‘Backbone of the Profession’ Sets Us Apart

Abstract

In the Academy’s 2020 Needs Satisfaction Survey, many of the top-ranked benefits relate to evidence-based practice. They include the Code of Ethics, position papers, practice guidelines, Standards of Practice, Evidence Analysis Library (itself ranked the seventh-most popular membership benefit), Scope of Practice, Nutrition Care Process, Nutrition Care Manuals; professional development such as distance learning and free CPE in the Journal; and programming available through Affiliates, dietetic practice groups, member interest groups and the Food & Nutrition Conference & Expo.2Rogers D. Report on the Academy/Commission on Dietetic Registration 2016 Needs Satisfaction Survey.J Acad Nutr Diet. 2017; 117: 626-631https://doi.org/10.1016/j.jand.2017.01.007Abstract Full Text Full Text PDF PubMed Scopus (8) Google ScholarThe Academy, Commission on Dietetic Registration and Accreditation Council for Education in Nutrition and Dietetics all support and encourage evidence-based practice.The phrase evidence-based appears twice in the Code of Ethics for the Nutrition and Dietetics Profession (items 1a and 1e) and comprises an entire domain (#1) for dietetics internships and didactic programs in dietetics competencies.CDR requires that programs be evidence-based to be eligible for continuing professional education credit, and the Center for Lifelong Learning requires the use of evidence before providing continuing professional education offerings via webinars and certificates of training.1Hand R.K. Davis A.M. Thompson K.L. et al.Updates to The Definition of Evidence-Based (Dietetics) Practice: Providing Clarity for Practice.J Acad Nutr Diet. 2021; 121: 1565-1573.e4https://doi.org/10.1016/j.jand.2020.05.014Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar The Academy, Commission on Dietetic Registration and Accreditation Council for Education in Nutrition and Dietetics all support and encourage evidence-based practice. The phrase evidence-based appears twice in the Code of Ethics for the Nutrition and Dietetics Profession (items 1a and 1e) and comprises an entire domain (#1) for dietetics internships and didactic programs in dietetics competencies. CDR requires that programs be evidence-based to be eligible for continuing professional education credit, and the Center for Lifelong Learning requires the use of evidence before providing continuing professional education offerings via webinars and certificates of training.1Hand R.K. Davis A.M. Thompson K.L. et al.Updates to The Definition of Evidence-Based (Dietetics) Practice: Providing Clarity for Practice.J Acad Nutr Diet. 2021; 121: 1565-1573.e4https://doi.org/10.1016/j.jand.2020.05.014Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar Those whom we serve need the best evidence-based care and services we can provide. I asked some of our most accomplished members: Why do you believe it is important for nutrition and dietetics to be evidence-based? and How do you personally translate the concepts of evidence-based practice to your work with clients/patients? “Consumers are constantly bombarded with information about food and nutrition, much of it promulgated by individuals with little or no nutrition science education,” says Sherry Coleman Collins, MS, RD, LD, a consultant and food allergy dietitian in Marietta, Ga. “What differentiates us from these folks is our training in the science of human nutrition and our commitment to evidence-based practice.The Academy defines evidence-based practice as “the process of asking questions, systematically finding research evidence, and assessing its validity, applicability and importance to nutrition and dietetics practice decisions; and applying relevant evidence in the context of the practice situation including professional expertise and the values and circumstances of patients/clients, customers, individuals, groups or populations to achieve positive outcomes.”3Academy of Nutrition and DieteticsAcademy of Nutrition and Dietetics Definition of Terms List, February 2021.https://www.eatrightpro.org/-/media/eatrightpro-files/practice/scope-standards-of-practice/academydotlist.pdfDate accessed: May 5, 2022Google ScholarAs noted in an article in the August 2021 Journal, “Updates to the Definition of Evidence-Based (Dietetics) Practice: Providing Clarity for Practice,” the Council on Research created a task force “with the charge of developing tools and criteria for the consistent evaluation of evidence upon which Academy-supported and Academy-generated materials are based.” The task force identified three main components of evidence-based practice: “best available research evidence, professional