Nutrition Care Process Research Articles

About the Cover: The Breakfast and Beyond Program: A Trainee's Experience

About the author: Rachel is a Registered Dietitian (RD) and a student in the Master of Science in Applied Human Nutrition (MScAHN) program at Mount Saint Vincent University. Her graduate thesis is a mixed-form questionnaire exploring Canadian RDs’ experiences, perceptions, and knowledge of weight-related evidence in practice, framed by the Nutrition Care Process. Outside of her studies, Rachel loves to cook, try new foods, spend time with her dog, and visit her family in New Brunswick.

Individual and contextual factors in the Swedish Nutrition Care Process Terminology implementation.

Standardised terminologies and classification systems play an increasingly important role in the continuous work towards high quality patient care. Currently, a standardised terminology for nutrition care, the Nutrition Care Process (NCP) Terminology (NCPT), is being implemented across the world, with terms for four steps: Nutrition Assessment (NA), Nutrition Diagnosis (ND), Nutrition Intervention (NI) and Nutrition Monitoring and Evaluation (NME). To explore associations between individual and contextual factors and implementation of a standardised NCPT among Swedish dietitians. A survey was completed by 226 dietitians, focussing on: (a) NCPT implementation level; (b) individual factors; and (c) contextual factors. Associations between these factors were explored through a two-block logistic regression analysis. Contextual factors such as intention from management to implement the NCPT (OR (odds ratio) ND 15.0, 95% Confidence Interval (CI) 3.9-57.4, NME 3.7, 95% CI 1.1-13.0) and electronic health record (EHR) headings from the NCPT (OR NI 3.6, 95% CI 1.4-10.7, NME 3.8, 95% CI 1.1-11.5) were associated with higher implementation. A positive attitude towards the NCPT (model 1 OR ND 3.8, 95% CI 1.5-9.8, model 2 OR ND 5.0, 95% CI 1.4-17.8) was also associated with higher implementation, while other individual factors showed less association. Contextual factors such as intention from management, EHR structure, and pre-defined terms and headings are key to implementation of a standardised terminology for nutrition and dietetic care. Clinical leadership and technological solutions should be considered key areas in future NCPT implementation strategies.

Defining the Practice of Dietitians in Malaysia Using the Nutrition Care Process in Patients with Type 2 Diabetes Mellitus

(1) Background: The quality of dietetic care is crucial to improve patient outcomes. The aim of this study was to measure the current practices regarding the provision of nutrition care in type 2 diabetes mellitus (T2DM) among dietitians in Malaysia. (2) Methods: A 49-item online survey was distributed via Malaysian Dietitians’ Association and Ministry of Health Malaysia social media platforms. Self-reported dietetic practices in the management of T2DM were evaluated against practice guidelines. (3) Results: A total of 173 dietitians completed the survey, with a response rate of 62%. Three-quarters of dietitians in the public sector consulted patients within two to three weeks or more than four weeks versus less than two weeks (86.3%) among private dietitians (p-value < 0.001). More than 95% of private dietitians spent 31–60 min or more than 60 min on new cases versus 71% among public dietitians (p-value < 0.001). Group counseling was only practiced among public dietitians (36.0%). Different practice settings led to the current findings. A limited use of behavioral counseling theories and strategies was observed among dietitians from both sectors. Limited adherence to nutrition-related recommendations (62.8%) and lack of readiness for diet/lifestyle changes (45.5%) were the key challenges faced by dietitians when managing T2DM. (4) Conclusions: The survey indicates that there is a need for the development of comprehensive training to increase the utilization of behavioral counselling. Practice setting is an element to consider when designing training.

Self-reported documentation of goals and outcomes of nutrition care - A cross-sectional survey study of Scandinavian dietitians.

