Do doctors who eat better provide better care? Tim Harlan believes they do. Educating medical students and residents about healthy foods and their preparation is central to the mission of the Goldring Center for Culinary Education at Tulane University, which Harlan directs. Both a trained chef and a doctor, Harlan is committed to showing future doctors—and the patients and communities they serve—that good-for-you foods can taste good too. In a high-fat, high-salt, high-alcohol environment like New Orleans, where the obesity rate is five points higher than the national average, that’s a crucial message to get across.
The idea for teaching medical students how to cook in order to make them better nutritional counselors in patient care originated with David Eisenberg at Harvard University, who created a course called “Healthy Kitchens, Healthy Lives.” [Now a national conference, the meeting was held last week in Napa Valley, California.] Inspired by Eisenberg’s ideas, Tulane built the Goldring Center, the first dedicated teaching kitchen to be implemented at a medical school, then took the education a step further: into the community.
“I thought the concept was cool but didn’t really get it at first,” Harlan admits. “I was unsure how to teach and apply the knowledge immediately. The community outreach we designed was the connection piece, the tipping point that really energized our efforts.”
In fact, the community curriculum was constructed first, then the medical student program was built on top of that. First offered in fall of 2012 for second-year medical students, the course was a semester-long elective offered in eight three-hour, hands-on modules. The curriculum has been revised continuously since then; in its current form, hands-on culinary experience complements online didactics, journal articles, and case studies. Students, working in teams of four, spend 60 to 75 minutes preparing dishes, which they then eat together while presenting the results of their case study. Fourth-year students lead the table discussions. The curriculum has been licensed by 11 other institutions, including UT Southwestern and the Robert Wood Johnson Medical School at Rutgers.
“The first curriculum was very patient-focused, culinary, all about nutrition,” says Harlan, who is also a family doc. “The students wanted more biochemistry, physiology—a tighter link to the rest of the curriculum. They also wanted a more clinical relationship that would allow them to take basic information and translate it into conversations with patients in the exam room.”
Research by Harlan and his Goldring Center colleague Dominique Monlezun demonstrates that they can. In a study published in the Journal of Medicine and the Person, they revealed that the culinary curriculum increased nutrition competencies among pediatric residents as well as residents’ own dietary habits.
This semester, the Foundations in Medicine class at Tulane will include an introductory module for first-year medical students, and a disease-specific curriculum in neurobiology is being rolled out for third and fourth-year students. The Goldring Center will welcome 10 interns this summer for the first time.
The Center also offers continuing medical education that focuses on translating basic science into practical clinical skills that help physicians change the dialogue with patients about food and health. Each module is certified for three to four hours of CME credit and some are conveniently tied to such New Orleans special events as the French Quarter festival and the New Orleans Jazz and Heritage Festival. The learning is experiential, team-based, and evidence-based.
Medical students, residents, and experienced physicians alike are reminded of the importance of role modeling through these efforts.
“The data shows that patients are three times more likely to follow the recommendations of doctors who walk the talk and share that with patients,” Harlan says.