expertise and client values and circumstances” [and] acknowledges that the application of evidence-based practice is complex and can vary when discussing a topic with high-quality research vs an emerging topic that may not have sufficient evidence.”1Hand R.K. Davis A.M. Thompson K.L. et al.Updates to The Definition of Evidence-Based (Dietetics) Practice: Providing Clarity for Practice.J Acad Nutr Diet. 2021; 121: 1565-1573.e4https://doi.org/10.1016/j.jand.2020.05.014Abstract Full Text Full Text PDF PubMed Scopus (2) Google ScholarThe article adds: “Although client preferences and professional expertise are important, they cannot be used independent of research evidence, except in the rare case for which no research evidence is available. It is the responsibility of the credentialed nutrition and dietetics practitioner to conduct a thorough and systematic search for evidence in order to accurately determine the extent and strength of the evidence available.”1Hand R.K. Davis A.M. Thompson K.L. et al.Updates to The Definition of Evidence-Based (Dietetics) Practice: Providing Clarity for Practice.J Acad Nutr Diet. 2021; 121: 1565-1573.e4https://doi.org/10.1016/j.jand.2020.05.014Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar The Academy defines evidence-based practice as “the process of asking questions, systematically finding research evidence, and assessing its validity, applicability and importance to nutrition and dietetics practice decisions; and applying relevant evidence in the context of the practice situation including professional expertise and the values and circumstances of patients/clients, customers, individuals, groups or populations to achieve positive outcomes.”3Academy of Nutrition and DieteticsAcademy of Nutrition and Dietetics Definition of Terms List, February 2021.https://www.eatrightpro.org/-/media/eatrightpro-files/practice/scope-standards-of-practice/academydotlist.pdfDate accessed: May 5, 2022Google Scholar As noted in an article in the August 2021 Journal, “Updates to the Definition of Evidence-Based (Dietetics) Practice: Providing Clarity for Practice,” the Council on Research created a task force “with the charge of developing tools and criteria for the consistent evaluation of evidence upon which Academy-supported and Academy-generated materials are based.” The task force identified three main components of evidence-based practice: “best available research evidence, professional expertise and client values and circumstances” [and] acknowledges that the application of evidence-based practice is complex and can vary when discussing a topic with high-quality research vs an emerging topic that may not have sufficient evidence.”1Hand R.K. Davis A.M. Thompson K.L. et al.Updates to The Definition of Evidence-Based (Dietetics) Practice: Providing Clarity for Practice.J Acad Nutr Diet. 2021; 121: 1565-1573.e4https://doi.org/10.1016/j.jand.2020.05.014Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar The article adds: “Although client preferences and professional expertise are important, they cannot be used independent of research evidence, except in the rare case for which no research evidence is available. It is the responsibility of the credentialed nutrition and dietetics practitioner to conduct a thorough and systematic search for evidence in order to accurately determine the extent and strength of the evidence available.”1Hand R.K. Davis A.M. Thompson K.L. et al.Updates to The Definition of Evidence-Based (Dietetics) Practice: Providing Clarity for Practice.J Acad Nutr Diet. 2021; 121: 1565-1573.e4https://doi.org/10.1016/j.jand.2020.05.014Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar “Other health care professionals expect dietitians to be able to back up their recommendations and provide support for their practice using the latest evidence-based guidance. We build credibility within the larger community of health professionals by sharing research and guidelines in nutrition that they may not even know. “In order for the registered dietitian nutritionist to maintain credibility in all areas of practice, it is essential that we lead from an evidence-based stance,” Coleman Collins says. “My role is to be the information provider who meets the client’s lifestyle and health goals,” says Connie B. Diekman, MEd, RD, CSSD, LD, FADA, FAND, who worked for more than 20 years as director of university nutrition at Washington University in St. Louis. “The role of the RDN is to understand how the body works and how the food we consume nourishes our body. Understanding the role of nutrition in health comes from that basic knowledge. “Our clients count on us to share science in practical