The documentation of goals and outcomes of nutrition care in Electronic Health Records is insufficient making further exploration of this of particular interest. Identifying common features in documentation practice among Scandinavian dietitians might provide information that can support improvement in this area. To explore the associations between clinical dietitians' self-reported documentation of patients' goals and outcomes and demographic factors, self-reported implementation of the systematic framework the Nutrition Care Process 4th step (NCP) and its associated terminology, and factors associated with the workplace. Data from a cross-sectional study based on a previously tested web-based survey (INIS) disseminated in 2017 to dietitians in Scandinavia (n=494) was used. Respondents were recruited through e-mail lists, e-newsletters and social media groups for dietitians. Associations between countries regarding the reported documentation of goals and outcomes, implementation levels of the NCP 4th step, demographic information and factors associated with the workplace were measured through Chi-square test. Associations between dependent- and independent variables were measured through logistic regression analysis. Clinically practicing dietitians (n=347) working in Scandinavia, Sweden (n=249), Norway (n=60), Denmark (n=38), who had completed dietetic education participated. The reported documentation of goals and outcomes from nutrition intervention was highly associated with the reported implementation of NCP 4th step terminology (OR=5.26; p=0.009, OR=3.56; p=0.003), support from the workplace (OR=4.0, p < 0.001, OR=8.89, p < 0.001) and area of practice (OR=2.02, p=0.017). Years since completed dietetic training and educational level did not have any significant associations with documentation practice regarding goals and outcomes. Findings highlight strong associations between the implementation of the NCP 4th step terminology and the documentation of goals and outcomes. Strategies to support dietitians in using standardized terminology and the development of tools for comprehensive documentation of evaluation of goals and outcome are required.

Academy of Nutrition and Dietetics: Revised 2022 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Pediatric Nutrition.

Pediatrics spans the first 2 decades of life and is a dynamic period with rapid changes in size and physical ability, cognitive development, behavior, and nutrient needs. Registered dietitian nutritionists (RDNs) who work with the pediatric population provide the nutrition knowledge and support needed to promote optimal health and nutrition during this time across a variety of settings. The Pediatric Nutrition Practice Group, along with the Academy of Nutrition and Dietetics Quality Management Committee, have updated the Standards of Practice (SOP) and Standards of Professional Performance (SOPP) for RDNs working with pediatric populations. The SOP and SOPP for RDNs in Pediatric Nutrition provide indicators that describe 3 levels of practice: competent, proficient, and expert. The SOP uses the Nutrition Care Process and clinical workflow elements for delivering patient/client care. The SOPP describes the 6 domains that focus on professional performance. Specific indicators outlined in the SOP and SOPP illustrate how these standards apply to practice. The SOP and SOPP are intended to be used as a self-evaluation tool for assuring competent practice in pediatric nutrition and for determining potential education and training needs for advancement to a higher practice level in a variety of settings.

Research at the Academy of Nutrition and Dietetics: What, How, and Why?

Research is essential to further advance our understanding of the role of nutrition and dietetics in maintenance and improvement of health. Research is also essential for nutrition and dietetics practitioners to create and provide evidence-based interventions, including medical nutrition therapy provided by registered dietitian nutritionists. Given this critical role of research, the Academy of Nutrition and Dietetics (Academy) has a variety of resources to assist its members in accessing, understanding, participating in, conducting, and disseminating nutrition research. These resources are comprehensive and include opportunities to participate in research (eg, Nutrition Research Network and Data Science Center), tools to aggregate practice data (Nutrition Care Process and Terminology and the Academy of Nutrition and Dietetics Informatics Infrastructure), funding opportunities to support primary research (eg, Academy Foundation), resources to understand the latest research informing evidence-based practice (eg, Evidence Analysis Center), and avenues for sharing research findings (eg, Food &amp; Nutrition Conference &amp; Expo™). The aim of this article is to encourage Academy members to get involved in research by describing Academy-based research resources and opportunities to contribute to nutrition and dietetics research, as well as describe specific examples of research conducted at the Academy. The information presented can serve as a framework to guide members in engaging in research through the Academy.

Reprint of: Development and Evaluation of a Global Malnutrition Composite Score.

Reprint of: Development and Evaluation of a Global Malnutrition Composite Score.

Effects of nutrition counselling on iron deficiency anemia in pregnancy

Anemia is a significant public health concern in pregnant women and women of reproductive age globally. The prevalence of anemia in Thailand was approximately 36.7%. Common causes of anemia were iron deficiency anemia (IDA) and beta-thalassemia trait (BTT). World Health Organization (WHO) recommends that dietary adjustments focusing on iron-rich foods foster the improvement of IDA and IDA with BTT. This study aimed to evaluate the effect of nutrition counselling in pregnant women with IDA on anemia parameters and dietary intake records. Retrospective data were obtained from the Division of Nutrition and Antenatal Care (ANC) Clinic at Bamrasnaradura Infectious Diseases Institute (BIDI) in Nonthaburi, Thailand. Nutrition Care Process Model was used in nutrition service at BIDI. During the second trimester, nutrition counselling was provided at the ANC Clinic by a dietitian routinely based on WHO guidelines for nutritional anemia. The anemia parameters and dietary intake records were recorded during ANC visits at the second and third trimesters. A paired t-test was used to evaluate differences within each group. Collected data from 61 pregnant women with anemia were analyzed (IDA: 55; BTT: 6). In the third trimester, the changes in hematocrit levels were significantly high in both IDA (p ≤ 0.001) and BTT groups (p = 0.016). In addition, the improvement in daily energy consumption and iron-rich foods was significantly observed in both groups (p ≤ 0.001). In conclusion, the delivery of nutrition counselling focusing on iron-rich foods significantly enhanced IDA parameters and eating behaviours, including increased hematocrit levels, and improved daily energy intake and iron-rich foods intake among pregnant women with anemia.

