Abstract
Even as new medical modalities, diagnostics, and technologies are rapidly changing healthcare, providing patients with safe, high-quality care remains the central focus. To provide safe patient care, healthcare providers are obligated to demonstrate and maintain the necessary competence. As more healthcare disciplines move toward a competency-based education model, it is essential to extend the competence verification from the academic educational level to the patient’s bedside. The nutrition-focused physical exam (NFPE) is a competency recently adopted by registered dietitian nutritionists (RDNs) for assessing patients’ nutritional status. Being a newly acquired skill, validated tools are required to measure NFPE competence during routine clinical practice. The Interactive Nutrition Specific Physical Exam Competency Tool (INSPECT) is a new tool developed specifically to observe and measure RDNs’ NFPE competence in clinical settings. The INSPECT was designed and validated for content using expert RDNs’ input in the first and second phases of the study. This current study aimed to assess the reliability of the INSPECT through multi-site observations by clinical supervisors evaluating RDNs’ NFPE competency during patient assessment. The INSPECT exhibited good inter-rater reliability (ICC = 0.78 for the first assessment and ICC = 0.68 for the second assessment), moderate to strong intra-rater reliability for 37 of 41 items (Spearman rho = 0.54 to 1.0), and excellent internal consistency (Cronbach’s α = 0.86 for the first assessment and α = 0.92 for the second assessment). In total, 10 out of the 11 INSPECT subsets showed good to excellent internal consistency (α ranging from 0.70 to 0.98). The results demonstrate that the INSPECT is a reliable tool, is stable over time, and has good agreement and excellent consistency between raters. The INSPECT can be a valuable tool to measure, promote and maintain RDNs’ NFPE competence in authentic acute care settings.
Highlights
The assessment of healthcare providers’ clinical performance during their everyday practice is crucial for the delivery of reliable, safe, and high-quality patient-centered care [1,2,3]
Once qualified to practice after passing the credentialing exam, some healthcare professionals such as registered dietitian nutritionists (RDNs), physical therapists, occupational therapists, and nurses can provide patient care for the remainder of their career with the sole requirement of maintaining their competency through the required continuing education hours within their area of expertise [5,6,7,8]
The Interactive Nutrition Specific Physical Exam Competency Tool (INSPECT) was developed in the first phase of the study with 70 items identified by seven content and practice experts who explored the nutrition-focused physical exam (NFPE) components through technology-based focus group discussions
Summary
The assessment of healthcare providers’ clinical performance during their everyday practice is crucial for the delivery of reliable, safe, and high-quality patient-centered care [1,2,3]. Once qualified to practice after passing the credentialing exam, some healthcare professionals such as RDNs, physical therapists, occupational therapists, and nurses can provide patient care for the remainder of their career with the sole requirement of maintaining their competency through the required continuing education hours within their area of expertise [5,6,7,8]. This system presumes that these healthcare providers remain competent by staying abreast with new knowledge and science relevant to their practice [9]. Ongoing competence verification is critical for all healthcare providers including allied health professionals
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