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.
Boston University, Dietetic Internship
Joan Salge Blake, EdD, MS, RDN, LDN
The Boston University Dietetic Internship and Medical Student Match Program was created in 2010 as a way to introduce BU medical school students to the role of registered dietitian nutritionists and the importance of medical nutrition therapy in the treatment of chronic disease prevention and management. Since few medical schools offer a depth of nutrition curriculum, BUMS must apply to participate in the program, while every dietetic intern gets the opportunity to participate each semester. Over the four-week program, a current BUDI is matched with a BUSMS to participate in education activities. The activities include: the BUDI counseling the BUSMS on his/her diet, a grocery store tour, the BUSMS learning how to extrapolate diet information from patients and a collaborative BUDI/BUSMS nutrition-based case study presentation. Each learning activity is well defined with the learning objectives and outcomes for both the dietetic interns and the medical students. Between 2010 and 2013, the program sought and was awarded IRB approval in order to evaluate learning outcomes. At the completion of the program, a survey was administered to both the BUSMS and BUDI. The results showed that the program led to an increased understanding by the BUSMS of the role RDN play in MNT, while the BUDI honed their outpatient counseling skills and expanded their professional network.
University of Massachusetts-Lowell, Coordinated Program
Renee Barrile, RD, PhD
The College of Health Sciences at UMass Lowell began an initiative to increase Interprofessional educational opportunities for health science students in 2014. This initiative included programs in nutrition, nursing, exercise physiology, physical therapy, public health and clinical laboratory sciences. To begin, IPE faculty fellows were selected from each academic program, an IPE student advisory council was formed, and mini-grants were awarded to encourage all faculty to incorporate IPE concepts into the existing curriculum. In fall 2016, a unique course offered an experiential learning opportunity to five students representing different health science programs at an adult day health services center. The students functioned as an interprofessional team by observing many health care providers from different disciplines and working together on group assignments throughout the semester. The students debriefed with faculty each week, wrote weekly reflective essays and completed a final group project. The final project involved creating an emergency preparedness plan to reflect all the disciplines in the group. The students reviewed the current emergency planning policies, interviewed members of the health care team and administrators and used other outside resources as part of this project. Using the data they gathered, they prepared an emergency preparedness checklist for the participants and gave small group educational sessions for the participants. They also developed an informational bulletin board, and gave a final presentation for faculty. The nutrition student highlighted food safety issues if there is a power outage, suggested nonperishable foods and drinks to have as part of an emergency kit, and outlined how to maintain nutritional status if housebound for an extended time for patients with diabetes or those taking blood thinning medications.
Youngstown State University, Coordinated Program
Jeanine L. Mincher, PhD, RDN, LD
Since 2014, the Youngstown State University Coordinated Program in Dietetics has been partnering with the Northeast Ohio Medical University on the practice of Inter-professional skill building. This collaborative effort involves CPD students in their Capstone Practicum and/or Community Wellness Laboratory along with M3 Medical Students, students in Pharmacy, PT, Social Services, Exercise Science, EMT and Nursing. In this half-day event, students learn the valuable skills of TEAM STEPPS communication techniques to reduce medical errors and improve patient care, learn about what each profession contributes to patient-centered care and practices mock case studies with one another complete with "Caregiver" input to simulate real-life experience. The project has expanded this year to include Didactic Program in Dietetics students and will also include Dietetic Technician students in the future as roles and opportunities continue to evolve. Students have rated this experience in an overwhelmingly positive way and consider it a valuable learning strategy. Five universities/schools are now involved in this effort that places Northeast Ohio at the forefront of Inter-Professional Education. We hope that through expanding this valuable opportunity, others can model and obtain similar positive results. Not only does this workshop provide valuable skill training, it also increases the comfort level of students in their future interactions with physicians and health care practitioners from other disciplines. Likewise, this experience also introduces other allied health disciplines to the field of dietetics and demonstrates the skills and knowledge base of dietetics students. This sets the stage for future best practice models.
Murray State University, Didactic Program in Dietetics
Kathy Stanczyk, PhD, RD, LD
Dietetics students enrolled in Nutrition Counseling and Education at Murray State University engage in simulated patient/client interviews and education sessions. For these simulations, students in the Department of Theatre at MSU play the role of patient/client, and the dietetics students play the role of the clinician. Theatre students are told that the first simulation will involve them being interviewed by a dietetics students, and the second simulation with each dietetics student will involve them being counseled for weight loss. For both simulations, theatre students have a list of roles to improv based on their craft, and these role include, but are not limited to ADD, Tourette syndrome, know-it-all, homeless person, internet surfer of nutrition information, etc. The dietetics students do not know what role the theatre student will improv during the first simulation, which increases the authenticity of the simulations and prepares them for real-life application of interviewing and counseling skills. The simulations are videotaped for the dietetics students. Upon viewing themselves for the first time, each student completes a self-evaluation that self-identified strengths and areas for improvement. Peer observes will complete anonymous evaluations providing constructive criticism and feedback related to competencies demonstrated during each respective simulation as well as areas in which the student could strengthen his/her interviewing or counseling skills.