Evaluation of Geriatric Sarcopenia and Nutrition in the Case of Cachexia before Exitus: An Observational Study for Health Professionals.

It is important to assess the physical and nutritional status of the body using a bioelectrical impedance analyzer (BIA) in patients with cachexia; however, the correlation between cachexia and nutritional evaluations remains unclear. The objective of this study is to follow the effects of diet therapy in patients with cachexia/sarcopenia, using parameters measured by BIA, clinical parameters, and other nutrition-related assessments in patients with osteoporosis. This study aims to clarify the correlation between BIA-measured parameters, clinical parameters, and other nutrition-related assessments. Methods: Measurements of body composition, a clinical assessment of the sarcopenia/cachexia, and nutritional goal setting/a nutrition care process were performed. Results: The number of subjects was 200, of which 15 people (7.5%) were diagnosed with sarcopenia/cachexia. Univariate analyses showed that participants with a high body-fat mass tend to develop sarcopenic obesity (p = 0.029), those who lost a significant and progressive amount of muscle mass tend to develop sarcopenia (p = 0.001), as well as those with malnutrition (p < 0.001). The regression study shows not only the correlation but also the cause of the correlation, as is the case with obesity. As obesity increases, so does the sarcopenic index (this can explain sarcopenic obesity), and as fat mass decreases it leads to muscle mass loss, increasing the risk of cachexia with age. Conclusions: There was an improvement, but statistically insignificant, in cachexia and the nutritional objectives (p > 0.05); at the same time, correlations were established between the independent parameters (sex, age) and malnutrition parameters (hemoglobin and amylase) with the parameters of the research.

A quasi-experimental study provides evidence that registered dietitian nutritionist care is aligned with the Academy of Nutrition and Dietetics evidence-based nutrition practice guidelines for type 1 and 2 diabetes.

BackgroundOne previous study examined implementation of evidence-based nutrition practice guidelines (EBNPG).ObjectivesTo describe alignment of registered dietitian nutritionists' (RDNs) documented nutrition care with the Academy of Nutrition and Dietetics' EBNPG for Type 1 and Type 2 diabetes and examine impact of a midpoint training on care alignment with the guideline.MethodsIn this 2-year, quasi-experimental study, 19 RDNs providing outpatient medical nutrition therapy to adults with diabetes (n = 562) documented 787 initial and follow-up encounters. At study midpoint, RDNs received a guideline content training. A validated, automated tool was used to match standardized nutrition care process terminology (NCPT) in the documentation to NCPT expected to represent guideline implementation. A congruence score ranging from 0 (recommendation not identified) to 4 (recommendation fully implemented) was generated based on matching. Multilevel linear regression was used to examine pre-to-post training changes in congruence scores.ResultsMost patients (~75%) had only one documented RDN encounter. At least one guideline recommendation was fully implemented in 67% of encounters. The recommendations “individualize macronutrient composition” and “education on glucose monitoring” (partially or fully implemented in 85 and 79% of encounters, respectively) were most frequently implemented. The mean encounter congruence scores were not different from pre-to-post guideline training (n = 19 RDNs, 519 encounters pre-training; n = 14 RDNs, 204 encounters post-training; β = −0.06, SE = 0.04; 95% CI: −0.14, 0.03).ConclusionsMost RDN encounters had documented evidence that at least one recommendation from the EBNPG was implemented. The most frequently implemented recommendations were related to improving glycemic control. A midpoint guideline training had no impact on alignment of care with the guideline.

Using Service-Learning to Teach the Nutrition Care Process and Gather Data to Address College Student Food Security

Discuss the influence of the home food environment on college student food security and identify key components of service-learning projects for nutrition students.

What is the level of nutrition care provided to older adults attending emergency departments? A scoping review protocol.

