Effect of structured education on family physician residents' knowledge of oral nutritional supplement use

Introduction: Family physicians are actively involved in primary, secondary, and tertiary care, as well as in palliative care and home healthcare services, and they frequently encounter patients with malnutrition. It is very important for family medicine residents to learn how to manage malnutrition during their training. However, there is no study in the literature that evaluates the skills of family medicine residents regarding the use of oral nutritional supplements (ONS) through educational interventions. This study evaluates the effectiveness of a structured, guideline-based educational session in improving family physician residents' knowledge of ONS. Methods: This guideline-based education intervention study was conducted on March 24, 2025, at a tertiary hospital. Thirty-five family medicine residents participated in a one-hour educational session; 33 completed both pre- and post-tests. A 12-question multiple-choice questionnaire was developed using the Clinical Enteral and Parenteral Nutrition Society (KEPAN) consensus report about ONS. The training covered the same knowledge areas as the test and was designed to align with the national consensus on ONS use. Pre and post-training responses were compared using the Wilcoxon signed-rank and McNemar tests. A p-value <0.05 was considered statistically significant. Results: Among 33 residents (mean age: 28.45 ± 3.77 years), 66.7% had no prior nutrition education. Baseline knowledge was already relatively high for ONS indications (81.8%) and planning its use at discharge (84.8%), and after training, the correct response rate for these questions reached 100%. 76.7% of participants felt confident in identifying malnutrition and initiating ONS. In the pre-training assessment, baseline knowledge levels about ONS use were below 50% in 6 out of 12 questions (storage, daily practices, patient monitoring, comorbidities and special conditions, and thickener use). After the training, only the knowledge related to ONS use in comorbidities remained below 50%; however, a significant improvement was observed, with correct responses increasing from 6.1% to 45.5% (p<0.001). Post-training, despite the increase in correct answers given to all questions, significant improvements were noted in questions concerning ONS indications, storage, daily practices, ONS use in comorbidities, swallowing disorders, older patients and thickener use (p < 0.05). After training, the average score of the questionnaire increased from 6.6 ± 2.4 to 9.7 ± 1.4 (p < 0.001). All participants reported benefiting from the session. However, residents still showed important gaps regarding patient monitoring, including follow-up and discontinuation of ONS, as well as the use of ONS in special populations such as patients with cancer, comorbidities and hip fractures after training. Conclusions: A one-hour educational session significantly improved family physician residents' knowledge of ONS usage. Despite the short duration, participants reported high satisfaction and better readiness to manage malnutrition. Integrating guideline-based structured nutrition training into family medicine programs may improve clinical decision-making and patient outcomes. However special conditions about ONS use may require more intensive or longitudinal training formats, potentially supplemented with mentorship or digital learning modules.