ACEND® has begun to identify Noteworthy Nutrition and Dietetics Education Practices among ACEND®-accredited programs and would like to highlight one or more program(s) per quarter for their noteworthy practices on the ACEND® website and in the ACEND® UPdate Newsletter. ACEND® will post due dates for practice submissions via email blasts and newsletter articles.
Program directors or other individuals associated with an ACEND®-accredited program are asked to complete the submission form and an abstract of their noteworthy practice and email it to ACEND® for review. Submissions will be reviewed by an ACEND® Board review team and selected entries will be posted.
Email completed submission forms and supporting documentation to [email protected] with the subject line: Noteworthy Practice Submission.
Meredith College Dietetic Internship
Tara Wind, MS, RD, LDN, CNSC
Interprofessional education simulation offers healthcare disciplines the opportunity to work together prior to entering practice to improve communication and possibly reduce preventable medical errors.
The purpose of this initiative was to evaluate whether a collaborative simulation with dietetic interns and novice nursing students would contribute to an increased ability to understand and solve clinical problems and a greater appreciation of their respective roles.
Faculty and staff determined bedside counseling skills, recognizing malnutrition in hospitalized patients, collaborating over pediatric patients and working with postoperative gastrointestinal surgical patients as realms that would foster communication between dietetic interns and nursing students.
A total of 66 IPE simulations were conducted between January 2015 and August 2017 involving 150 students. Ninety nine percent agreed or strongly agreed that IPE simulation helped better understand each other's disciplines and 100 percent agreed or strongly agreed that patients benefit from collaborative care. Written feedback emphasized participants experienced significant gains in understanding the importance of communication between team members, recognition of the value of shared goals for patients, new found respect for each profession and a better understanding of roles.
lnterdisciplinary simulations between dietetic interns and nursing students proved to be very effective as a deliberate part of their curriculum. However, there are a lot of other disciplines that need to be represented in simulation such as doctors, speech therapists and respiratory therapists to make it congruent with real life clinical practice.
Missouri State University Dietetic Internship
Hillary Roberts, MS, RDN, LD
Interprofessional education within the College of Health and Human Services at Missouri State University is thriving. Fall of 2017, students from five programs, Dietetic Internship, Nursing, Pharmacy, Physician Assistant Services and Psychology, are involved in a 90 minute IPE simulation. Students complete pre-simulation work which includes reviewing the patient's physical assessment, physician orders and lab sheet. In addition, students listen to an audio recording introducing them to IPE.
The dietetic interns have 10 minutes with the "patient" who has diabetes. Interns focus is improving motivational interviewing skills while assessing the patient’s current diabetes knowledge, importance level of change and eliciting patient-centered goal setting. After this 10 minute consult the intern's provide a hand-off report of their findings to the other health professional students. After all students have been if the simulation lab, the IPE coordinator leads a debrief session. The dietetic interns then compose a written reflection of their experience.
Interns' reflections have been positive, highlighting the IPE simulation as an effective learning method. An intern stated in her reflection, "multiple people commented on not knowing what a dietitian did before the simulation and now they understand the importance of our field. From the simulation, we all have more respect for each discipline and what is entailed in the discipline. I loved this experience and I am so happy I was able to be a part of it!”
Each intern has noted that their interprofessional communication and teamwork improved from the simulation experience. MSU's dietetic internship will continue involvement in IPE simulation and plans to expand on other IPE learning methods spring of 2018!
University of Arizona Didactic Program in Dietetics
Mary Marian, DCN, RDN, CSO, FAND
The DPD students at the University of Arizona have been working together with medical, nursing, pharmacy, public health, social work and some law students in a variety of interprofessional activities. Interdisciplinary activities have included working as an interprofessional team during a pandemic activity, geriatric clinic, refugee clinic and pharmacy medication management program. Students work with other disciplines to develop strategies for working together during a potential flu epidemic and physical disabilities focused IPE event.
