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.
Noteworthy practices in the following topic areas are requested.
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 ACEND@eatright.org with the subject line: Noteworthy Practice Submission.
Note from the ACEND® Review Committee: Because many programs directors have contacted ACEND® for ideas regarding preceptor training, the ACEND® Review Committee felt that other programs may benefit from reading about this practice. The Committee felt that programs may be able to incorporate ideas from this program's practice into their own program.
New York-Presbyterian Hospital, Dietetics Internship
Coleen Liscano, MS, RD, CSP, CDN, CNSC, FAND
In a 2017 survey hosted by the Nutrition and Dietetics Educators and Preceptors (NDEP) group, preceptors continue to express the need for training in the role of precepting. To enhance the training of preceptors, the NewYork-Presbyterian Hospital Dietetic Internship Program hosted an inaugural preceptor training event entitled, Preparing Resourceful Empowered Collaborative Engaged and Passionate Teachers (PRECEPT) Workshop. The dietetic intern-led workshop was offered nationally to preceptors either on-site or virtually.
This innovative professional education event provided preceptors with knowledge on trending Fad Diets via debate format. Interns presented three Fad Diets and shared evidence-based pros and cons for each Fad Diet. The three Fad Diets were Raw Food, Blood type and Ketogenic Diet. To provide preceptor training for practitioners who are new to precepting and for those who are more experienced, breakout sessions Precepting 101 and Crucial Conversations were offered. Precepting 101, led by the Dietetic Internship Program Administrator/Director, afforded those new to precepting the foundational knowledge and skills in their new role as teachers. Experienced preceptors expanded their skills through Crucial Conversations, a scenario-based round-table session led by the Program Preceptors.
This event engaged both dietetic interns and preceptors to understand the important role preceptors hold in the training of dietetics students and interns. The preceptors in attendance were able to see how the interns' self-directed learning can lead to a symbiotic relationship in the training and education of dietetic interns and students beyond the day-to-day activities of the practitioner.
Iowa State University, Dietetic Internship
Erin Bergquist, MPH, RD, CNSC, LD
Iowa State University Dietetics Internship (ISU DI) has developed an innovative way to provide preceptor incentives in their distance internship. In 2013, an online Preceptor Training specific to ISU DI was developed using a web-based survey platform. Preceptors can take the training when convenient to them and receive 1 CPE credit. The Preceptor Training is a series of short videos that are easy to start and stop. To date, over 525 preceptors have completed this training. Using this model, ISU DI developed an Oncology training, which reached 216 preceptors before being discontinued after 3 years. Most recently, ISU DI has focused on malnutrition and nutrition-focused physical examination (NFPE), which interns are required to perform as part of the 2017 ACEND Competencies. This topic was chosen because intern surveys showed very low preceptor use of NFPE in the clinical setting. Using the same model, ISU DI developed a training titled Nutrition Assessment: Malnutrition and Nutrition-Focused Physical Examination for preceptors. This training also provides 1.0 CPEU credit and assists preceptors in understanding the 2012 ASPEN-Academy Consensus Statement for Adult Malnutrition as well as detailed steps to perform a NFPE. Over 173 preceptors have taken this training in the past year.
Montclair State University, Didactic Program in Dietetics
Kathleen Bauer, PhD and Yeon Bai, PhD, RDN
In order to address gaining cultural competence, a key component of the Academy of Nutrition and Dietetics strategic plan, dietetic students take a nutrition counseling course designed to improve cultural competency. The Campinha-Bacote Model of Cultural Competence in the Delivery of Health Care Services was used to design, implement, and evaluate the course. Five interdependent constructs of this model include cultural awareness, cultural knowledge, cultural skill, cultural encounter, and cultural desire.
Cultural competence is influenced by working on any of these areas and strengthens the impact of the others on the journey towards cultural competence. Each assignment and activity addressed one or more of the five constructs of the model. Throughout the course, there are numerous activities and assignments focusing on the constructs of the model. One of the assignments designed to address the encounter construct was a book club. Students read The Spirit Catches You and You Fall Down - A Hmong Child, Her American Doctors and the Collision of Two Cultures by Anne Fadiman, winner of the 1997 National Book Critics Circle Award for nonfiction. Each week for eight weeks, students read designated chapters, journaled answers to assigned questions, and participated in class discussions regarding perceptions of their readings. After eight weeks, students read and analyzed the complete book. Encounters create opportunities to develop attitudes congruent with cultural competence, such as appreciation, curiosity, and respect. Evaluation of the book club experience as well as the complete course indicated that the assignments and activities favorably impacted all constructs of the model.