Introduction: Nutrition status among older adults is an important factor in health and clinical outcomes but malnutrition goes unrecognised in routine health care. Older adults often present to emergency departments (ED) and are subsequently discharged without hospital admission. Discharge is a transitionary time of care when nutritional vulnerability could be mitigated with the instigation of targeted nutrition care pathways. This protocol outlines a scoping review to identify the level of nutrition care provided to older adults attending emergency departments. Methods: This scoping review will be conducted using the framework proposed by the Joanna Briggs Institute. The Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR) will be used to guide the reporting. Two researchers will search electronic databases (Medline, CINAHL Complete, EMBASE, Cochrane Library and Scopus), grey literature sources (DART-Europe E-theses portal, Open Grey, and Trip Medical database) and website searches (Google, Google Scholar, Pubmed, NICE and LENUS) to identify appropriate data for inclusion within the last 10 years. Key information will be categorised and classified to generate a table charting the level of nutrition and dietetic care initiated for older adults in the ED according to the Nutrition Care Process Model. A narrative synthesis will be conducted. Conclusions: This scoping review will be used to inform a foundational concept of nutrition care in an ED setting and allow the future examination of nutrition care pathways, practice, policy, and research within models of integrated care for older persons.

Individualised Nutritional Care for Disease-Related Malnutrition: Improving Outcomes by Focusing on What Matters to Patients

Delivering care that meets patients’ preferences, needs and values, and that is safe and effective is key to good-quality healthcare. Disease-related malnutrition (DRM) has profound effects on patients and families, but often what matters to patients is not captured in the research, where the focus is often on measuring the adverse clinical and economic consequences of DRM. Differences in the terminology used to describe care that meets patients’ preferences, needs and values confounds the problem. Individualised nutritional care (INC) is nutritional care that is tailored to a patient’s specific needs, preferences, values and goals. Four key pillars underpin INC: what matters to patients, shared decision making, evidence informed multi-modal nutritional care and effective monitoring of outcomes. Although INC is incorporated in nutrition guidelines and studies of oral nutritional intervention for DRM in adults, the descriptions and the degree to which it is included varies. Studies in specific patient groups show that INC improves health outcomes. The nutrition care process (NCP) offers a practical model to help healthcare professionals individualise nutritional care. The model can be used by all healthcare disciplines across all healthcare settings. Interdisciplinary team approaches provide nutritional care that delivers on what matters to patients, without increased resources and can be adapted to include INC. This review is of relevance to all involved in the design, delivery and evaluation of nutritional care for all patients, regardless of whether they need first-line nutritional care or complex, highly specialised nutritional care.

Academy of Nutrition and Dietetics: Revised 2022 Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Public Health and Community Nutrition

Awareness of the social determinants of health has been increasing in recent years. These include equitable access to health care and foods that support healthy eating patterns. A wide range of issues related to these determinants influence practice in the public health and community nutrition field. In response to these evolving needs, the Public Health and Community Nutrition Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed Standards of Practice and Standards of Professional Performance as a tool for Registered Dietitian Nutritionist (RDNs) currently in practice or interested in working in public health and community nutrition, to assess their current skill levels and to identify areas for professional development. The Standards of Practice address the four steps of the Nutrition Care Process for community and public health RDNs: assessment, diagnosis, intervention, and evaluation/monitoring. The Standards of Professional Performance consists of six domains of professional performance for community and public health RDNs: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate the ways in which RDNs can address population nutrition and health. The indicators describe three skill levels (Competent, Proficient, and Expert) for RDNs. These tools highlight the unique scope of expertise that RDNs provide to the field of public health and community nutrition.

What is the level of nutrition care provided to older adults attending emergency departments? A scoping review protocol.

Introduction: Nutrition status among older adults is an important factor in health and clinical outcomes but malnutrition goes unrecognised in routine health care. Older adults often present to emergency departments (ED) and are subsequently discharged without hospital admission. Discharge is a transitionary time of care when nutritional vulnerability could be mitigated with the instigation of targeted nutrition care pathways. This protocol outlines a scoping review to identify the level of nutrition care provided to older adults attending emergency departments. Methods: This scoping review will be conducted using the framework proposed by the Joanna Briggs Institute. The Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR) will be used to guide the reporting. Two researchers will search electronic databases (Medline, CINAHL Complete, EMBASE, Cochrane Library and Scopus), grey literature sources (DART-Europe E-theses portal, Open Grey, and Trip Medical database) and website searches (Google, Google Scholar, Pubmed, NICE and LENUS) to identify appropriate data for inclusion within the last 10 years. Key information will be categorised and classified to generate a table charting the level of nutrition and dietetic care initiated for older adults in the ED according to the Nutrition Care Process Model. A narrative synthesis will be conducted. Conclusions: This scoping review will be used to inform a foundational concept of nutrition care in an ED setting and allow the future examination of nutrition care pathways, practice, policy, and research within models of integrated care for older persons.

