Incorporating Subjective Global Assessment into The Dietetic Internship Curriculum

Abstract

Dietetics practitioners are looking for new skills to enhance their position in the healthcare arena. While dietitians are experts in traditional nutrition assessment, few are as well versed in techniques featuring physical assessment of nutritional status. In order to help dietetic interns acquire these new skills, a faculty member, using funding from a faculty development award and corporate support, undertook an intensive training program in the techniques of subjective global assessment (SGA), a method of assessing nutritional status using subjective clinical criteria. Faith Ottery, M.D., Ph.D, a nationally known teacher and researcher, conducted the initial faculty training program. The program offered an in-depth didactic component, hands-on physical assessment of malnourished patients, and hospital rounds. The training session educated department faculty members, graduate students, dietetic clinical preceptors, and other dietitians and healthcare practitioners. Nearly all participants gave the program the highest ratings possible. Immediate benefits of the training in SGA were enhanced faculty competence and stronger educational preparation and clinical training of graduate students and interns in nutrition and dietetics. Using skills and materials from the initial training workshop, a program was developed for the dietetic internship and incorporated into the curriculum. Basic information on the techniques of SGA is presented in a lecture format, followed by a hands-on program where interns were guided through a physical assessment of two malnourished patients and normal comparison subjects. The interns were enthusiastic about physical nutritional assessment, particularly the opportunity to examine real patients. Feedback indicates that students have applied these techniques during the course of the year in their clinical rotations. In addition to the internship workshop, subjective global assessment has been and is in the process of being incorporated into additional graduate courses in the curriculum.