Additionally, during the monthly geriatric clinic activity, a topic is highlighted and begins with a short didactic lecture. Students are then grouped into teams where they complete an assessment on their patients and develop a care plan. The interdisciplinary team must report out to a medical provider and a faculty representative to present their assessment and have their plan approved before sharing their findings and recommendations with their patients.
This activity gives the DPD students real life experience working on an interdisciplinary team as well as hands on patient care experience. For the first time, nutrition and nutrition assessment was the chosen topic for the Geriatric clinic focused session this fall.
In the pharmacy medication management program, interdisciplinary teams assess a patient's medication history and develop a plan for interviewing and counseling the patient regarding not only medication usage but also strategies to improve their health and wellness over the phone. Taken together, these IPE activities facilitate teamwork, communication and respect for the expertise that the various disciplines provide.
Camden County College, Dietetic Technician Program
Marsha Patrick, MS, RDN, FAND
On April 24 the Food and Nutrition Science Department, faculty and staff, hosted their first annual Dietetic Technician Preceptor Appreciation Dinner at Camden County College, Blackwood, New Jersey. The event was planned by the Meeting and Special Event Class and catered by the Quantity Food Production class.
The Meeting and Special Event students after weeks of establishing goals and objectives, selecting the date, identifying the venue and negotiating details, getting cost estimates (e.g. room rental, food & beverages, equipment, invitations, programs, flowers, etc.) and creating a budget. The event allowed the students to apply their knowledge and showcase their front of house skills.
The Quantity Food Production students after 13 food production laboratory classes had an opportunity to cater the event. The menu was designed to allow the students to prepare food items using a variety of cooking techniques, equipment and skills learned within the class.
New York-Presbyterian Hospital, Dietetic Internship
Gena Seraita, RD, CDN
Despite improvements in health care delivery, underprivileged communities continue to struggle with access to health screenings and interventions. Heart-to-Heart is a free health-screening program through the Weill Cornell Clinical and Translational Science Center for underserved communities in New York City. Since the start of H2H events in 2010, 30-40 percent of participants have been newly diagnosed with diabetes, hypertension and/or dyslipidemia.
Nutrition therapy is among the first interventions to delay progression of these diagnoses. New York-Presbyterian Hospital Dietetic Interns, under the supervision of a registered dietitian, work as part of the H2H inter-professional team to deliver individualized and culturally sensitive nutrition counseling to participants.
The dietetic interns are assigned to research demographic information pertinent to the target populations from local government resources. They develop resource handouts which include population specific data (educational background, dietary practices, and health risks of the assigned community) and cultural food practices.
These resource handouts are shared with the inter-professional team to empower them to best serve the community. Using the demographic information, the dietetic interns also craft nutrition education handouts specific to their health risks and cultural background. These education handouts have to meet program criteria and have multiple layers of review to ensure the information is appropriate and accessible to the community being served.
University of Texas Health Science Center-School of Public Health Dietetic Internship Program, DI
Jeanne PigaPlunkett, MS, RD, LD
To help prepare dietetic interns and meet the demands of a growing profession, the UTHealth School of Public Health Nourish Program was designed to create nutrition experiences through hands-on training and simulation. In 2015, the Nourish Program opened their state-of-the-art nutrition education hub for dietetic interns, dietitians, medical, and nursing students. The three main initiatives of Nourish include:
The Holistic Garden addresses the gap in the current dietetic training regarding the linkages between food sourcing, sustainability, and disease prevention. Dietetic interns learn gardening techniques through a horticulturist faculty member. Interns participate in the overall care of the garden including yield studies, crop rotation, and scheduling, harvesting, and seed-to-plate community nutrition education.
The Research and Demonstration Kitchen supplements the dietetic training program with basic cooking skill courses. Standard approaches for teaching cooking education in community settings are taught using produce from the garden, allowing students to model seed-to-plate nutrition education for disease prevention.
The Clinical Simulation Lab allows students to gain patient care experience, including conducting NFPATs, in a realistic practice environment as part of their medical nutrition therapy coursework prior to entering clinic rotations.