Persepsi ahli gizi di Indonesia terhadap penerapan nutritional care process (NCP) di rumah sakit

Dietitians’ perception of the implementation of the nutrition care process (NCP) in IndonesiaBackground: The nutrition care process (NCP) developed by The Academy of Nutrition and Dietetics was adopted and implemented in Indonesia. Some hospitals in Indonesia do not have a proper facility to support dietitians to implement NCP optimally.Objective: To evaluate dietitians’ perception of the NCP implementation in hospital settings in Indonesia.Methods: This study was a cross-sectional design with dietitians who have been working in a hospital as the study subject. Data were collected by questionnaire. Each subject answered questions on general data, nutrition screening practice, and 20 questions about the NCP implementation. The perception score is ranged from one(1) for ‘strongly disagree’ to five(5) for ‘strongly agree.’ The score was summarized and categorized into two groups ‘good’ and ‘less’ positive perception. Univariate and bivariate analysis was used to evaluate the data statistically. Results: More than half of the participants have a good/positive perception of NCP implementation (62.5%). There was a significant association between the level of education and nutrition screening training to other health workers' perceptions statistically. Conclusion: NCP has been implemented very well in a hospital setting in Indonesia. There are improvements needed in some key aspects to improve the quality of the nutrition care process in the hospital, especially for each dietitian to have a better and more standardized perception nationally on implementing NCP.

Sports nutritionists adopt the nutrition care process road map to develop individualized meal planning for athletes

Background: It is considered that the implementation of nutrition care process (NCP) leads to more efficient and effective care, as well as enhancing the roles of dietetics and nutrition professionals in the clinical setting. However, little is known about the NCP being implemented in the sports nutrition setting to deliver nutrition care, especially in meal planning. Therefore, this study aims to identify the process that sports nutritionists (SNs) practice in meal planning to plan meals for athletes and identify the application of NCP. Methods: In-depth interviews, using semi-structured interview questions, were conducted with SNs employed at the National Sports Institute of Malaysia. Five SNs who managed different types of sports were recruited. The interviews were audio-recorded and transcribed verbatim. Data were entered into ATLAS.ti 8 and analysed using thematic analysis. Results: The following processes were identified: (i) collecting pertinent data, (ii) analysing the collected data, (iii) determining nutrition prescriptions, (iv) formulating goals and determining actions, (v) implementing actions and recommendations and (vi) monitoring. Conclusions: This study identified six general processes practiced by SNs in meal planning that comprised the NCP's interrelated steps, except nutrition diagnosis statement from the nutrition diagnosis step of the NCP. A comprehensive process and workflow can help sports dietitians or nutritionists to develop individualised meal plans that can improve athletes' nutritional status, adherence, health and sports performance.

P140 Use of the Nutrition Care Process Quality Evaluation and Standardization Tool to Inform Training in a Student Cohort

<h3>Objective</h3> To assess changes in quality of nutrition care documentation as students progress through a Future Education Model dietetics program. <h3>Use of Theory or Research</h3> Adult Learning Theory guided design and delivery of courses within the Future Education Model dietetics program at The Ohio State University. <h3>Target Audience</h3> First-year students enrolled in the masters-level Future Education Model dietetics program during the fall semester of 2021 (n = 31). <h3>Curriculum Description</h3> Lecture, peer-to-peer activities, case studies, and standardized patient experiences are used to develop student competence in nutrition care over the course of the semester. <h3>Evaluation Methods</h3> Two case study notes written in the eighth and fifteenth weeks of the course were assessed for quality using the validated NCP Quality Evaluation and Standardization Tool (NCP-QUEST). Interrater reliability was established on 10% of the notes. Differences in mean scores between the first and second notes were assessed for changes with a paired samples t-test. <h3>Results</h3> Mean NCP-QUEST scores on the first and second case study notes were 7.2 (2.8 SD) and 8.7 (2.7 SD) out of a total of 18, respectively. A significant improvement was observed between scores of the two notes (<i>P =</i> 0.013, Cohen's D = 3.3). In both notes, all students received a point for writing a nutrition prescription (NI2). Documenting succinct and relevant assessment data (NA4), noting the etiology matrix category (ND3), and utilizing standardized terminology in the intervention (NI5) were areas where students were challenged, with <1 student receiving a point in these categories. The greatest improvement between the two notes was observed in NA3: measurable assessment data provides evidence that a nutrition diagnosis is present. <h3>Conclusions</h3> Students showed significant improvement between writing their first and second nutrition notes, indicating gains in knowledge and skill as they progressed through the program. This study elucidates areas of focus for educators to improve quality of student nutrition notes. <h3>Funding</h3> None

