Hello, my name is Autumn Stevens, and I am an Ole Miss II student at the Alabama College of Osteopathic Medicine. Today, I will be presenting research assessing osteopathic medical student knowledge of common vitamin and mineral deficiencies. Vitamins and minerals, often referred to as micronutrients, are commonly deficient in the United States. Micronutrients are essential for an individual's overall health and well-being, and deficiencies in certain vitamins and minerals can predispose patients to a variety of illnesses. The health burden of vitamin deficiencies range from mild disruptions in well-being to life-threatening complications. Recognizing vitamin deficiencies within primary care settings is crucial for improving the overall health of our communities and for prevention of further stress on the health care system. Vitamin D deficiency among Americans has been found to be as high as 41.6%. Vitamin D is crucial for reducing bone fracture risk, reducing risk of developing multiple sclerosis, and decreasing overall cancer mortality. Vitamin B12 insufficiency may be as high as 12.5% and is linked to increases in anemia, nervous system degeneration, and psychiatric illness. Magnesium deficiency affects nearly half of all Americans and is linked to increased incidence of migraines, Alzheimer's disease, stroke, hypertension, cardiovascular disease, and type 2 diabetes mellitus. Folate deficiency has been on the decline since the 1990s and is estimated to be about 0.3% today, but still remains an important vitamin to assess due to its connection to vitamin B12 deficiency and purine synthesis. Recognition of these vitamin inadequacies starts with education of physicians. If student doctors are trained to recognize the signs and symptoms of micronutrient deficiencies, they will be better able to treat the patients and avoid serious health complications. Generally, these issues present within primary care settings. More than half of all osteopathic medical graduates practice within primary care settings, so ensuring osteopathic students receive sufficient micronutrient education is an essential step in the quest to reduce micronutrient deficiency within the United States. This study will primarily assess the knowledge of osteopathic medical students regarding the benefits of four micronutrients, vitamin B12, vitamin D, magnesium, and folate. The study objectives are to investigate the confidence osteopathic medical students have in their nutrition knowledge, investigate the micronutrient knowledge of preclinical versus postclinical students, investigate student knowledge of specific micronutrients, and investigate the willingness of students to recommend specific micronutrients to their future patients. This was a survey-based study that utilized a cross-sectional convenience sample of first, second, third, and fourth-year osteopathic medical students at the Alabama College of Osteopathic Medicine. Demographic questions assessed each student's class year, prior education and nutrition, confidence in their nutrition knowledge. Knowledge-based questions assessed students' ability to identify the specific functions and benefits of four vitamins and minerals. A four-point Likert scale was used to assess students' likelihood of prescribing nutrients to future patients. Vitamin B12, vitamin D, magnesium, and folate were considered for assessment because they are commonly deficient in the U.S. population. These deficiencies are easily assessed through serum tests and can be rectified with oral supplements, easing the barrier for evaluation and administration on the prescriber and the patient. Respondents included 44 students composed of 27 OMS1, 7 OMS2, 8 OMS3, and 2 OMS4 students. A t-test was conducted comparing the percent of correctly answered vitamin and mineral benefit questions by the pre-clinical OMS1 and OMS2 and post-clinical OMS3 and OMS4 students. An ANOVA was performed comparing the correctly answered micronutrient benefit questions by all students, assessing for differences in knowledge between the specific vitamin or mineral. All tests utilized a significance value of 0.05. Results show that 82% of students have had some exposure to nutrition education prior to taking the survey, with most students having attended a lecture on nutrition or taking a nutrition class. Self-rated competence in this knowledge, however, showed that most students are only somewhat confident in what they've learned. Zero students are very confident in their nutritional education. This data suggests that while students may have attended a lecture or even taken a class in nutrition, their learning has not persisted throughout medical school. Additional nutrition education within medical school and alternative methods of teaching that have greater lasting impact are needed to boost the competence level in these students. Responses also show that students retain more knowledge of certain vitamins compared to others, as assessed by an ANOVA comparing the number of students who correctly answered the specific benefits of the four micronutrients. These results indicate that, at least for folate and vitamin D, different educational emphasis is being placed on certain micronutrients. Varied instruction results in greater persistence in learning for these specific vitamins, which is counterproductive for practice in the field. All four of these vitamins and minerals are commonly deficient in the population, and it is important for our future physicians to be able to recognize the benefits of each of these micronutrients. Four two-tailed t-tests were performed comparing the number of preclinical students to the number of postclinical students that correctly identified the specific benefits of vitamin B12, vitamin D, magnesium, and folate. None of the p-values were statistically significant, meaning there was no difference in the knowledge level of these micronutrients between preclinical and postclinical students. A lack of a difference is an important finding, as it demonstrates that students are not retaining micronutrient knowledge throughout medical school. As they acquire clinical experience in their rotations, students are still not demonstrating any gain in knowledge compared to preclinical students. A four-point Likert scale was administered to all students, assessing the likelihood that they would recommend these four nutrients to their future patients. Survey results indicate that a large majority of students are either somewhat likely or very likely to recommend these micronutrients to their future patients. It's encouraging that students are inclined to prescribe these nutrients, but it also highlights a gap in learning that must be rectified. Students are supportive of the solution, but they must also be informed of the magnitude of the deficiencies in our population and be able to correctly identify the signs of specific vitamin deficiency once they enter practice. Each of the findings of this study demonstrate a clear need for further education in micronutrient deficiencies, specifically targeting vitamin B12, vitamin D, magnesium, and folate. Today's education will likely result in improved student confidence, increases in recognition of micronutrient benefits, and a closure of the gap between actual content knowledge and willingness to recommend. Osteopathic medical students are in greater need of this education due to the large number of graduates entering the primary care fields, so micronutrient curriculum within osteopathic schools should be addressed promptly. We acknowledge several limitations in this study, including a small sample size. Only 44 of 804 students at ACOM responded to the survey, resulting in reduced statistical power and statistical analysis being performed on a non-normal distribution. We are in the process of conducting a follow-up study with a larger sample size to increase the power and better justify the application of this data to the population. Thank you for your attention today, and please feel free to reach out with any questions or concerns.

osteopathic students

vitamin deficiencies

micronutrient education

nutrition knowledge

medical curricula