Micronutrients and surgical care: A mixed-methods study of medical students' knowledge and perceptions.

Abstract

Micronutrients are often overlooked in the differential diagnosis, optimization, and treatment of patients who undergo surgery. This study evaluated medical students' perceptions of micronutrient science in connection with surgical care and outcomes. This cross-sectional mixed methods study included students in their first (M1) through fourth (M4) years at an accredited U.S. medical school (2023-2024 academic year). Participants were recruited for a 1-hour videoconference, with a 10-minute online survey before a 50-minute focus group. The survey collected demographics and gauged knowledge of micronutrient biology. Focus group prompts addressed knowledge and self-efficacy in the surgical context, attitudes toward micronutrients, and reflections from participants' medical training. Summary characteristics were calculated for survey responses. Each focus group transcript underwent iterative grounded theory analysis. Twelve students participated (5 male; 7 M4s, 2 M3s, 1 M2, 1 M1, 1 scholar year between M3-M4 for research). In the initial online test, the average of correct responses in the knowledge-based survey was 66.7% and 11/12 students indicated significant comfort in identifying micronutrient imbalances. Once presented with actual patient scenarios in the focus groups, discussion shifted to inadequate familiarity with micronutrient biology, variability in micronutrient science education, and recognition that knowledge acquisition had focused on studying for United States Medical Licensing Examination Step 1 board examinations, rather than on relevance to clinical cases managed during rotations. Most students recognized micronutrient science as important in the care of the patient who undergoes surgery, although some wondered if this topic lies outside a surgeon's expected scope of knowledge. These observations may inform curriculum design connecting micronutrient biology to general care of patients who undergo surgery.