Implementation of an Intervention Based on Nutritional Care Process to Improve Glycemic Parameters in a Type 2 Diabetes Comprehensive Care Program. The CAIPaDi Program

Abstract Objectives Personalized and evidenced-based nutritional interventions are needed to overcome the burden of type 2 diabetes (T2D) epidemic. The aim of this study was to describe the implementation and impact on glycemic control of an intervention based on Nutritional Care Process Terminology (NCPT) within a T2D comprehensive care program in Mexicans. Methods This is a single-arm study of a 2-years follow-up. We evaluated 258 individuals of the CAIPaDi program across six visits. The program seeks to achieve metabolic goals and provide self-efficacy to recently T2D-diagnosed patients. The customized nutritional intervention was implemented for all participants based on an NCPT model. The intervention was implemented by two dietitians, following the NCPT program. Each participant engaged in a 30-minutes session each visit. The main outcome is the achievement of treatment goals defined by the National Committee for Quality Assurance criteria (NCQA). Results The program was effective to reduce the prevalence of subjects with poor glycemic control from 85% to 57% (P &amp;lt; .0001) after 2 years. Nutritional diagnoses were grouped into the three main domains, 1) ingestion, 2) clinical, and 3) Behavioral/Environmental. At baseline, the most prevalent diagnostic was behavioral diagnostics (44%), followed by ingestion (39%), and clinical (17%). The majority of individuals with behavioral diagnostics migrated to ingestion, whereas individuals with ingestion diagnoses at baseline migrated to the non-diagnostic at the final visit. At the end of the follow-up, the most frequent diagnostic was ingestion (45%), with 29% of the subjects with good glycemic control, contrasting with 79% of the non-diagnostic individuals (p = .0001). Subjects in the category the non-diagnostic nutritional in one previous visit, were 89% more likely to reach a good glycemic control in the last visit (HR 1.89; 95CI% 1.17–3.05) even after adjusting by confounders: age, sex, body fat, years of onset and HbA1c at baseline. Conclusions An intervention based on NCPT can help provide individualized nutritional interventions and prioritize clinical attention to improve the effectiveness of a T2D comprehensive care program. Funding Sources Consejo Nacional de Ciencia y Tecnología project 214,718.

Development and Evaluation of a Practiice-Based Assignment in Chronic Kidney Disease to Enhance Clinical Nutrition Coursework

ObjectivesThe objective of this work was to develop and evaluate a novel practice-based clinical nutrition assignment to support competency-based academic nutrition programs that integrate didactic and experiential program components. The target audience was graduate nutrition students enrolled in a clinical nutrition course sequence. MethodsAs an alternative to a traditional “paper and pencil” case study assignment, each student was assigned to conduct an in-person, out-of-class interview with a practicing renal nutritionist. In written assignment directions, students were provided with questions for a structured interview which followed the nutrition care process, i.e., nutrition assessment, diagnosis, intervention, monitoring/evaluation, with application to nutrition management of chronic kidney disease. Subsequently, students responded anonymously to Likert scale questions regarding clinical knowledge and confidence in clinical skills derived from the practice-based assignment compared to their expected gains from a traditional “paper and pencil” case assignment plus an open-ended question. ResultsThe assignment supported clinical nutrition students’ competency in nutrition management of chronic kidney disease and facilitated their networking within the professional nutrition practice community. In class, students shared details of their interview findings from an array of practicing renal nutritionists which generated rich discussions in contrast to a single case study. In evaluating the practice-based assignment, n = 31 students reported on 5 point scales a mean of 4.4 regarding knowledge of clinical nutrition management and a mean of 4.0 regarding confidence in clinical skill derived from the practice-based assignment compared to expectations from a traditional case study assignment (where 5 = better than what I expected and 4 = slightly better than what I expected I would have gained from “paper and pencil” case). ConclusionsThis practice-based assignment in chronic kidney disease provided a unique approach to enhancing clinical nutrition coursework and facilitated an interactive learning environment to support students’ professional growth. Funding SourcesNone.