ways so that they can feel healthy and enjoy the foods they choose to eat. Evidence-based practice grounds us, makes us a trusted partner with our clients and ensures that the health goals of our clients are met.I asked our experts how practitioners can become even more evidence-based on our work:•Cochran: Students need to learn how to access peer-reviewed studies, interpret and evaluate them and use critical thinking skills to apply this evidence in practice. Utilizing the Academy’s Evidence Analysis Library and professional Standards of Practice, obtaining specialty certifications and participating in appropriate continuing professional education activities are all ways to ensure evidence-based practice.•Coleman Collins: We should dig deeper into the science and research through peer-reviewed journals, attending health and nutrition conferences and expanding our education. We can learn so much by collaborating with others within our own discipline and others, such as physicians, nurses, psychologists and more. And we should be able and willing to refer others to those who can provide the best evidence-based care for our patients and clients, recognizing our limitations and scope of practice.•Diekman: One of the main things I encourage all RDs and students to do is to make use of the EAL. It provides the body of evidence on so many practice areas so RD's can stay abreast of evolving research. In my opinion it is important for RD’s to take advantage of information provided by DPGs in their practice areas. These resources can help RDs design their practice approach knowing that the evidence is at the foundation. I asked our experts how practitioners can become even more evidence-based on our work:•Cochran: Students need to learn how to access peer-reviewed studies, interpret and evaluate them and use critical thinking skills to apply this evidence in practice. Utilizing the Academy’s Evidence Analysis Library and professional Standards of Practice, obtaining specialty certifications and participating in appropriate continuing professional education activities are all ways to ensure evidence-based practice.•Coleman Collins: We should dig deeper into the science and research through peer-reviewed journals, attending health and nutrition conferences and expanding our education. We can learn so much by collaborating with others within our own discipline and others, such as physicians, nurses, psychologists and more. And we should be able and willing to refer others to those who can provide the best evidence-based care for our patients and clients, recognizing our limitations and scope of practice.•Diekman: One of the main things I encourage all RDs and students to do is to make use of the EAL. It provides the body of evidence on so many practice areas so RD's can stay abreast of evolving research. In my opinion it is important for RD’s to take advantage of information provided by DPGs in their practice areas. These resources can help RDs design their practice approach knowing that the evidence is at the foundation. “My goals are to hear my clients concerns and needs. Once I know those, we then begin to talk about how they eat, what they enjoy and what would help them make changes in their eating pattern to achieve health,” Diekman says. Evidence-based practice also is critical for those who do not work in clinical settings or provide medical nutrition therapy. Neva H. Cochran, MS, RDN, LD, FAND, is a communications consultant in Dallas, Texas, with the agriculture and food industries. “There is rampant misinformation circulating in the media, on the internet and via social media that instills fear of safe food and ingredients,” she says,” which could potentially contribute to a nutritionally inadequate diet and health problems if people avoid certain foods or choose foods or products that may not be safe or appropriate for their personal nutrition needs or health status. “Therefore, I translate the science of food production, processing and preparation so people feel confident enjoying a variety of nutrient-rich foods to promote health and wellness. “Examples of topics I address include GMOs, organic and conventional farming practices, pesticides, antibiotics, growth hormones, animal welfare and sustainability in agriculture; food processing (canned, frozen, packaged, juice); food ingredients (sugar, salt, MSG, fat, low calorie sweeteners, additives, preservatives); and convenience and restaurant foods, among others,” Cochran says. Back up our recommendations…. Translate the science … Correct misinformation … Maintain credibility … and above all, lead. Evidence-based practice helps us accomplish all these priorities and more.