Teaching medical students the subjective global assessment

OBJECTIVE: Clinical nutrition assessment is a clinical skill not taught in many medical schools in North America. The purpose of this study is to determine whether second-year medical students can be taught to perform a nutritional Subjective Global Assessment (SGA). METHODS: In this study, second-year medical students were given a didactic session and a bedside demonstration of the SGA. Subsequently, they performed an SGA on unknown patients and classified those patients into one of three categories: A) well nourished, B) moderately malnourished, or C) severely malnourished. This was compared with the assessments of clinical dietitians and a physician. RESULTS: After this instruction, medical students correctly identified malnourished individuals. They were less accurate in their subclassification between mildly and severely malnourished individuals. The degree of agreement with clinical dietitians and a physician was fair (kappa = 0.34). CONCLUSIONS: With a multidisciplinary team of physicians and clinical dietitians, medical students can be taught the SGA in a 3h format. This is an important clinical skill that emphasizes the importance of clinical nutrition and may help identify malnourished individuals early in the course of their hospitalization. (C) Elsevier Science Inc. 2002.