Golden Gate Dietetic Internship
Susan Sherman, MS, RD
Committed, professional preceptors play an important role in this stand-alone program. To found this program, hundreds of phones calls were made to prospective preceptors. Countless visits occurred for collaboration with new preceptors while securing rotations to launch the program. When many of those contacted declined to precept, it was thought of as an opportunity, not rejection. Negative comments about other program’s interns: not understanding WIC regulations, lacking medical terminology proficiency and email etiquette and entitlement. As a result, our program's interns focused on preparatory work and training during the summer and orientation to address these previously perceived deficiencies. Interns are oriented to value and appreciate experienced preceptors not paid by the program. Collaboration with preceptors also allowed outlining activities supporting competencies, streamlining paperwork, developing cohesiveness and defining meaningful needed tasks or projects interns could accomplish while gaining valuable practice — a win-win for everyone. To combat ingratitude, interns receive training addressing the art of noticing and being grateful. Thank you cards and stamps are provided to write preceptors at each rotation end. A contest is held each year for interns to create Preceptor and RDN Day cards, which are then mailed out as a group. Also, Interns randomly select a peer to "secretly admire" to then make and present an award to the peer at year's end. Thus far, positive "noteworthy" evaluations have been received about the program from both preceptors and interns alike. This not only reflects the program's capacity building — but where everyone notices and appreciates our supportive preceptors.
Utah State University Dietetic Internship
Nicole Vance, MS, RD, CD
Since its inception in 2008, the Nutrition Care Process has been a part of dietetic student coursework. The Utah State University Distance Dietetic Internship accepts interns from didactic programs all over the nation. We have found that interns' knowledge, skills and abilities surrounding the NCP come with great variation. Previously, the USU DI curriculum required all interns to complete NCP case studies to be graded and scored by faculty. We saw little improvement in case study scores despite faculty providing ample feedback for interns to review. We determined it was necessary to implement a new process to facilitate interns' application of comments and feedback to subsequent case studies. In 2015, the USU DI added a self-grading element to NCP case study assignments. Under this new protocol, interns evaluate their own completed case studies against detailed rubrics to identify which areas of the NCP they understand, and specific areas in which they can improve. Interns give themselves a score out of 10 points. Additional feedback and final assignment scores are given by faculty members to ensure interns are evaluated equally. Case studies are sequential and cannot be completed until the previous one is scored by faculty. Preliminary evaluation of the new protocol has shown an increase in the average score of all case studies, as well as an increase in individual interns’ scores by approximately 2.0 points from the first to the last case study, compared to an increase in 0.60 points in the previous year.
Concordia College Didactic Program in Dietetics
Dr. Betty Larson, RD, FADA
The IOM Committee on Health Professional Education emphasized the need for team-based interdisciplinary education strategies to create professionals that could collaborate effectively to provide quality care. To develop graduates with the ability to work effectively with other disciplines, Concordia has designed unique collaborative events. Professors from dietetics, exercise science, healthcare administration, nursing and social work have developed six scenarios. The six scenarios include a client with allergies, an elderly man with Parkinson's, a coronary heart disease client, a woman with an eating disorder, a public policy issue and a child with severe disabilities that requires enteral feedings. The clients are from diverse cultural groups, living situations and income levels. Students from each discipline have only the information that would typically be available to a professional from their discipline. Therefore, there are differences in the information students from each discipline has available. Students are asked to develop the appropriate care plan for the scenario within their respective disciplinary classes in advance. Then on six specific Fridays the students meet in assigned groups during the campus community time. Each group includes a student from dietetics, exercise science, health care administration, nursing, and social work. The students are asked to provide the recommendations that a professional from their discipline would make for the scenario and as a group they must determine the top three priorities in care. Student feedback about the experience from all six scenarios has been positive for all the disciplines.
