A realist review of educational interventions to improve the delivery of nutrition care by doctors and future doctors

BACKGROUND Dietary interventions are considered an important aspect of clinical practice, more so in the face of the rising prevalence of obesity, diabetes and cardiovascular diseases globally. Routinely, most doctors do not provide such intervention to their patients, and several barriers, present during both training and clinical practice, have been identified. Educational interventions to improve nutrition care competencies and delivery have been implemented but with variable success, probably, due to the complex nature of such interventions. Using traditional methods only to investigate whether interventions are effective or not could not provide appropriate lessons. It is therefore pertinent to conduct a realist review that investigates how the interventions work. This realist review aims at determining what sort of educational interventions work, how, for whom, and in what circumstances, to improve the delivery of nutrition care by doctors and future doctors. METHODS/DESIGN This realist review will be conducted according to Pawson's five practical steps for conducting a realist review: (1) clarifying the scope of the review, (2) determining the search strategy, including adopting broad inclusion/exclusion criteria and purposive snowballing techniques, (3) ensuring proper article selection and study quality assessment using multiple methods, (4) extracting and organising data through the process of note taking, annotation and conceptualization and (5) synthesising the evidence and drawing conclusions through a process of reasoning. This realist review protocol has not been registered in any database before now. DISCUSSION Findings will be reported according to the publication criteria outlined by the realist and meta-narrative evidence synthesis (RAMESES) group.