Nourish informs and enhances standard skill development in gardening, culinary arts, and clinical care for dietetic interns. Standardization of these skills allows dietetic interns to visit rotation sites with more confidence and experience and allows them to fully reach dietetic training competencies.
Concordia College, Dietetic Internship
Meredith Wagner, PhD, RD, LRD
America is experiencing a food waste crisis, with an estimated 30-40 percent of the food supply, approximately 35 million tons annually, never eaten. Wholesome food that could have helped feed the over 48 million Americans living in food insecure households, is going to landfills where it breaks down to produce methane, contributing to greenhouse gas, resulting in climate change. Given the magnitude of the food waste problem in the U.S., national efforts have been implemented.
In fall 2015, the first-ever national food loss and waste goal was announced by the EPA and USDA: a 50 percent reduction in food loss and waste in the U.S. by 2030. In response to the food waste crisis, and modeling after the national goal, Concordia College committed to reducing plate waste in their dining service by 50 percent by 2020. To track progress towards the goal, Concordia College Dietetic Interns are conducting front-of-the-house plate waste studies in Concordia's dining service using a standardized methodology the Dietetic Interns developed.
The standardized methodology will be used to conduct a plate waste study once per semester until fall of 2020. The two-day baseline study, conducted in October 2016, revealed 658 pounds of wasted food. Following programming led by Dietetic Interns to increase awareness of plate waste on campus, another study was conducted in March 2017, which revealed a two-day total plate waste of 485 pounds.
The change in plate waste from October 2016 to March 2017 represents a 26 percent reduction. Additional programming by Dietetic Interns will hopefully result in continued reduction in plate waste in the dining service.
New York University, Dietetic Internship
Lisa Sasson, MS, RD, CDN and Erin Embry, MPA, MS/CCC-SLP
The focus of this course is treating patients with complex medical conditions with varying degrees of dysphagia (swallowing difficulty) and creating a patient-centered, collaborative learning environment. Ten graduate students from NYU's Clinical Nutrition program and ten graduate students from the Speech-Language Disorders program participate. The goal of this course is to recognize the importance of delicious, appealing and healthy foods, regardless of one’s medical condition.
The course also includes simulated real-world opportunities that enhance learning. At NYU Langone Medical Center, residents from Rusk Institute of Rehabilitation Medicine participate by leading our students in case-specific mock team rounds. The culminating experience includes a "Quick Fire" mocktail and "Iron Chef" dysphagia cooking competition, in which student groups select and prepare a beverage and a meal specific to each patient's swallowing and nutritional needs.
Esteemed professionals from the medical field, culinary arts and food profession serve as our guest judges. The audience is made up of faculty and students from different health professions and medical residents from NYU Langone Medical Center.
The students always rise to the challenge and create meals that meet all the criteria: tasty, eye appealing, and culturally and medically appropriate. This can make it very challenging for the judges to select a winner! The emphasis of this course is treating the patient, not the disease, and to place special value on sensory importance of a meal.
University of North Carolina at Chapel Hill, Coordinated Program
Amanda Holliday, MS, RD, LDN
The task for tracking students through the dietetic internship process is a challenge for any school. At the University of North Carolina at Chapel Hill, we developed a software platform called PRISM (Preceptor Instructor Student Management) to meet the needs of our 72 students and multiple preceptors in the field at any given time, and to aid instructors in data tracking and reporting.
PRISM supports preceptors by allowing them to easily track past, present, and current students and to complete student evaluations online. PRISM supports instructors by housing student, site and preceptor data (including secure storage of students' onboarding documentation for each site) as well as assignments and evaluations. The software supports students by storing contact information for instructor's and preceptors; tracking various rotations; storing syllabi, due dates, and assignments.
The software also provides a "blogging" feature that allows students to share their experiences with instructors and members of their cohort, and to respond to the posts of others. In addition, PRISM allows for private communication between students, instructors, and preceptors. PRISM can even follow students and survey them beyond graduation, allowing for continued data tracking and assistance in meeting ACEND® requirements.
PRISM has been a vital tool for UNC's students for three years and because it is fully customizable, we are beginning to market it to various programs in other universities.