Normandale Community College, Dietetic Technician Program
Krista Jordheim RD, MPH
In "Nutrition Education and Tools" class the students complete the"Counseling Assignment". The students are provided a client from a pool of Normandale employee who are interested in improving their nutritional intake. The student meets with their at least client 3-4 times during the semester. The first meeting involves conducting a 24 hour recall, food frequency, completion of a health history questionnaire, assessing the client's readiness for change and developing rapport. At that point, the student educates the client about how to maintain a food journal. After the client has documented their intake for 7 days, the student meets with them again to validate the food journal using appropriate interviewing techniques and food models.
A nutritional analysis program is employed to determine the client's nutritional needs. The student reviews the data with the client and identifies the strengths and weaknesses of the client's diet. At this point, the client decides which 1-2 goals they would like to address. The student creates measurable goals for the client that are realistic and sustainable. The student also provides the client with any nutrition education materials that are appropriate and promote eatright.org as a reliable source of nutrition information. The client and the student meet one last time to discuss whether or not any further goals need to be set. If necessary, the student will meet again with the client to follow up.
Throughout the process, the client and instructor provide constructive feedback to the student.
Cedar Crest College Dietetic Internship and Didactic Program in Dietetics
Marilou Wieder, MS, RD, CNSC, LDN
Patricia LaSalle, MS, RD, CDE, LDN
The undergraduate, dietetic intern and undergraduate nursing students at Cedar Crest College have developed a program of Inter-professional Education Collaboration participating in joint mock patient clinical simulations. The IPEC simulations replicate a mock patient simulation experience where the nursing and nutrition students participate jointly to assess, evaluate and provide intervention for patient care. Senior undergraduate MNT students rotate to participate in the simulations as a component of their MNT course. Dietetic interns have the opportunity to act as mentors to the undergrad seniors. The IPEC patient simulation focuses on nutrition students conducting a patient bedside nutrition interview and the nursing students complete a med pass administration. Both disciplines review the patient electronic medical record and record their assessment, evaluation and interventions. Upon review of the EMR, nursing and nutrition "enter" the patient's room for a joint patient care experience. The "mock" patient has been versed of their proposed medical diagnoses and contents of their medical record. Nursing students initiate and complete the patient assessment and med pass, with the nutrition students present. The nutrition students then conduct a focused nutrition assessment interview with nursing students present. At the conclusion of the "patient care" the instructor leads a discussion and the implications for both disciplines.
Murray State University Dietetic Internship and Didactic Program in Dietetics
Kathy K. Stanczyk, PhD, RD, LD
In an effort to foster interdisciplinary education among healthcare disciplines at Murray State University, faculty in the School of Nursing and Health Professions partnered to host an interdisciplinary workshop on enteral nutrition in the Fall of 2017.
The four-hour workshop focused on the Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient, which were developed by the American Society for Parenteral and Enteral Nutrition and the Society of Critical Care Medicine; these guidelines were published in 2016.
Participants of the workshop included senior nursing students in their final clinical course, senior dietetics students enrolled in Medical Nutrition Therapy II, and post-baccalaureate dietetic interns in the Murray State University Dietetic Internship. The students were divided into three groups, with an equal number of nursing students, dietetics students, and dietetic interns in each group.
During the four-hour workshop, groups rotated between three stations. The first of the three stations involved simulation, with students placing feeding tubes in mannequins. A nursing faculty member led this station, and nursing students peer taught the dietetics students and interns how to place the feeding tubes. The final two stations were led by faculty of the dietetics program. In each of these two stations, students discussed case studies that required them to delve into the guidelines developed by ASPEN and SCCM. Specifically, the case studies focused on the information presented in guideline D (Monitoring Tolerance and Adequacy of EN) and guideline E (Selection of Appropriate Enteral Formulation).