University of Oklahoma Health Sciences Center, Coordinated Program
Peggy Turner, MS, RD/LD, FAND
The OUHSC is a 300 acre campus that is home to 7 health care colleges and educates over 3,500 students every year. A campus wide effort to provide IPE was lacking until 2012 when a private foundation provided the financial incentive to bring 20 core faculty members (which included the DPD Program Director) together to figure out a way to change the status quo. Given a three year time line, faculty meet regularly and reviewed the literature, designed and implemented a project entitled: "Empowering Patients through Interprofessional Collaboration" or EPIC for short. Eighty students, including 12 from nutrition, attended four interactive classroom session during the fall 2013 which was followed by 4 interprofessional team-based, patient-centered clinic sessions at a charitable clinic during the spring 2014. Because of the success of the inaugural EPIC project, the core faculty’s next goal was to expand the project to include more students and enlist the financial support from administration. The original curriculum was collapsed, additional faculties were trained, more disciplines were included and the idea of All Professions Day (APD) was piloted in AY 2015/2016. Over 800 students participated in one half-day session in the fall where interprofessional teams were formed and another half-day session in the spring. Each team also arranged and conducted a service learning project during the intersession. With the help of student feedback, the second year of APD will begin in the fall of 2016. Plans are also underway for administration to hire 1 FTE IPE coordinator to assist with the planning process.
Iowa State University Dietetic Internship
Erin Bergquist, MPH, RD, CNSC, LD
Iowa State University Dietetic Internship provides an optional, four-week community nutrition rotation in Asesewa, Ghana for qualified interns. ISU DI partners with McGill University and the University of Ghana (UG) to provide this experiential leaning opportunity that is offered twice per year, in the Spring and Fall semesters. ISU dietetic interns team-up with Canadian and Ghanaian dietetic interns to practice the Nutrition Care Process in a rural community in the Upper Manya Krobo District of Ghana. This opportunity takes place in a region of substantial nutritional need and limited resources; it takes the intern out of their own cultural experience and greatly enhances the number of real-life problems that test interns creativity and critical thinking skills. The first week of the community nutrition rotation is spend in Accra, the capital city of Ghana where interns visit hospitals where UG dietetic interns are placed. The second week of the experience focuses on community nutrition assessment of the target population, children ages 0-36 months. Dietetic interns are taught how to collect: 1) anthropometric measurements and 2) detailed 24-hour recall from the children’s’ caregivers to assess complementary feeding practices of breastfed infants. The third week focuses on data interpretation and nutrition diagnosis. The final week of the experience concludes with a community-wide health fair and nutrition education using the teach-back method. Throughout the experience, interns interact with local people, customs, and food-practices and develop new insights into a culture different from their own.
Kansas State University, Didactic Program in Dietetics and Coordinated Program in Dietetics
Kevin Sauer, PhD, RDN, LD and Amber Howells, PhD, RDN, LD
Acquiring useful feedback from diverse stakeholders is paramount to the continuous improvement of any dietetics academic program. The faculty affiliated with the Coordinated and Didactic Programs at Kansas State University formally engage with a dynamic Advisory Board throughout the academic year. Board members represent diverse areas of dietetics employment and practice. A novel process has been implemented that strategically engages board members while on campus with students, for the primary purpose of gathering candid feedback about many facets of the dietetic programs. Specifically, during the spring term, graduating senior students are assigned to small groups, depending on the size of the class. During our spring board meeting, two advisory board members are then appointed to each student group; one board member serving as small group facilitator and one as note taker. Using a facilitator guide and series of questions pre-determined by the faculty, board members conduct structured discussions with the graduating senior students. The questions are specific to the sub-programs (CP, DPD, online). Faculty are not present during the sessions to encourage open dialog, and distance/online students are included in the discussions using a video conferencing platform. The exit interview sessions last about two hours, the comments gathered remain anonymous, and the responses are themed and summarized by a third party for faculty to review at a later time.
Memphis VA Dietetic Internship
Jacqueline Roos, MS, RDN, LDN, CDR and Michelle Grabowski, RDN, LDN
Veterans Health Administration (VHA) Handbook 1109.05 and the 2016 ASPEN Critical Care Guidelines outline interdisciplinary Nutrition Support Teams as a best practice to manage patients receiving parenteral nutrition support. The dietitian's contribution to the team as the nutrition expert is vital, but newly credentialed practitioners may lack the confidence and/or knowledge to assume this role. The Nutrition Support Team at the Memphis VAMC rounds daily and consists of a surgeon, surgical resident, pharmacist, and dietitian. Dietetic interns, along with clinical pharmacy residents, complete a one month clinical rotation with this team. Prior to rounds, dietetic interns are required to collect ins/outs, assess tube feeding and parental nutrition tolerance, and calculate nutrient needs for all of their patients. During rounds they are expected to communicate recommendations to the team (under the supervision of the NST RDN). After completing rounds the team writes a single note as a group, with each member contributing. This collaboration fosters a sense of team work, as well as enhances patient care. Dietetic interns spend an afternoon with the pharmacist observing a TPN solution being compounded along with a lecture on TPN. The dietitian reviews enteral nutrition articles and problems/case studies with both the dietetic interns and pharmacy resident. This close team relationship facilitates arranging dietetic interns observing procedures such as PEG placement, CABG, etc. Consistently, dietetic interns comment that they are more comfortable interacting with the interdisciplinary team following this rotation.
University of New Hampshire Dietetic Internship
Joanne D. Burke, Associate Clinical Professor, PhD, RD, LD
Interest in the ability to purchase, cook and prepare foods 'from scratch, or almost scratch' is growing. Historically, interns and dietetics professionals have been asked to lead grocery store tours and conduct cooking classes, with minimal food demonstration and/or culinary arts training. In addition to consumer interest, increasing demand for requests from school food service, dining hall and long term care operations for information on local and sustainable foods and for cooking skills training are indicative of the growing interest in preparing fresh foods in the food service sector. Thus, the UNH Dietetic Internship designed the "Culinary Arts Camp and Related Research Experience" to build peer relationships, enhance culinary arts skills, explore food system principles and practices, and introduce research skills. Some of the learning activities completed by interns are: identify and implement strategies to limit and assess food waste; calculate anticipated food yields based on "As Purchased and Edible Portion" data and related guidelines; develop cooking skills and demonstrate via 'Cooking Demonstration' techniques video; demonstrate mastery of a variety of culinary concepts as evaluated in oral, written and food preparation activities; and contribute to the development and planning, thus applying the skills learned in the culinary course into the comprehensive group planning for the local/organic lunch. Sustainability principles are integrated throughout the dietetic Internship and local, organic and sustainable and food access concepts are unified via the capstone Local-Organic Luncheon and related research report.
Minneapolis VA Health Care Systems, Dietetic Internship
Heidi Hoover MS, RD, LD, and Allison Greenwood MS, RD, LD
The Minneapolis VA Nutrition and Food Services (NFS) Department has expanded its care to over 21,000 veterans with the implementation of TeleNutrition. The implementation of TeleNutrition has provided a unique experience for dietitians and dietetic students to work with underserved populations. Many patients that participate in TeleNutrition would not typically have the opportunity to see a dietitian due to their rural demographics. Students are able to provide medical nutrition therapy to patients that are miles away and in surrounding states. Students become familiar with using telehealth equipment, and learn various unique education styles to effectively teach and motivate patients in a non-traditional setting. Students learn how to navigate the many barriers that rural dwelling patients deal with on a daily basis such as little access to fresh foods, grocery stores, gym facilities and community programs. Students also gain the skills of using technology to provide care, and discover the importance of nutrition intervention for the overall health of patients. After the implementation of TeleNutrition, the Minneapolis VA Health Care System experienced a 75 percent follow-up rate after initial appointments. With frequent contact, we have been able to personalize care by tracking weights and lab values such as Hemoglobin A1c and lipid panels to patients that would otherwise rely on their annual visit from their Primary Care Provider.
Georgia State University, Coordinated Program
Jessica Todd MS, RD, LD
Staying organized is essential to an accredited ACEND program. Maintaining preceptor information, contracts, student schedules, time logs, and assignments can be cumbersome. The Coordinated Program (CP) at Georgia State University (Georgia State) accepts 20 graduate dietetic students each year. Typhon Group's AHSPM Student Tracking System (Typhon) is the tool that provides a place to house all of the aforementioned material and more. Each student and preceptor has a profile within Typhon. Students and preceptors are linked together for scheduling purposes, allowing preceptors and students access to their schedules and each other's contact information. This act alone decreases the workload of the CP Director. Additionally, students are able to pull documents related to their rotations, which include rotation syllabi, rotation fact sheet, and any related pre-rotation-assignments. Contracts are housed in Typhon and reports can be run to determine when contracts are about to expire, which is another time saver. Students log their hours and preceptors sign off, keeping all parties accountable. We also use Typhon as a place for CP students to turn in assignments. After each rotation, students are required to submit a post-rotation packet. The Director goes to the assignment on Typhon and provides feedback. Typhon has many capabilities, including evaluations. We are currently using the evaluation feature for student evaluation of preceptors and to administer our annual preceptor evaluations. Typhon is a one-stop-shop and has made a huge impact on how we collect and manage data related to the CP.